The BCPS Exam - Inside Advice

You graduated pharmacy school, passed your NAPLEX and MPJE, and think "I never have to take another exam ever again!"

Technically speaking, you are correct. You do not have to take another exam. That does not mean there are not any exams to be taken, however.

The Board Certified Pharmacotherapy Specialist (BCPS) exam is one of the first exams many pharmacists take post-graduation. I was one of those pharmacists. With the results coming out recently, I thought it would be fitting to share my experience with this 175-question exam.

The Board of Pharmacy Specialties (BPS) is an autonomous division of the American Pharmacists Association (APhA) that offers 14 different specialty certifications.

Pharmacists are eligible to apply for one of the above examinations if they have completed residency training and/or 3-4 years in that practice area. The rest of this article will specifically be focused on the Pharmacotherapy exam.

What is the BCPS exam?

"The BPS Board Certified Pharmacotherapy Specialist (BCPS) program is a credential for pharmacists who have met the eligibility criteria below and who in their unique practice ensure the safe, appropriate, and economical use of medications as part of interprofessional treatment teams in a variety of settings, including hospitals and health systems."

Eligibility requirements (tl;dr version)

• Graduation from a pharmacy program accredited by the Accreditation Council for Pharmacy Education or a program outside the U.S. that qualifies as such
• A current, active pharmacist license/registration
• Pharmacy practice experience demonstrated by at least 3 years of Pharmacotherapy practice experience within the past 7 years -OR-successful completion of PGY1 pharmacy residency within the past 7 years

Exam content

• Domain 1: Patient-Centered Pharmacotherapy (65% of examination)
• Domain 2: Application of Evidence to Practice and Education (25% of examination)
• Domain 3: Healthcare Systems and Population Health (10% of examination)

My Experience

^^ That's me looking out into the vast 1214-page ACCP BCPS study materials.

I qualified to sit for the exam through successful completion of a PGY1 residency in June 2022. To be honest, I had every intention to wait until Spring 2023 to take the exam. It wasn't until my residency program director and Emergency Medicine preceptor pushed me to take it in Fall 2022. Their reasoning:

• Residency knowledge was fresh on my mind
• Get it out of the way
• My workplace reimburses the $600 application fee
• "You got this don't worry"

What a great last reason, right.

Regardless, I got my hands on the ACCP study materials for 2018, 2019, 2020, and 2022 (how lucky I was!). There are also study materials available through ASHP and High Yield Med Reviews. Seeing as I did not use either of these materials, I cannot comment on them.

The ACCP study materials come in two volumes, each roughly 600 dense pages. They also provide PowerPoint slides and video lectures. Personally, I learn best through videos and having someone explain the information to me. I found them extremely helpful for studying.

The 600-page volumes are broken down into 22 different topics (i.e. nephrology, infectious disease, psychiatry, cardiology, etc.). Each section has self-assessment questions at the beginning and additional case questions throughout. These were nice to test your knowledge and practice answering numerous case-based questions. The BCPS exam is composed primarily of case-based questions. By the end of the exam, your brain is mentally exhausted merely from orienting yourself to each case situation prior to selecting the best answer.

How much did I study?

Way less than I should have.

What was my study strategy?

I started (this is a relative term) mid-July once I began staffing at my hospital pharmacy as a clinical pharmacist (not a resident!!). My strategy was to focus on the topics I did not cover in residency (psychiatry, oncology, gastrointestinal, pediatrics). I hit those topics in depth by reading and highlighting the ACCP sections as well as watching the video lectures.

For topics I was strong in (cardiology, infectious disease, nephrology, endocrinology, critical care), I took the self-assessment quizzes at the beginning of the sections. If I scored 80% or greater, I considered myself proficient and didn't look back!

I started watching a TON of video lectures about a week before my exam (which was Sept 15^th). I would pause the lecture and take brief notes and screenshots of key tables/graphics. I would then reference these short notes the day or two before the exam. Personally, that is what worked for me in pharmacy school and residency. I focus on what I don't know, take notes on things I really don't know, and study my own notes right before the exam.

Many blogs and websites will recommend that you spend 3-6 months studying for the exam. I think this is up to personal preference and confidence. I placed a significant amount of trust in my residency training and spent less than 2 months studying. Fortunately, it worked out for me.

**HOT TAKE: Recently I was told by two colleagues that took the exam with 6 weeks notice that the PSAP chapters were incredibily beneficial. I have used PSAP chapters before in residency for topic discussions, and I agree that I think they would be of great benefit for BCPS study materials.

What was the exam like? Did you feel prepared?

Exam day was low stress for me. Unlike the NAPLEX, I knew going into the BCPS exam that if I did not pass, I would still have a job and technically wouldn't be out any money (thanks, Sentara Healthcare).

I went to a Prometric testing center and did the whole "no headbands, baggy clothes, or hats" gig and then took a seat at my individual cubby with oversized headphones for noise cancellation. What was nice about the BCPS exam was the format. There are two portions: a 100-question section and a 75-question section with an optional break in between. In each section, you could highlight, strikethrough, comment, flag, and click around to any question you wanted to without penalty. If you have taken the NAPLEX or MPJE, you understand how vastly different that is!

During the break, my testing center allowed the examinee to go outside, use their phone, walk around, and basically do whatever they wanted until it was time to go back in for the second portion. I opted to power through and not take my break, but I wish I would have! I definitely could have looked up a few things from the first portion that would have helped me in the second.

Overall, the questions were dense. They really focused on your role as a "clinical pharmacy specialist" and getting back to the literature. Most people will tell you the exam hits heavy on study design and statistics. I did not feel like this was the case for my exam. I guess this varies with each individual and testing period.

All in all, I was bummed because I memorized all the study designs and tests AND NONE WERE ASKED. *sigh* oh well.

If you have been debating signing up in the Spring or taking it next Fall after you complete your PGY1 residency, this is your sign to do so. This applies to those who want to sit for a different BPS exam. Why do I think you should sit for such an expensive exam? Simple:

--> More and more clinical positions are moving towards BCPS as a baseline requirement for applying.

--> If you have ever considered becoming a Board Certified Pharmacist and if you just finished a residency, DO IT. Do not wait.

--> It will humble you. As much validation as passing the exam gives you, I was extremely humbled and constantly seeking out new knowledge and growth as a clinical pharmacist. Everyone needs to be reminded that they have room to improve.

So there you have it, my experience with the BCPS exam. Have your own story? Drop it in the comment section below!

Fun fact: I was working overnights at the hospital when I found out I passed the exam. It was definitely the boost of endorphins I needed to power me through the 19:00 - 07:00 shift.