The New 2024 BCPS Exam Content Outline

The Board of Pharmacy Specialties (BPS) has released a new Content Outline₁ for the BCPS (Board-Certified Pharmacotherapy Specialist) exam that goes into effect September 2024.

We will explain what has changed, what has stayed the same, and how you can use the new content outline to prepare for success on this challenging exam.

BCPS EXAM FAST FACTS

First, there are a few things you should know about the BCPS Exam.

Most Popular BPS Certification: The number of BCPS candidates each year nearly equals the sum of all other BPS specialty candidates combined.
Low Pass Rates: In 2023 the overall pass rate for this exam averaged 65%. This means 35% of the highly qualified candidates that paid for and sat for the exam did not achieve the certification.
Growing Demand: The number of BCPS active certifications has grown every year since its inception in 2002, and no end is in sight. As the pool of pharmacists continues to grow, BPS specialty certifications are an excellent way to set yourself apart among your peers.₂

BCPS certification is an excellent way to show you have clinical skills that set you apart, and obtaining this certification will continue to be a valuable measure in coming years. It is a challenging exam and even the most gifted clinical pharmacists should not approach it lightly. The BCPS covers the broadest content base of all the BPS exams, which means you will be expected to demonstrate and apply clinical knowledge across a broad range of domains. Most clinicians do not see a uniform exposure to different practice areas, so a study plan that identifies the areas where you lack knowledge or experience gives you the best opportunity to prepare for success. One final note, a BCPS certification is a great first certification to pursue as there has been a movement towards pharmacists holding multiple certifications. Achieving a BCPS notch in your professional belt can be followed by more specialized certifications in the future demonstrating you have both broad, deep, and specialized clinical understanding.

Ok, so now that we have covered what the BCPS certification is and why it matters, let's dive into the details of the blueprint.

WHAT HASN'T CHANGED IN THE CONTENT OUTLINE

Rather, what has stayed the same? In many respects, the exam under the new content outline should be extremely similar to what previous candidates have seen.

The exam is still 3 hours and 45 minutes. It is still 150 questions of which 125 are scored items and 25 are unscored items (we'll say a word about this later.) More importantly, what is being tested is the same. The goal of the exam is to show that board-certified pharmacists have the advanced skills and knowledge to manage patients and have a positive impact on outcomes. The stated program purpose is identical in the old and new outlines:

"To validate that the pharmacist has the advanced knowledge and experience to improve patient outcomes by evaluating, implementing, monitoring, and optimizing of pharmacologic and nonpharmacologic therapy; providing patient-centered, evidence-based therapeutic interventions and information; functioning as a member of an interprofessional team providing direct patient care; and collaborating within an interprofessional team to improve quality and safety."

So "what" you should study remains largely unchanged but understanding the breakdown of the testing is an excellent first step in developing your study plan.

WHAT HAS CHANGED IN THE 2024 BCPS CONTENT OUTLINE?

We at High-Yield Med Reviews are very excited about the newest update to the BCPS Content Outline. If you aren't familiar with High-Yield, let me tell you about the source of our excitement. Our mission is to "Impact Healthcare for Good through Premier Medical Education" and we do that by ensuring all of our products are easy to understand, evidence-based, clinically relevant and oriented to the patient. Our teaching approach is unique because we teach to ensure learners understand the "why" behind a treatment or therapy so that they can make better clinical decisions.

Enough about us. You'll see this is why we think this shift in the outline is a good thing. The overall focus of the exam has not changed, but the organization of the content and assignment of percentages is more granular. There is an increased focus on patient care, therapeutics, and management: a change from 65% to 72%. Areas 1 and 2 of the new Outline cover Patient Care Specialty Areas and Therapeutics and Patient Management. These areas are testing whether candidates have a sophisticated ability to manage patient care and treatment across different disease states, patient populations, and practice settings. This goes beyond the core content you learned in pharmacy school and extends past facts you can memorize from flashcards or a textbook. The BCPS exam aims to test your ability to demonstrate your ability to manage complex cases while considering numerous factors spanning pharmacology, disease state knowledge, the context of the evidence, clinical and diagnostic assessments, factors of lifestyle and economics, drug interactions and allergies...just to name a few. And we think that's fantastic because as clinicians grow in their knowledge and practice, they provide better care to patients and join High-Yield in impacting healthcare for good.

Area 1: Patient Care Specialty Areas

Area 2: Therapeutics and Patient Management

Area 3: Professional Practice

Total

Area 1 lists out the primary, secondary, and tertiary specialty areas and populations with a breakdown by percentage for each section. Though all these areas were certainly covered in the previous outline, they were not explicitly outlined.

Area 2 outlines the specific types of considerations and knowledge you should be able to demonstrate when managing patients in each of the Area 1 specialties.

Area 3 addresses professional practice with sections for:

Quality of Care, which includes things like medication safety and preventative care.
Evidence-Based Practice, which addresses biostatistics and research.
Practice Management, which includes guidelines, regulations, pharmacoeconomics, etc.

It is unlikely that questions would (or could!) fit only one area. Likely, a question in cardiology will have elements of diagnostic testing, therapeutic targets, etc. which crosses Areas 1 and 2. Or, you will see questions in Area 1 for a Sepsis case that fall both into Infectious Diseases (Area 1A1) and Critical Care (Area 1B1) or Emergency Medicine and Toxicology (Area 1B5). Even practice management considerations are likely to be drawn into case-based therapeutic questions. For example, if a question asks about the best medication to treat an infection, and two of the answer choices have similar efficacy, pharmacoeconomics should be considered when determining the "best choice" if one medication is significantly more expensive than the alternate option.

The same can be expected of special populations like Geriatrics (Area 1B2), Pediatrics (Area 1C5), or Women's Health (Area 1C3). You will probably not have 5 questions focused on each of these special populations. However, you will have questions where it will be critical that you note that the patient is a 5-year-old female or an 83-year-old male and consider how the pediatric or geriatric status should impact your answer. Your understanding is being tested through the application of that knowledge to the special population. So, as you are studying diseases or drug classes, be sure to take note of how special populations should be considered and why that status makes a difference.

You might be thinking: "This sounds great in theory, and I'm all for elevating clinical practice and improving patient outcomes but... how do I study for an exam that has this kind of depth and complexity if I can't just memorize some facts in each area of the outline?" We get it. You want to be a great pharmacist, or you wouldn't be thinking about board certification, but you also want a clear path to pass the test. We've got you covered.

HOW TO EFFECTIVELY STUDY FOR THE BCPS EXAM

Review Core Disease State & Drug Class Topics
You need to approach this exam with a focus on understanding the underlying concepts. This means doing a review of key disease states and, if needed, core drug classes. Each candidate is in a different point in their career. A pharmacist fresh out of residency may not need the same reviews as a clinician who has been practicing in the same environment for 10+ years. They will have different knowledge deficits.
Seek to Understand Why
As you review, you must ask the question, "Do I understand why?" For example, you may know that secondary stroke prevention includes a patient taking a daily low dose aspirin. But, if a student you were precepting asked you to explain "why" that is the prescribed treatment, could you explain it to them? When you reach the point of understanding the reason behind a therapy well enough that you could teach someone else, you will be equipped to answer any number of questions on that topic.
Train Your Weaknesses
It is natural for us to spend time in the areas we like best or are most confident. Most emergency medicine clinicians work in that environment because they enjoy the pace and impact of it. The same can be said for those who specialize in clinics that focus on diabetes and lifestyle management. But don't let your interests and strengths blind you to the areas you need to review. Identifying your knowledge and experience gaps and spending more time studying in your weaker topic areas has the greatest impact on your ability to score well on the exam.
Practice Test Questions
Ultimately, you'll be taking a multiple-choice test, and you must train for the task. There is a reason that excellent clinical pharmacists fail these difficult exams. Successful candidates have the necessary knowledge and experience but also know how to demonstrate that knowledge through multiple choice questions. Practice for the task you will be asked to perform. A high-quality question bank will provide case-based questions of varying difficulties that help train you to think like the exam while also providing feedback through answer rationales and helpful clinical pearls.

BOARD EXAM PREP VS. CLINICAL UPDATES

Do you remember that the Content Outline includes 150 questions but 25 of those questions would be unscored? Let's discuss why. First, you will not know which questions are scored or unscored. The 25 unscored questions are scattered throughout the exam and are being vetted to see how they perform before being included as scored items. This information is helpful in the bigger discussion of how board exams are different from clinical practice and clinical updates.

Universal Standards of Practice: Board exams will only test universal standards of practice. This means that the concept must be accepted without debate across all regions. If the treatment or use of a drug is a debate, it will not be tested on a board exam. If one region is inclined to use one therapy, but another uses a different first-line therapy, this will not be tested. Side note: this is a good reason for using a review product that spans beyond the region you practice in as you may not be aware of regional bias you have because of your practice experience.

Guideline Updates...Delayed: One of the most challenging things for a clinical practitioner with a healthy habit of lifelong learning is that they tend to stay on top of the newest literature, research, and guideline updates. This is a wonderful practice and should be encouraged, but it can create a problem for board exam preparation.

Since a tested concept must be established as a universal standard of practice, and since a question must be vetted and tested for bias before it can be included as a "scored" item on an exam, new guidelines are likely not tested on a board exam until 18-24 months after they are released.

It can look something like this. A new guideline is released for a first-line treatment in a psychological disorder by one organization. However, that new guideline does not align with the guideline of the other leading organization. A board exam cannot ask which is first-line when there are conflicting guidelines.

Another example is a new guideline is released to replace the guideline for how to treat a specific disorder. A minimum of 6-12 months must pass to determine if the new guideline is being accepted and used universally, or if there is pushback and may require modification. If after 6-12 months the new guideline is considered the universal standard, then exam questions must be written to test the guideline. These questions must be included on the next round of board exams as unscored items, and the performance of the questions must be analyzed. If improvements are needed, the updated question will appear on the next round of exams (another 6 months) as an unscored item. Once the question passes this vetting process, it can be included on an exam as a scored item. You can see how the delay can quickly reach 18-24 months.

It is important as a savvy test taker to understand this process and delay, and to align your study accordingly. Don't walk into your board exam skewed by the practice- changing research that was released last month. It might change the world, but it won't change your board exam. You also do not have the opportunity to debate your answer like you could in Monday morning rounds, so you are answering questions based on established standards of care, not what you have seen work for a patient using your clinical judgment.

We know there are studies and information being released daily, so our editorial team tracks these types of changes and releases content updates on a continual basis. As content is updated, it is pushed live to active subscriptions. However, we hope you understand that this content takes time to make it to your exam, so minute-by-minute updates are not ideal for your success.

LET THE STUDYING BEGIN

Once you are committed to earning your BCPS certification, we recommend you dedicate 6-12 months to preparing for the exam. There is a lot of content to cover and you will improve your exam readiness if you have ample time to review the topics.

High-Yield has everything you need to prepare to pass the BCPS Exam in our BCPS Premium Course including:

Lectures: Disease State and Drug Class topic reviews organized by body system as well as reviews for Pharmacokinetics and Pharmacodynamics, special populations, and special drug topics, practice management, and a top-rated EBM & Biostatistics course. Our faculty teach to ensure you understand the "why" behind the clinical applications and can connect the dots.

Q-Bank: Equally important is the robust BCPS Q-Bank with 2,000+ practice questions that include answer rationales, core concepts, fast-facts, and references. The "My Performance" tool in the Q-Bank is a living report card that helps you identify your areas of strength and weakness so you can focus your study on the areas that matter most.

We are passionate about preparing our customers for success on the board exam and elevating clinical practice. We believe the new content organization is more clearly aligned to the content categories to make the identification of strengths and weaknesses more valuable for our customers; increasing their ability to prepare effectively for this difficult exam. Remember, you are preparing for a board exam, not the latest and greatest clinic, and we want to help you succeed. This is why we have carefully designed our content to focus on the highest yield topics, universal standards of practice, and clear and long-standing guidelines.

Best of luck with your studies, remember to keep learning fun. We're here to support your lifelong learning journey!