MANUAL OF ADMINISTRATION

for the
CLINICAL PROFICIENCY EXAMINATION

2024 Edition
(version January 1, 2024)
 Table of Contents

Table of Contents for the Manual of Administration

GENERAL INFORMATION ......................................................................................................... 1

Statement of Intent ...................................................................................................................... 1
Animal Requirements ................................................................................................................. 2
Personnel Requirements.............................................................................................................. 2
Facilities and Equipment............................................................................................................. 3
Taking Breaks ............................................................................................................................. 4
Other Policy Information ............................................................................................................ 4
General Discussion about the CPE ............................................................................................. 4
Disabled or Pregnant Candidates Requesting Testing Accommodations ................................... 5
Rules of Conduct......................................................................................................................... 5
Layout of CPE............................................................................................................................. 9
Information Supplied to Candidates ......................................................................................... 10
Requirements of Candidates ..................................................................................................... 10
Supplies Candidates Must Provide ........................................................................................... 10
Assessment of Candidates......................................................................................................... 11
Other Considerations in Candidate Assessment ....................................................................... 11
Passing Standard and Score Reporting ..................................................................................... 12
Candidates Not Passing All Sections ........................................................................................ 12
Use of Reference Material ........................................................................................................ 13
Extended score reports to candidates ........................................................................................ 13
Common Diagnoses/Conditions ............................................................................................... 13
References for the CPE ............................................................................................................. 13
Standard Script for General Candidate Orientation to the CPE and the Examination Site ...... 16
ANESTHESIA .............................................................................................................................. 19
Competencies ............................................................................................................................ 19
Time .......................................................................................................................................... 19
Set-up Information .................................................................................................................... 19
General Requirements of the Candidate ................................................................................... 21
Overview of the Anesthesia Section ......................................................................................... 21
Standard Script for Drug Protocol and Dose Calculations Station ........................................... 23
Assessment Sheet for Anesthesia (AN01) ................................................................................ 26
Anesthesia Appendices ............................................................................................................. 36
Appendix 1—Fatal Flaw List................................................................................................ 36
Appendix 2—Preanesthetic Physical Status ......................................................................... 37
Appendix 3—Anesthesia Record (Page 1) ........................................................................... 38
Appendix 4—Anesthesia Equipment Incident Report .......................................................... 42
EQUINE PRACTICE ................................................................................................................... 43
Competencies ............................................................................................................................ 43
Time .......................................................................................................................................... 43
Set-up Information .................................................................................................................... 43
General Requirements of the Candidate ................................................................................... 45
Station One–Clinical Evaluation............................................................................................... 45
Overview of Station One ...................................................................................................... 45
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Standard Script for Station One ............................................................................................ 46

Station Two–Clinical Techniques ............................................................................................. 51
Overview of Station Two ...................................................................................................... 51
Standard Script for Station Two ........................................................................................... 51
Assessment Sheet for Equine Practice—Station Two (EQ02) ............................................. 51
Station Three–Lameness Evaluation......................................................................................... 54
Overview of Station Three .................................................................................................... 54
Standard Script for Station Three ......................................................................................... 54
Assessment Sheet for Equine Practice—Station Three (EQ03) ........................................... 55
Equine Practice Summary Score Sheet ..................................................................................... 59
Equine Practice Appendices ..................................................................................................... 60
Appendix 1—Blank Page for Candidate Notes .................................................................... 60
FOOD ANIMAL PRACTICE ...................................................................................................... 61
Competencies ............................................................................................................................ 61
Time .......................................................................................................................................... 61
Set-up Information .................................................................................................................... 61
General Requirements of the Candidate ................................................................................... 62
Station One–Clinical Case, Bovine........................................................................................... 62
Overview of Station One ...................................................................................................... 62
Standard Script for Station One ............................................................................................ 63
Station Two—Clinical Case, Other Food Animal .................................................................... 66
Overview of Station Two ...................................................................................................... 66
Standard Script for Station Two ........................................................................................... 66
Station Three—Clinical Procedures ......................................................................................... 70
Overview of Station Three .................................................................................................... 70
Standard Script for Station Three ......................................................................................... 71
Assessment Sheet for Food Animal Practice—Station 3 (FAP03) ....................................... 71
Station Four—Bovine theriogenology and public health, food safety, and regulatory issues .. 75
Overview of Station Four...................................................................................................... 75
Standard Script for Station Four, part A ............................................................................... 75
Standard Script for Station Four, parts B and C ................................................................... 76
Assessment Sheets for Food Animal Practice—Station 4 (FAP04/FAP05) ......................... 76
Food Animal Practice Summary Score Sheet ........................................................................... 79
Food Animal Practice Appendices............................................................................................ 80
Appendix 1—Blank Page for Candidate Notes .................................................................... 80
Appendix 2—Candidate Answer Sheet—Food Animal Practice Station 4, Part C .............. 81
NECROPSY.................................................................................................................................. 82
Competencies ............................................................................................................................ 82
Time .......................................................................................................................................... 82
Set-up Information .................................................................................................................... 82
General Requirements of the Candidate ................................................................................... 83
Overview of Necropsy Section ................................................................................................. 83
Standard Script for Necropsy Section ....................................................................................... 84
Assessment Sheet for Necropsy (NEC01) ................................................................................ 85
Necropsy Appendices ............................................................................................................... 91
Appendix 1—Fatal Flaw List................................................................................................ 91

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Appendix 2—Necropsy Report Form (page ONE) .............................................................. 92

Appendix 2—Necropsy Report Form (page TWO).............................................................. 93
Appendix 3—Necropsy Tissue Samples .............................................................................. 94
RADIOGRAPHIC POSITIONING .............................................................................................. 95
Competencies ............................................................................................................................ 95
Time .......................................................................................................................................... 95
Set-up Information .................................................................................................................... 95
General Requirements of the Candidate ................................................................................... 95
Overview of Radiographic Positioning Section ........................................................................ 96
Standard Script for Radiographic Positioning Section ............................................................. 97
SMALL ANIMAL MEDICINE ................................................................................................... 99
Competencies ............................................................................................................................ 99
Time .......................................................................................................................................... 99
Set-up Information .................................................................................................................... 99
General Requirements of the Candidate ................................................................................. 100
Station One–Clinical Evaluation............................................................................................. 100
Overview of Station One .................................................................................................... 100
Station Two–Medical Management ........................................................................................ 105
Overview of Station Two .................................................................................................... 105
Standard Script for Station Two ............................................................................................. 106
Station Three–Clinical Techniques ......................................................................................... 109
Overview of Station Three .................................................................................................. 109
Standard Script for Station Three ....................................................................................... 109
Assessment Sheet for Small Animal Practice—Station Three (SAM03) ........................... 110
Small Animal Medicine Summary Score Sheet...................................................................... 115
Small Animal Medicine Appendices ...................................................................................... 116
Appendix 1—History and Physical Examination Form ......................................................... 116
Appendix 2—Prescription Form ......................................................................................... 118
Appendix 3—Medical Management and Treatment Order Form....................................... 119
SURGERY .................................................................................................................................. 126
Competencies .......................................................................................................................... 126
Time ........................................................................................................................................ 126
Set-up Information .................................................................................................................. 126
General Requirements of the Candidate ................................................................................. 127
Overview of the Surgery Section ............................................................................................ 128
Assessment Sheet for Surgery (SU01) .................................................................................... 130
Surgery Appendices ................................................................................................................ 136
Appendix 1—Fatal Flaw List.............................................................................................. 136

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 General Information

GENERAL INFORMATION

Statement of Intent
The Clinical Proficiency Examination (CPE) is an examination for international veterinary
graduates wishing to gain educational equivalency or pursue licensure in the United States or
Canada, respectively, and who have not graduated from a veterinary school accredited by the
American Veterinary Medical Association (AVMA) Council on Education (COE). In some
instances, the Canadian National Examining Board (NEB) also uses the CPE for examination of
graduates of veterinary schools accredited by the AVMA COE who have not been successful on
the national licensure examination. The CPE is intended to assess the practical clinical veterinary
skills of an “entry-level” veterinarian (i.e., a new graduate of an AVMA/COE-accredited school).
Each site administering the CPE must comply with all laws within their jurisdiction (e.g., those
relating to animal use and drug availability). Further, a site must report any legally necessary
deviation from this Manual of Administration to the AVMA’s Educational Commission for
Foreign Veterinary Graduates (ECFVG) or to the NEB for final approval. The ECFVG and NEB
will notify candidates of legally necessary deviations.

General Requirements for CPE Sites—

In order for any entity to become a CPE provider, three resource areas must be assured. The site
must provide appropriate animals and their care; qualified personnel; and adequate facilities and
equipment.

The CPE Manual of Administration (MOA) describes specific sections and skills to be assessed
and serves as the guide for administering the CPE to all candidates. The ECFVG recognizes that
there are variables that cannot be controlled completely (e.g., the temperament of the animals
used, equipment malfunction, etc.), but expects that each site will adhere as closely as possible to
the standards set forth in the CPE Manual. All CPE sites (existing or new) must agree to be
monitored by the Educational Commission for Foreign Veterinary Graduates (ECFVG) or the
National Examining Board (NEB) of the Canadian Veterinary Medical Association. The process
for monitoring CPE sites is described in the ECFVG document titled Quality Assurance for the
CPE—Site Proposal, available as an appendix in the CPE Candidate Bulletin at
www.avma.org/professionaldevelopment/education/foreign/pages/ecfvg-cpe-bulletin.aspx; see
specifically www.avma.org/professionaldevelopment/education/foreign/pages/ecfvg-cpe-
bulletin.aspx#cpe-appendix-2.

Candidates will not be assessed at a CPE examination site if:

They are graduates of that school/college.*
They have participated in a clinical training program at that site or
school/college.*
They are employees or former employees of that site or school/college.*

*Exception only for Université de Montréal, St. Hyacinthe (French speaking; for NEB purposes
only).

Candidates may take the CPE at a site at which they took Continuing Education courses,
provided that candidates are not tested by the same individual(s) who provided the training. Also,
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training must have taken place at least six months prior to examination at same site. Candidates
are not permitted to take examinations at the same site at which they were a resident or an intern.

Animal Requirements
It is imperative that the CPE site provide for humane care and treatment of animals. In order to
assure proper care and treatment, the following are required:
• Animal resources (species, weights, age, sex, numbers, etc.) must meet the standards
set forth in the CPE Manual of Administration.
• Local, state, and United States federal animal welfare laws, or similar laws applicable
in Canada, must be enforced and the facility must meet the standards of the most
current United States Federal Animal Welfare Act or the Canadian Council on
Animal Care.

Acceptable sources of live and necropsy animals and bovine fetuses may include the following:
• Those consistent with Provincial Animals for Research Acts
• United States Department of Agriculture, licensed animal dealers
• Purpose bred animals
• Animal Shelters
• Food animal producers
• Livestock sales
• Slaughterhouses
• Institution/practice owned
• Donated animals must be accompanied by a signed consent form from the donor.
• Owned animals with signed consent from the owner.

All weights provided for animals used in the CPE will be given in kilograms (kg).

Personnel Requirements
Personnel utilized for administration and scoring of the CPE must possess demonstrated
expertise to test entry-level clinical skills of veterinary graduates. The site and section
coordinators and examiners must possess well-founded knowledge of the list of common
conditions/diseases and pharmaceuticals/biologicals as they pertain to the practice of veterinary
medicine in the United States and Canada.

In order to assure adequate personnel, the following minimum standards are required:
• Personnel must be provided as specified in the CPE Manual of Administration.
• Four levels of personnel are identified. Each level must meet the minimum standards listed:
o Site Coordinator or equivalent—This person coordinates and manages the activities
of the examination site. They must have a DVM degree (or equivalent) with a
minimum of five (5) years clinical experience in the United States or Canada in a
discipline representing one of the examination sections that make up the CPE. Site
Coordinators must also consistently attend CPE Site Coordinators Meetings
facilitated by the ECFVG and NEB.
o Section Coordinator or equivalent—This person organizes and sets up the specific
section of the examination and is responsible for the overall quality control and

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administration of that section (see CPE Manual of Administration). Section

Coordinators must have a DVM degree (or equivalent) and been practicing in the
section/discipline within the last 10 years, with a minimum of five (5) years’
experience in the section/discipline in the United States or Canada.
o Examiner—This person coordinates and sets up the station with the Section
Coordinator, administers the station, and is directly responsible for evaluating the
candidates. The examiner also signs off as the primary examiner on all assessment
sheets, even when a secondary examiner or veterinary technician takes part in
assessing a candidate’s performance. Examiners must have a DVM degree (or
equivalent) and been practicing in the section/discipline within the last 10 years, with
a minimum of two (2) years clinical experience in the section/discipline in the United
States or Canada.
o Veterinary Technician - An individual who is credentialed as a veterinary technician
or veterinary technologist. They must possess training and expertise in the
species/procedure for which they are assisting. If a veterinary technician is assisting
the examiner(s) in candidate evaluation and documenting observations on the
assessment sheet, they must be under the direct supervision of the examiner. The
veterinary technician must have licensing, certification, or other documentation of
expertise in that section/discipline.
Facilities and Equipment
The facilities and equipment used in the CPE should meet contemporary practice standards for
the US and/or Canada. Facilities refer to structures and equipment refers to movable items used
to practice clinical veterinary medicine. CPE sites are expected to comply with the following:
• Facilities and equipment used for the CPE should meet the requirements outlined in
the CPE Manual of Administration.
• The facilities should assure the safety of personnel and candidates and provide for the
safety and welfare of the animals.
• The facilities and equipment should be adequate to examine multiple candidates
simultaneously.
• The facilities and equipment may vary slightly between sites in order to comply with
all relevant local, state, provincial and United States or Canadian Federal regulations.
These requirements include, but are not limited to zoning, radiation safety, personnel
and animal safety, animal care and use, and potentially toxic or dangerous substances
(anesthetic gases).
• Because candidates are being evaluated on their ability to practice veterinary
medicine at the entry level of competence, physical facilities and equipment should
be equivalent to those used in a United States or Canadian contemporary veterinary
clinical facility.
• Candidates for the examination must be provided with an adequate staging area for
orientation, storage, and rest.

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All sites must provide timers, visible to all candidates, for each station or section. Whenever
possible, timers should be of the “count-down” variety to allow candidates and examiners alike to
clearly see time remaining in station or section.

Taking Breaks
CPE candidates should make all effort to limit breaks to between CPE sections or stations. If a
candidate urgently needs to take a break in the middle of an exam station, they should be aware
that the timer for that station will continue during that break in accordance with the MOA.
Notably, taking a break does not relieve Surgery candidates from maintenance of aseptic
technique and the timer will not be stopped for re-gloving, re-gowning, etc. In any instance, if
taking a break endangers an animal or creates an inhumane situation as determined by the
examiner (e.g., leaving an anesthetized patient unattended), the candidate may receive a fatal
flaw for the station or section of the CPE.

Other Policy Information

For other policy information specific to the CPE, ECFVG candidates are advised to contact the
ECFVG office (847-925-8070 or 800-248-2862, ext. 6778 or 6682; ECFVG@avma.org;
www.avma.org/education/ecfvg/default.asp) and NEB candidates, the NEB office (613-236-
1162, ext. 123; ohoffmann@cvma-acmv.org;
http://www.canadianveterinarians.net/programs/national-examining-board.aspx).

General Discussion about the CPE

Candidates are urged to carefully read the CPE Candidate Bulletin (available at
www.avma.org/professionaldevelopment/education/foreign/pages/ecfvg-cpe-bulletin.aspx) and
this Manual of Administration (MOA) and understand the skill requirements of the CPE prior to
applying for the CPE. In this way, each candidate can begin to critically self-assess their
competencies to determine those areas of weakness that require further instruction. If further
instruction is required, the support and expertise of a veterinary mentor is strongly recommended
prior to scheduling and attempting the CPE.

The CPE assesses a subset of the entry-level clinical veterinary skills taught in an
AVMA/Council on Education-accredited veterinary school. All candidates taking the CPE are
encouraged to critically consider whether the education they received is sufficient to provide
them with the necessary skill level to be successful perform on the CPE. For example, candidates
need to have performed small-animal surgery and anesthesia in an instructional or clinical setting
with supervision/oversight prior to attempting the CPE. Candidates who do not have hands-on
experience in all facets of veterinary medicine, including those tested on the CPE, are
encouraged to seek additional clinical instruction prior to attempting the CPE. For example,
candidates could contact veterinary schools and colleges or continuing education programs to
determine potential clinical training opportunities, if any, and requirements, costs, and
restrictions for foreign veterinary graduates.

A candidate preparing to take the CPE should be knowledgeable with the animal species used in
this exam. Most emphasis is placed on the dog, cat, horse, and cow with a lesser emphasis on
goats, sheep, and pigs. Candidates are advised to focus on these species. A candidate lacking in
experience working with any of these species should seek this experience before taking the

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examination. This may include working with the animals in a non-veterinary capacity doing such
things as feeding, cleaning, exercising, restraining, grooming and routine health care (e.g.,
equine foot care).

Although experience gained from reading material and viewing videotapes, DVDs, CDs,
PowerPoints, etc, is helpful in preparing for the CPE, the candidate must not consider these to be
a substitute for the “hands-on” clinical instructional experience outlined above.

Communication skills and service to clients are a high priority in veterinary practice in the
United States and Canada. Throughout the CPE candidates will be expected to communicate
clearly and effectively with a client (role played by the examiner) in order to take an accurate
history, and to communicate information to the client including clinical findings, diagnostic
plans, test results and interpretation, therapeutic options, and prognosis. Other sections will
require the candidate to explain findings to the examiner directly. Lack of adequate entry-level
communication skills in English (or French at the Université de Montréal, St. Hyacinthe
for NEB purposes only) will negatively impact a candidate’s performance on the CPE.

Disabled or Pregnant Candidates Requesting Testing Accommodations

The nature of the CPE necessitates usage of live animals. While every attempt is made by examination
personnel to use animals of mild temperament, the behavior of such animals cannot be predicted, and
there is a potential hazard to candidates, particularly those who are disabled or pregnant. In
addition to the trauma that may result from working with animals, particularly large animals, hazards
exist for the unborn child whenever a pregnant candidate is exposed to infectious agents, inhalant
anesthetics, radiation, and other agents.

Candidates requesting testing accommodations in compliance with the Americans with

Disabilities Act (ADA) should refer to the Testing Accommodations procedures outlined in the
CPE Candidate Bulletin (available at
www.avma.org/professionaldevelopment/education/foreign/pages/ecfvg-cpe-bulletin.aspx; see
specifically www.avma.org/professionaldevelopment/education/foreign/pages/ecfvg-cpe-
bulletin.aspx#cpe-testing-accommodations).

A candidate may appeal any decision imposed under the above guidelines by presenting a written
statement to the Chair, ECFVG c/o American Veterinary Medical Association, 1931 North
Meacham Rd, Suite 100, Schaumburg, IL, 60173-4360 or chairman, NEB c/o Canadian
Veterinary Medical Association, 339 Booth St, Ottawa, Ontario, K1R 7K1. ECFVG candidates
may also refer to the ECFVG Policies and Procedures Manual at
www.avma.org/professionaldevelopment/education/foreign/pages/ecfvg-pp-toc.aspx for the
ECFVG appeal procedure. Appeals may also be sent via E-mail to ECFVG@avma.org

Rules of Conduct
The ECFVG has established Rules of Conduct to govern administration of the CPE to ensure that
no examinee or group of examinees receives unfair advantage on the examination, inadvertently
or otherwise.

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CPE site team members (i.e., coordinators, examiners, veterinary technicians, and technical
assistants) monitor all sections of the CPE. If CPE site team members observe a candidate
violating the Rules of Conduct or engaging in other forms of irregular behavior during a CPE,
the team members will not necessarily advise the candidate at the time of the examination but
shall report such incidents to the ECFVG (or NEB for Canadian sites). Each report shall be fully
investigated, with the ECFVG or NEB making the final decision.

ECFVG testing sites may also utilize video and/or audio recording for the purposes of test
security and quality assurance. If there is a reason to believe that the integrity of the examination
process is jeopardized, the ECFVG may invalidate all or any part of a CPE administration. If
information indicates that continued testing would jeopardize the security of examination
materials or the integrity of scores, the ECFVG reserves the right to suspend or cancel any CPE
administration.

By applying to take the CPE, a candidate agrees to the following Rules of Conduct:

1. You are the person named on the CPE application.

a. Admission to the CPE—When candidates arrive at the CPE site for orientation
and check in for the full CPE or to retake one or more sections, they must present
a photo ID with signature. Acceptable forms of identification include the
following forms of unexpired identification:
• passport;
• driver's license;
• national identity card; or
• other form of unexpired, government-issued identification.

The identification must contain both the candidate’s signature and photograph. If a
candidate does not bring acceptable identification, they will not be admitted to the CPE.
In that event, the candidate will be required to reschedule the CPE in accordance with
current ECFVG policy.

Candidates will also be required to show photo ID each day of the examination on entry
into the secure testing area. The candidate’s name as it appears on their CPE
application must match the name on the form(s) of identification exactly. If a
candidate’s name listed on their CPE application is not correct, contact the ECFVG
office immediately at ECFVG@avma.org or 800-248-2862, ext. 6682 or 6778. If you
registered to take the CPE through the NEB, please contact the NEB directly at
(613) 236-1162.

2. You will not use a telephone at any time while you are in the secure areas.

3. You will not give, receive, or obtain any form of unauthorized assistance during the
testing session, including any breaks. NOTE: Talking to another examinee during the
examination may be reported as evidence of giving, receiving, or obtaining unauthorized
assistance. Candidates may not discuss the cases with fellow examinees at any time,
and conversation among examinees in any language other than English (or French
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at the Université de Montréal, St. Hyacinthe) is prohibited at all times. CPE site
team members will monitor all examinee activity. See “Irregular Behavior” below.

CPE site team members are not authorized to answer questions from examinees regarding
examination content or scoring.

4. You will not have in your possession any formulas, study materials, notes, papers, or
electronic devices of any kind unless you are out of the secure testing areas of the CPE
site.

You will not remove materials in any form (written, printed, recorded, or any other type)
from the secure testing area unless instructed to do so by the examiners. You understand
and acknowledge that all examination materials remain the property of the CPE site and
ECFVG, and you will maintain the confidentiality of the case content for all seven
sections of the CPE. You will not reproduce or attempt to reproduce examination
materials through memorization or any other means, nor will you provide information
relating to examination content that may give or attempt to give unfair advantage to
individuals who may be taking the examination, including, without limitation, by posting
information regarding examination content on the Internet.

5. Personal Belongings—Unless specifically authorized, candidates may not bring personal

belongings into secure testing areas of the CPE site. Failure to follow these rules shall
constitute a violation of the Rules of Conduct for the administration of the CPE and may
lead to adverse action regarding a candidate’s examination. For the CPE, candidates
should understand that the entire testing session over the 3- to 4-day testing period,
including all breaks, is considered a closed and secure testing session, and that the entire
CPE site, including any on-site lunchroom, break rooms, and restrooms, is a secure
testing area. Therefore, the rules regarding unauthorized possession during the CPE
extend to lunch, if lunch is provided on site, and all breaks.

For the CPE, unauthorized personal belongings include, but are not limited to:
• mechanical or electronic devices, such as cellular telephones, personal digital
assistants (PDAs), watches with computer communication and/or memory capability,
electronic paging devices, recording or filming devices, radios;
• outerwear, such as coats, jackets, head wear, gloves;
• book bags, backpacks, handbags, briefcases, wallets; and
• books, notes, study materials, or scratch paper.

If candidates bring any personal belongings to the CPE site, they must store them in a
designated locker or storage cubicle as directed by the CPE site team. All stored
mechanical or electronic devices must be turned off. Upon reasonable suspicion, a
candidate’s personal belongings and their contents may be inspected. Any materials that
reasonably appear to be reproductions of any case material specific for the CPE
administration in which a candidate is participating will be confiscated. Making notes of
any kind during the CPE, except on the materials provided by the CPE site for this
purpose, is not permitted. If candidates have any questions regarding the appropriateness
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of personal belongings to be brought into the CPE site, contact the ECFVG or a CPE site
team member prior to admission.

6. Irregular Behavior—Irregular behavior consists of any action by CPE candidates or

others that subverts or attempts to subvert the examination process, including, without
limitation:
• Falsification of information on the application form, including additional
documentation, or failure to provide the ECFVG with information material to your
application.
• Impersonating an examinee or engaging someone else to take the examination for
you.
• Giving, receiving, or obtaining unauthorized assistance during the examination, or
attempting to do so.
• Unauthorized possession, reproduction, or disclosure of any test materials through
interpersonal communication, sharing on social media, or other avenues, including,
but not limited to, examination cases, before, during, or after the examination.
• Making notes of any kind during an examination except on the writing materials
provided by the CPE for that purpose.
• Disruptive or unprofessional behavior at a CPE site.
• Offering any benefit to any CPE site team member or agent of the ECFVG in return
for any right, privilege, or benefit which is not usually granted by the ECFVG to
other similarly situated candidates.

If a candidate is determined to have failed to abide by the Rules of Conduct of the ECFVG
or otherwise to have engaged in any form of irregular behavior, the ECFVG may terminate
the candidate’s participation in an examination, invalidate the results of an examination,
withhold or revoke the candidate’s scores or certification, bar the candidate’s participation
in future examinations, and/or take other appropriate adverse action. In addition, such
determination shall become part of the candidate’s permanent ECFVG record and the fact
of such determination may be provided to third parties that receive or have received
verification of ECFVG status. Such information may also be provided to other legitimately
interested entities.

Candidates also should understand that the ECFVG may or may not require a candidate to retake
one or more portions of the ECFVG if presented with sufficient evidence that the security of the
examination has been compromised, notwithstanding the absence of any evidence of a
candidate’s personal involvement in such activities.
Test Centers and Testing Conditions—For ECFVG candidates, the time and location for
arrival at the CPE site for orientation and check in will be sent to each candidate by E-mail prior
to the administration of the examination. If a candidate arrives late, they will not be admitted,
and will have to reschedule the test date in accordance with current ECFVG policy. (For all
travel-and-lodging information specific to your site, please access the letter via a link from your
ECFVG Online account (CPE step).

In addition, please note the following:

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• You should bring only the equipment specified for each section within the CPE Manual
of Administration; all other equipment is provided at the CPE.
• You should wear comfortable, professional clothing.
• There are no waiting facilities for family and friends at the center; plan to meet them
elsewhere after the examination ends.
• CPE site team members (wearing name tags) will direct you throughout each day of the
CPE, and their instructions should be followed at all times.

There will be an on-site orientation to each section of the CPE to acquaint candidates with
specific procedures and regulations.

Once candidates enter the secure testing area of the CPE site, they may not leave that area until
directed to do so by a member of the CPE site team. Breaks, including a lunch break, are
provided. CPE site team members will direct candidates to any on-site break and lunchrooms.

Should a candidate wish to file a concern regarding the CPE testing experience, they may do so
at the site on the test day(s). If a candidate does not file a report at the site, they must notify the
ECFVG office in writing within three weeks of the final day of the administration of the CPE.
Concerns that are reported in this way will be investigated in accordance with the current
ECFVG Complaints Procedure, available in the Policies and Procedures Manual at
www.avma.org/professionaldevelopment/education/foreign/pages/ecfvg-pp-complaints.aspx.

Note: Visitors as approved by the ECFVG or NEB, may, on some occasions, be observing a
CPE in progress. Other than site evaluators, they will be given no information regarding
examinee identity or performance and will have no interaction with examinees.

Appeal Process—ECFVG candidates determined to have violated the Rules or Conduct or

otherwise engaged in irregular behavior may appeal the decision by following the current
ECFVG Appeal Procedure available in the ECFVG Policies and Procedures Manual at
www.avma.org/professionaldevelopment/education/foreign/pages/ecfvg-pp-appeal.aspx. NEB
candidates must contact the NEB office.

Layout of CPE
The following seven sections make up the CPE:
▪ Anesthesia (AN)
▪ Equine Practice (EQ)
▪ Food Animal Practice (FAP)
▪ Necropsy (NEC)
▪ Radiology (RAD)
▪ Small Animal Medicine (SAM)
▪ Surgery (SU)

Some of the sections have multiple stations. Due to the need for rotation of candidates at
different sections and stations, candidates should be aware that their exam is unlikely to follow

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the sequence of the MOA and should be prepared to start and progress through sections and
stations within sections in any order.

Each section of the CPE Manual of Administration is laid out as follows:

• Competencies. Outlines those skills on which the candidate will be assessed.
• Time. Defines maximum time limit(s).
• Set-up information. Will assist veterinary examiners and support staff in examination
preparation and provide the candidate with a ‘picture’ of the testing environment.
Included in the set-up information is a description of the:
o Animal requirements
o People requirements
o Facilities and equipment
o Supplies/information provided by the examiner
o Supplies provided by the candidate
o Special equipment or supplies specific for the section
• General Requirements of the candidate. Overview of the section/station. Describes
specific skills that will be required of the candidate.
• Standard scripts for the section/station.
• Assessment sheets for the section/station.
Appendices, if any, for the section.

Information Supplied to Candidates

In all of the examination sections, the examiners will provide the candidates with an orientation
to the examination room(s), supplies and equipment, including dosages of all drugs required by
the CPE. The quality of the examination facilities will be consistent with those in common use in
veterinary practice in the United States and/or Canada. The examiners will provide the
candidates with copies of forms included in various parts of the CPE Master Manual of
Administration that are required for completion by the candidate and also will provide paper for
rough work (if required).

Requirements of Candidates
The “General Requirements of the Candidate” and “Overview” paragraphs found in each section
of this MOA contains paragraphs that outline behaviors and groups of clinical proficiency skills
expected of each candidate. The Assessment Sheet lists the required skills outlined in the
preceding paragraphs and the maximum point score allocated for each skill and provides a space
for the veterinary examiner to enter the candidate's score.

Supplies Candidates Must Provide

Although the incidence of rabies in domestic animals within the USA and Canada is extremely
low, the ECFVG strongly encourages candidates to complete vaccination against rabies prior to
taking the CPE.

Each section of the CPE Manual of Administration lists supplies that must be provided by the
candidates for that specific section and may include:
• clean laboratory coat

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• coveralls (except for necropsy; necropsy coveralls are provided by site)

• dosimeter (optional; if the candidate wishes to monitor personal levels of radiation during
the examination, the candidate will provide their own dosimeter)
• penlight
• digital rectal thermometer (large and small animal)
• safety boots (except for necropsy; necropsy boots/shoe coverings are provided by site)
• stethoscope
• wristwatch with second hand
• surgical scrubs
• pens/pencils

Assessment of Candidates
The Manual of Administration specifies the knowledge and technical skills (globally referred to
as clinical proficiency skills) that will be asked during the examination.

Examiners will assess each candidate’s knowledge and technical skills by direct observation, and
in some cases, will assess their written descriptions of findings or conclusions. ECFVG testing
sites may utilize video and/or audio recording for the purposes of test security and quality
assurance. However, video and/or audio recording will not be used in the scoring process, nor
will recordings be used to reverse failing scores during the appeals process. Recordings are not
precise enough to replace the level of discernment that the examiners have in real-time, face-to-
face encounters.

Other Considerations in Candidate Assessment

The term “efficiency” is an element in some of the assessments. Efficiency is a component of
competency. Candidates are to be assessed on their timeliness and effective use of resources to
complete a procedure.

A candidate who, in the judgement of the examiner, requires an unreasonable amount of time to
the extent that the outcome of the procedure is jeopardized will be penalized. The penalty for this
type of assistance will be reflected in the number of points assigned to the particular clinical
skill. A candidate who cannot complete a skill or set of skills in the maximum time allowed will
be penalized and may receive no points for a given station or section.

In several stations candidates are required to do multiple tasks. In all stations, candidates must
manage their time to ensure that they complete all tasks in the time allotted for the station.
Examiners will not be responsible for prompting candidates through their tasks or for reminding
them of their impending tasks. Candidates will be fully responsible for their own completion of
all tasks required to be demonstrated.

If a candidate compromises their personal safety or the safety of personnel while working around
animals during the course of the CPE (e.g., too close to the rear legs of a horse), the examiner
may terminate the procedure. Similarly, the examiner will assist an animal if a candidate, by an
act of omission or commission, puts an animal into an inhumane or life-threatening situation and
the situation is not corrected by the candidate. Depending upon the severity of the action, the

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examiner may deduct points from that particular skill, or the candidate may be dismissed with a
fatal flaw for the station.

Fatal Flaw
Throughout the MOA, the term ‘fatal flaw’ is used to denote an action attempted, performed, or
specified by a candidate that would have a high likelihood of causing serious injury to a patient,
to the candidate, and/or to associated personnel. Note that ‘fatal flaw’ is an assessment issued by
the examiner that may terminate the examination immediately and does not necessarily imply
that the action would be fatal to the patient. Correspondingly, a ‘fatal flaw’ assessment is not
restricted to use only in live animal situations but may also be awarded in either simulated
patient encounters or written exam elements. Numerous examples of fatal flaws are provided
throughout different sections of the MOA, but these lists are not comprehensive, and examiners
may award ‘fatal flaws’ for any action not specified in the MOA that, in their discretion, would
have a high likelihood of serious injury to the patient, candidate, or personnel.

Passing Standard and Score Reporting

Most sections of the examination use a point system as outlined in the scoring rubrics in each
section of the Manual of Administration. Anesthesia & Surgery sections use a Pass/Fail system.
A score of 60 points or greater, or a “Pass”, is required in each of the 7 sections of the CPE in
order to pass the examination. Candidates passing all sections of the exam will be awarded their
ECFVG certificate [or, in Canada, will be allowed to proceed to the next step leading to the
Certificate of Qualification], provided all other documentation is complete, as determined by
the ECFVG [or NEB] office.

Results (pass or fail only) from examinations administered at ECFVG-approved CPE sites will
be reported by the ECFVG office via E-mail and through ECFVG Online. Scores will be
released no more than twenty (20) business days following the final day of any given CPE
administration. Scores CANNOT be released via fax or telephone. To ensure timeliness in delivery
of score reports, it is essential that candidates update their E-mail address immediately via
ECFVG Online.

Scores from examinations administered at Canadian NEB-approved sites will be reported by the
NEB in accordance with NEB protocols.

Candidates Not Passing All Sections

A candidate with a “fail” in four or more sections of the examination must retake the entire
examination. A candidate with a “fail” in one, two, or three sections is allowed two additional
opportunities to retake and successfully pass the failed sections as long as the candidate applies
for retakes within 6 months of each failure and accepts one of the first available retakes offered.
Failure to successfully pass the retake sections within 2 retake attempts or failure to accept one
of the first available retakes will necessitate the candidate retaking the entire CPE. PLEASE
NOTE: only a total of two retake attempts are allowed for each failed section, regardless of
whether those attempts are taken at an ECFVG- or NEB-approved CPE site. The ECFVG and
NEB offices will communicate with each other regarding candidates registered in both programs.

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Use of Reference Material

The CPE is an examination that measures a candidate's proficiency in performing veterinary
clinical skills at the entry level. The expectation is that each candidate will demonstrate the
required skill without reference material unless reference material is required for a specific
portion of the examination. In this case, the reference material is listed in the section
Supplies/Information Provided by The Examiner and will be supplied by the examiner.

Extended score reports to candidates

An unsuccessful candidate may request an extended but standardized score report of failed
section(s) from the office of administration (i.e., ECFVG or NEB offices). The report will
identify areas in the MOA (manual of administration) in which the candidate has failed to
demonstrate knowledge and/or technical proficiency (scored less than 60% or fail). For example,
if the candidate scored less than 60% on the “developing a diagnostic plan” for the Food Animal
Practice, station 2, the extended score report will list “developing a diagnostic plan” as an area
where the candidate has demonstrated a deficit of knowledge and/ or technical proficiency. For
sections in which skills are scored pass or fail, the extended score report may include statements
such as “failed to appropriately test the anesthetic machine for leaks” for the anesthesia section
or “failed to demonstrate appropriate draping techniques” for the surgery section. The purpose of
the extended score report is to identify for a candidate’s areas of skills and knowledge that they
need to improve broadly in preparation for a career in veterinary medicine rather than identifying
exact points of failure specific to the particular case or circumstance the candidate encountered
on the exam. Candidates will not be provided further information beyond that included on the
extended score report. Requests for extended score reports must be received within two weeks
(14 days) of distribution of the candidate’s CPE score report. Candidates intending to file an
appeal of a failing score must request an extended score report within 14 days of the score
notification and before initiating the ECFVG Appeal Process. ECFVG candidates must request
the extended score report via E-mail to ECFVG@avma.org. The extended score report will then
be returned to the candidate via E-mail within 15 business days of receipt of the
request. Candidates may only request extended score reports from the ECFVG office (or
the NEB office for CPEs administered in Canada) and are prohibited from asking
examiners for feedback or for more details of their failure during or after completion of the
CPE.

Common Diagnoses/Conditions
The CPE is a test of “entry-level skills.” Therefore, cases/conditions selected for inclusion on the
examination should be common conditions with which the new graduate of an AVMA-
accredited school should be familiar. An example list of common diagnoses is maintained in the
CPE Candidate Bulletin at www.avma.org/professionaldevelopment/education/foreign/pages
/ecfvg-cpe-bulletin.aspx. Candidates and examiners must realize that this list is not exhaustive
and that there is no requirement that the CPE be limited to the diagnoses and conditions on this
list.

References for the CPE

The knowledge level expected to receive a passing score on the CPE is that of an entry-level
U.S. or Canadian veterinarian (i.e., new graduate of an AVMA/COE-accredited veterinary
school). Reference lists for curricula at accredited veterinary schools are extensive. The

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following list represents a relevant subset that appropriately covers the content of the CPE.
While experience gained from reading material is helpful in preparing for the CPE, the candidate
must not consider these to be a substitute for hands-on clinical instruction and experience.

1. Ballweber, LR. Veterinary Parasitology, (2001), Boston: Butterworth-Heinemann.

2. Baxter, GM. Adams & Stashak’s Lameness in Horses, 6th ed. (2011), Ames, IA: Wiley-
Blackwell.
3. Bertone, JJ. Equine Clinical Pharmacology, (2004), Philadelphia: Saunders (Elsevier).
4. Birchard, SJ. Saunders Manual of Small Animal Practice, 3rd ed. (2006), St Louis:
Elsevier.
5. Bonagura, JD. Kirk’s Current Veterinary Therapy, XIV, 14th ed. (2009), St Louis:
Saunders (Elsevier).
6. Boothe, DM. Small Animal Clinical Pharmacology & Therapeutics, 2nd ed. (2012), St
Louis: Elsevier).
7. Butler, JA. Clinical Radiology of the Horse, 3rd ed. (2008), Ames, IA: Wiley-Blackwell.
8. Castro, AE. Veterinary Diagnostic Virology: A Practitioner’s Guide, (1992), St. Louis:
Mosby.
9. De Lahunta, A. Applied Veterinary Anatomy, (1986), Philadelphia: Saunders.
10. Dennis, R. Handbook of Small Animal Radiology and Ultrasound: Techniques and
Differential Diagnosis, 2nd ed. (2010), St Louis: Churchill-Livingstone (Elsevier).
11. Dyce, KM. Textbook of Veterinary Anatomy, 4th ed. (2010), St Louis: Elsevier.
12. Ettinger, SJ. Textbook of Veterinary Internal Medicine, 7th ed. (2010), Philadelphia:
Saunders (Elsevier).
13. Evans, HE. Miller’s Anatomy of the Dog, 4th ed. (2013), St Louis: Elsevier.
14. Farrow, CS. Veterinary Diagnostic Imaging – The Dog and Cat, (2003), St. Louis:
Mosby.
15. Fossum, TW. Small Animal Surgery, 4th ed. (2012), St Louis: Mosby (Elsevier).
16. Frandson, RD. Anatomy and Physiology of Farm Animals, 7th ed. (2009), Ames, IA:
Wiley-Blackwell.
17. Greene, CE. Infectious Diseases of the Dog and Cat, 4th ed. (2012), St Louis: Elsevier.
18. Grubb, T, et al. 2020 AAHA Anesthesia and Monitoring Guidelines for Dogs and Cats. J
Am Anim Hosp Assoc 2020: 56: 1-24. (https://www.aaha.org/globalassets/02-
guidelines/2020-anesthesia/anesthesia_and_monitoring_guidelines_final.pdf)
19. Jones, TC. Veterinary Pathology, 6th ed. (2010), Ames, IA: Blackwell.
20. Kahn, CM. Merck Veterinary Manual, 10th ed. (2010), Whitehouse Station, NJ: Merck.
21. Kealy, JK. Diagnostic Radiology and Ultrasonography of the Dog and Cat, 5th ed.
(2011), St Louis: Elsevier.
22. Knottenbelt, DC. Color Atlas of Diseases and Disorders of the Horse, (1994), St Louis:
Mosby.
23. Kumar, V. Robbins and Cotran Pathological Basis of Disease, 8th ed. (2010),
Philadelphia: Saunders (Elsevier).
24. Latimer, KS. Duncan & Prasse’s Veterinary Laboratory Medicine – Clinical Pathology,
5th ed. (2011), Ames, IA: Wiley-Blackwell.
25. Lavin, LM. Radiography in Veterinary Technology, 3rd ed. (2003), Philadelphia:
Saunders (Elsevier).

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26. Maxie, MG. Jubb, Kennedy, & Palmer’s Pathology of Domestic Animals, 5th ed. (2007),
St Louis: Elsevier.
27. Muir, WW, III. Handbook of Veterinary Anesthesia, 5ht ed. (2013), St Louis: Elsevier.
28. Nelson, RW. Small Animal Internal Medicine, 4th ed. (2009), St Louis: Mosby
(Elsevier).
29. Osborne, CA. Urinalysis: A Clinical Guide to Compassionate Patient Care, (1999),
Shawnee Mission, KS: Bayer.
30. Plumb, DC. Plumb’s Veterinary Drug Handbook, 7th ed. (2011), Ames, IA: Wiley-
Blackwell.
31. Pugh, DG. Sheep and Goat Medicine, 2nd ed. (2012), Maryland Heights, MO: Elsevier.
32. Radostits, OM. Veterinary Medicine: A textbook of the diseases of cattle, horses, sheep,
pigs and goats, 10th ed. (2007), St. Louis: Saunders (Elsevier).
33. Reed, SM. Equine Internal Medicine, 3rd ed. (2010), St Louis: Saunders (Elsevier).
34. Riviere, JE. Veterinary Pharmacology & Therapeutics, 9th ed. (2001), Ames, IA: Wiley-
Blackwell.
35. Rollin B, Wilson, JF, and Jarbe JL. Law and Ethics of the Veterinary Profession, (2002),
Priority Press Ltd
36. Ross, MW. Diagnosis and Management of Lameness in the Horse, 2nd ed. (2011), St
Louis: Elsevier.
37. Slatter, D. Textbook of Small Animal Surgery, 3rd ed. (2002), St Louis: Elsevier.
38. Smith, BP. Large Animal Internal Medicine, 4th ed. (2009), St Louis: Elsevier.
39. Spiers, VC. Clinical Examination of Horses, (1997), Philadelphia: Saunders.
40. Stockham, SL. Fundamentals of Veterinary Clinical Pathology, 2nd ed. (2008), Ames,
IA: Blackwell.
41. Thrall, DE. Textbook of Veterinary Diagnostic Radiology, 6th ed. (2013), St Louis:
Elsevier.
42. Thrall, MA. Veterinary Hematology and Clinical Chemistry, 2nd ed. (2012), Ames, IA:
Wiley-Blackwell.
43. Timoney, JF. Hagan and Bruner’s Microbiology and Infectious Diseases of Domestic
Animals, 8th ed. (1988), Ithaca, NY: Comstock.
44. Tranquilli, WJ. Lumb and Jones’ Veterinary Anesthesia and Analgesia, 4th ed. (2007),
Ames, IA: Blackwell.
45. Willard, MD. Small Animal Clinical Diagnosis by Laboratory Methods, 5th ed. (2012),
St Louis: Elsevier.
46. Wingfield, WE. Veterinary ICU Book, (2002), Jackson Hole, WY: Teton NewMedia.
47. Youngquist, RS. Current Therapy in Large Animal Theriogenology, 2nd ed. (2007), St
Louis: Elsevier.
48. Zachary, JF. Pathologic Basis of Veterinary Disease, 5th ed. (2012), St Louis: Elsevier

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Standard Script for General Candidate Orientation to the CPE and the Examination Site
The examiner should read the following script (in quotes) to all candidates as a general
will not be asked anything that is not expected of a newly graduated veterinarian, and hundreds
of candidates before you have successfully completed the CPE and gone on to rewarding careers
in veterinary medicine.

During the next three days you will participate in a comprehensive practical examination of your
clinical veterinary skills.

A comprehensive schedule of the examination is included in your information packet. If you

have any questions related to the schedule please ask them now, or at the end of this orientation.

If you have not already done so, please sign the registration sheet.

Let me talk a few minutes about facilities. [Each site will have to specifically inform
candidates about break rooms, library access, available rest rooms, and access to food.]

The [insert name or number of room] has been reserved as the "home base" for candidates
participating in the Clinical Proficiency Examination. Feel free to work out of this room, leave
materials in this room (at your own risk) and convene in this room prior to sections of the
examination. Be sure that you assemble no later than the time listed on your schedule for each
section of the exam. [Each site may have to insert specific information related to candidates
assembling at other locations during the exam].

Be sure you wear your identification badge at all times in the examination and provide your
number and/or name on all papers submitted during the examination. Failure to identify your
work could disqualify the work from scoring.

Within fifteen (15) working days following the last day of this examination, we will submit a
report to the ECFVG office at the AVMA [Canadian sites, use NEB office]. The ECFVG
[Canadian sites, use NEB], will review the scores and notify each of you by E-mail and through
ECFVG Online [Canadian sites, use by mail or E-mail] of your final score on the CPE. Thus,
it may take up to four weeks from the end of the examination until you receive your report from
the ECFVG [Canadian sites, use NEB].

Discussing components of your exam with other candidates while the exam is in progress is not
allowed. To avoid any appearance of impropriety, all conversations must be conducted in
English language while at the testing site. [Montreal test site may use French/English].
Remember that you already earlier signed an honor statement—an oath— that you will not
discuss the exam with other candidates. The ECFVG [Canadian sites, use NEB] has the right to
dismiss any candidate who violates the security of this exam during the administration of the
exam. No cell phones, PDAs, or other electronic assisting devices may be used during the exam.
If you have any questions about what you may take with you into the examination, please check
with me or one of the section coordinators.

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If there is a reason to believe that the integrity of the examination process is jeopardized, we will
immediately notify the ECFVG [Canadian sites, use NEB] office. The ECFVG [Canadian
sites, use NEB] may invalidate all or any part of a CPE administration. If information indicates
that continued testing would jeopardize the security of examination materials or the integrity of
scores, the ECFVG reserves the right to suspend or cancel any CPE administration.

By applying to take the CPE, you agree to the following Rules of Conduct:
1. You are the person named on your CPE application.
2. You will place in a locker or cubicle all personal belongings, including cellular
telephones, watches with computer communication and/or memory capability, pagers,
personal digital assistants (PDAs), formulas, study materials, notes, papers, and your
purse or wallet, before you enter the secure testing areas. Lockers are available for your
use and are located [insert location of lockers for Candidates]
3. You will not use a telephone at any time while you are in the secure areas.
4. You will not give, receive, or obtain any form of unauthorized assistance during the
testing session, including any breaks.
5. You will not have in your possession any formulas, study materials, notes, papers, or
electronic devices of any kind unless you are out of the secure testing areas of the CPE
site.
6. You will not remove materials in any form (written, printed, recorded, or any other type)
from the secure testing area unless instructed to do so by the examiners.
7. You understand and acknowledge that all examination materials remain the property of
the CPE site and ECFVG, and you will maintain the confidentiality of the case content
for all seven sections of the CPE.
8. You will not reproduce or attempt to reproduce examination materials through
memorization or any other means, nor will you provide information relating to
examination content that may give or attempt to give unfair advantage to individuals who
may be taking the examination, including, without limitation, by posting information
regarding examination content on the Internet.
9. You will conduct yourself professionally with examiners and staff before, during, and
after completion of your exam. If you are dismissed from any exam, you must leave the
testing area promptly. Otherwise, the test site may request security to escort you from the
testing area. This may result in your inability to participate in other CPE section exams.

Unless specifically authorized, candidates may not bring personal belongings into secure testing
areas of the CPE site. Failure to follow these rules shall constitute a violation of the Rules of
Conduct for the administration of the CPE and may lead to adverse action regarding a
candidate’s examination.

For the CPE, candidates should understand that the entire testing session over the 3-day testing
period, including all breaks, is considered a closed and secure testing session, and that the entire
CPE site, including any on-site lunchroom, break rooms, and restrooms, is a secure testing area.
Therefore, the rules regarding unauthorized possession during the CPE extend to lunch, if lunch
is provided on site, and all breaks.

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All of the CPE site team members, including site and section coordinators, examiners, veterinary
technicians, and technical assistants will be monitoring all sections of the CPE. If a CPE site
team member observes a candidate violating the Rules of Conduct or engaging in other forms of
irregular behavior during a CPE, that person will report such incidents to the ECFVG [Canadian
sites, use NEB]. Each report shall be fully investigated.

As a CPE site, we have an obligation to administer the examination as described in the Manual
of Administration. If at any point you believe that an examiner has asked you to do something
that is not in the MOA, you should perform the task to the best of your ability. Afterward, inform
either myself [or insert names and introduce any appropriate staff] of the issue. You should
perform the task to the best of your ability because it is possible that you misread or
misinterpreted the MOA. You should let us know so we can investigate your concerns and make
a determination. It is certainly possible for an examiner to misread or misinterpret something in
the MOA and in that in case we will not allow that to impact your scores on the CPE.

As I said at the beginning, we recognize that this is a stressful process. The examiners will do
everything they can to minimize this stress. Do not allow a simple mistake to diminish your
performance on the rest of the exam. No one has ever made a perfect score on this examination;
everyone makes mistakes. When you make a mistake, put it behind you and continue to perform
at your best throughout the remainder of the exam.

Good luck, do your best!

Any questions?”

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 Anesthesia

ANESTHESIA

Competencies
The Anesthesia Section consists of two parts. Part 1 must be administered the day before Part 2.
• Part 1
o Select appropriate anesthetic drugs and plan for a prolonged (over 3 hours)
anesthetic period and calculate correct doses (assessed within a stand- alone Drug
Protocol and Dose Calculation station or incorporated into another section)
• Part 2
o Perform a preanesthetic examination to determine a patient’s anesthetic risk status
o Select, assemble, and use appropriate anesthetic equipment and accessories.
o Premedicate, induce and maintain general anesthesia in a canine patient.
o Monitor and maintain a patient under general anesthesia
o Discuss recovery of the patient from anesthesia, to include postoperative pain
management.
Time
• The candidate will be given forty-five (45) minutes for the Drug Protocol and Dose
Calculation Station.
• Total time required for any candidate from beginning to end of the live AN station
assessment may be up to 4hrs 10minutes. The candidate will be given one hundred (100)
minutes (1 hour and 40 minutes) from the start of the preoperative examination to having
the patient anesthetized and ready for surgical preparation. This means that all tasks
outlined in the MOA are complete and the dog’s airway is secure (intubated with
endotracheal tube secured appropriately); the dog is connected to the anesthetic machine
with inhalant anesthetic started at an appropriate level; a functional/patent IV catheter is
in place and appropriately secured and IV fluids are started; the dog is at a suitable plane
of anesthesia for surgical preparation to begin; and the candidate has begun initial
monitoring of the patient. Required monitoring equipment can be placed after the 100-
minute limit. However, the candidate must still monitor the patient appropriately
(assessment of cardiovascular and respiratory status and depth of anesthesia) during this
peri-induction period. Candidates who exceed the 100-minute maximum for these
activities/skills will be immediately dismissed from, and receive a failing score for, this
section of the CPE.
• Candidates completing all necessary tasks in less than 100 minutes should tell the
examiner that they have completed all tasks and are ready for the surgeon
• Once the surgical procedure begins, the Anesthesia candidate will continue to be assessed
on the maintenance phase of anesthesia and recovery of the patient. The Anesthesia
assessment will end at the conclusion of the ovariohysterectomy or immediately
thereafter.

Set-up Information
1. Animal Requirements— One female dog per candidate, body weight with a minimum of
6 kg (BCS within 2-4 out of 5), not visibly or palpably pregnant, not visibly in heat (i.e.,
no visible external evidence of bloody vaginal discharge), acceptable anesthetic risk
based on physical examination.

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2. People Requirements (minimum)

a. For the Drug Protocol and Dose Calculation station:
i. One proctor
b. For the rest of the Anesthesia Section:
i. One veterinary examiner per 3 candidates
ii. One technical assistant or veterinary technician per 2 candidates

3. Facilities and Equipment–Facilities and Equipment for Anesthesia and Surgery are the
same.
a. A room/area for the Drug Protocol and Dose Calculation station to allow candidates
to develop drug protocols and calculate doses.
b. Rooms (or areas) equipped for the preparation of animals for surgery.
c. Rooms (or areas) equipped to carry out the required surgical procedure.
d. Timing device visible from each station to track examination time. Whenever
possible, timers will be of the “count-down” variety to allow candidates and
examiners alike to clearly see time remaining in station or section.

4. Supplies/Equipment/Accessories Provided by The Examiner

a. Standard anesthetic machines (each machine to have a precision isoflurane or
sevoflurane vaporizer which is temperature and flow compensated and its own
oxygen supply; availability of specific vaporizer dependent on site of examination
administration).
b. Rebreathing and non-rebreathing systems.
c. Standard anesthetic and monitoring accessories such as esophageal stethoscope,
Doppler or oscillometric blood pressure monitoring equipment (either one or the
other will be provided, dependent on CPE site), thermometer and/or electronic
monitoring equipment, endotracheal tube, laryngoscope (different blade sizes),
intravenous catheters, IV fluids, pulse oximeter, capnograph.
d. Scratch paper and nonprogrammable basic calculator for drug dose calculations.

5. Supplies Provided By The Candidate

a. Stethoscope, clean laboratory coat, surgical scrubs

6. Anesthetic Drugs
The candidate will be asked to choose from the following anesthetic drugs for use during
the procedure. Examiners will provide dosages and concentrations of the following drugs
to candidates for use on site in specific dose and volume calculations. Specific drugs
available for use may vary dependent on the CPE site, but will come from the following
list:

• Acepromazine • Butorphanol
• Alfaxalone • Carprofen
• Atipamezole • Diazepam
• Atropine • Dexmedetomidine
• Buprenorphine • Glycopyrrolate

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 Anesthesia

• Hydromorphone • Methadone
• Isoflurane • Midazolam
• Ketamine • Morphine
• Maropitant citrate • Propofol
• Meloxicam • Sevoflurane

General Requirements of the Candidate

The Anesthesia and Surgery Sections of the CPE will be administered at the same time. The
anesthesia candidate will anesthetize, stabilize, and monitor the animal while the surgery
candidate, or another person designated by the site, performs an ovariohysterectomy.

Candidates are expected to handle all animals in a humane and safe manner. If, in the opinion of
the examiner, the candidate does not handle the animal humanely or handles the animal in a
manner that is unsafe to them or other personnel the examiner may assess penalties ranging from
a reduction in score to termination of the exam and dismissal of the candidate.

The Anesthesia Section is scored as Pass or Fail. Candidates receiving a FAILING evaluation for
anyone (1) MAJOR skill or any combination of four (4) MINOR skills as noted on the Anesthetic
Skills Assessment Sheet (AN01) may be allowed to complete the examination but will receive a
FAILURE for the Anesthesia Section. Candidates committing a fatal flaw (see Appendix 1 in this
section of the MOA for examples of fatal flaws) as determined by the examiner will be
immediately dismissed from, and will receive a failing score for, this section of the CPE.
Candidates must also note that there are many factors that go into the pass/fail decision in this
section. Successful entry-level performance of the skills assessed in the Anesthesia Section
involves much more than having the patient survive the anesthesia—in other words, more than
getting through the procedure without being dismissed for committing a fatal flaw.

The examiner will assist an animal and terminate the Anesthesia Section if a candidate by an act
of omission or commission puts an animal into an inhumane or life-threatening situation and the
situation is not corrected by the candidate (fatal flaws; please see Appendix 1 in the Anesthesia
Section of the MOA). Examples of life-threatening situations include but are not limited to
esophageal intubations that are unrecognized and uncorrected by the candidate, failure to open
the pop-off valve, and failure to adjust the depth of anesthesia to an appropriate level. Such
errors may be considered fatal flaws. In the case of a fatal flaw, the examiner will document and
verify the error, correct it, and ask the candidate to leave the Section immediately. The candidate
will receive a failing score for the Anesthesia section regardless of the score accumulated at the
point of termination.

Overview of the Anesthesia Section

1. Anesthetic drug protocol selection and drug dose calculation (45-minute time limit): The
Drug Protocol and Dose Calculation station must be completed the day before
administering anesthesia to patient. At the station, the candidate will be given a list of
available drugs, the concentrations of the drugs that are available, and recommended dose
ranges. Based upon the weight and estimated age of the canine patient, and assuming an
ASA status of 1, the candidate will design an anesthetic protocol (preanesthetic drugs,

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anesthesia induction, anesthesia maintenance, and pain management); calculate the

volume of each drug selected based upon the drug concentration provided; and enter the
results on the Anesthesia Record (Appendix 3). The candidate will also record their
reasons for selecting the specific drugs used on the Anesthesia Record.

2. Anesthetic Procedure: Preanesthetic examination and premedication; selection and set-up

of anesthetic equipment; induction, intubation, and initiation of Inhalant Anesthesia; and
initial patient monitoring (100-minute time limit; time begins after all instructions have
been read and when candidates receive their dog):
1. Preanesthetic examination and premedication—The candidate will perform a
preoperative physical examination on a female canine patient scheduled for
ovariohysterectomy and will record the results of the preoperative examination. The
candidate should request appropriate minimum laboratory tests for the patient and
procedure; interpret and record results of those laboratory tests (which will be
provided by the examiner); and assign an ASA preanesthetic physical status to the
patient (see Appendix 2 of the Anesthesia Section). The candidate will also
premedicate the dog via intramuscular or subcutaneous injection, using the drug
protocol that they indicated earlier. All information is to be recorded on the
Anesthesia Record (Appendix 3). Please note: doses/volumes of all anesthetic drugs
were calculated initially, assuming an ASA status of 1. However, if the candidate
determines from their preanesthetic physical exam that the actual ASA status is
different, then the candidate may modify the actual drug doses to be administered
accordingly.

2. Selection and set-up of anesthetic equipment—the candidate will determine and

record fresh gas flow rates for the patient; select other accessories (e.g.,
endotracheal tube) appropriate for the patient; choose and attach appropriate
breathing system to machine, systematically check the assembly and operation of
the anesthetic equipment; and verbally explain or describe the assembly and
operation of the anesthetic equipment to the examiner.

3. Induction, intubation, and initiation of inhalant anesthesia—The candidate will place

an IV catheter, and administer induction agent, using the drug protocol that they
indicated earlier. Please note: doses/volumes were calculated initially, assuming an
ASA status of 1. However, if the candidate determines from their preanesthetic
physical exam that the actual ASA status is different, then the candidate may modify
the actual drug doses to be administered accordingly. Within 5 minutes of the start of
administration of the induction agent, the candidate will intubate the patient, , secure
the endotracheal tube, appropriately inflate the cuff, and connect the endotracheal
tube to the anesthetic machine with inhalant anesthetic and fresh gas flow rates set at
appropriate levels to bring the patient to a surgical plane of anesthesia. Failure to
complete all those tasks within the 5-minute limit will result in immediate dismissal
of the candidate and a failing score for the Anesthesia Section.

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 Anesthesia

4. Initial patient monitoring—The candidate will begin initial monitoring of the

patient within 3 minutes of intubation (i.e., assessment of cardiovascular and
respiratory status and depth of anesthesia), record findings on the Anesthesia
Record, and administer IV fluids (appropriate type and rate).

Tasks 1-4 above must be completed within 100 minutes. To avoid unnecessary prolongation
of anesthesia of the patient, the candidate SHOULD indicate they are ready for the surgery
candidate to begin patient preparation if they have completed tasks 1-4 above in less than 100
minutes. PLEASE NOTE: when an anesthesia candidate calls for the surgery candidate, this is
an indication they have completed tasks 1-4 above. Failure to complete tasks 1-4 above in the
100-minute time limit will result in immediate dismissal of the anesthesia candidate and a
failing score for the Anesthesia Section.

5. Maintenance (2.5 hour time limit, with actual time dependent on surgery
candidate)—As soon as possible after calling for the surgery candidate, the candidate
will apply the remaining monitoring equipment, which includes placement of ECG
leads, a blood pressure monitor, pulse oximeter, thermometer, and capnograph, to the
patient; maintain and monitor the animal in a surgical plane of anesthesia during the
ovariohysterectomy; record findings and other information on the anesthetic record
(Appendix 3) in a timely manner (e.g., every 5-10 minutes); be able to explain to the
examiner what parameters they are monitoring and how they are monitoring those
parameters; interpret their assessment of patient parameters and monitoring
equipment readouts for that specific patient; correct any abnormalities as assessed
during monitoring; and be able to explain why corrections were or were not made..
Please note results, interventions, and any other comments must be recorded as soon
as assessments are made. Candidate score will be negatively impacted if she/he does
not complete the Anesthesia Record in real time.

If a candidate believes that a piece of equipment is malfunctioning, the candidate must

immediately bring this concern to the examiner’s attention. The examiner will determine if
the concern is valid and, if so, take appropriate remedial action. If a candidate believes that
a piece of equipment was malfunctioning, that the issue was not appropriately corrected
after alerting the examiner, and the malfunctioning equipment had the potential to affect
the outcome of the candidate’s assessment, then the candidate must document the issue
immediately upon the conclusion or termination of the exam using the ‘Anesthesia
Equipment Incident Report’ in Appendix 4. Failure to file an Anesthesia Equipment
Incident Report may result in the denial of an appeal of the examination result based upon
a claim of faulty equipment.

Standard Script for Drug Protocol and Dose Calculations Station

Prior to beginning the Drug Protocol and Dose Calculations station, the examiner should
read the following script (in quotes) to each candidate. The script may be modified to
meet specific facility or equipment restrictions at each site. “You will be anesthetizing a
dog for a routine ovariohysterectomy. You will have a list of available drugs, their
concentration and their recommended dose range. You will also have your Anesthesia

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 Anesthesia

Record with details of the dog assigned to you, including the body weight and an
estimated age.

Assuming an ASA status of 1, you will have a maximum time of 45 minutes to decide on
your anesthetic protocol including your plan for preanesthetic drugs, anesthesia
induction, anesthesia maintenance, and pain management. Calculate the final dose and
final volume for all the selected drugs. Enter the results in the appropriate places in the
Anesthesia Record. You can indicate to the examiner on the day of the Anesthesia section
if you want some of the drugs to be mixed prior to administration.

You will also need to describe your reasons for choosing the drugs for your dog. There is
space for this on the Anesthesia Record and on the back of the sheet. Extra paper can be
provided for calculations. Please put your candidate ID/name on the paper and all pages
of the Anesthesia Record and return completed sheets to the examiner at the end of the 45
minutes. The Anesthesia Section Coordinator or Examiner will grade your drug choices,
calculations and comments. All drugs will be prepared by the Anesthesia Examiners or
Veterinary Technicians in accordance with your calculations and instructions. You will
have a maximum of 45 minutes to complete this task.

Standard Script for Anesthesia Section—Preanesthetic Exam to Maintenance Phase

“You will be anesthetizing a dog for an elective ovariohysterectomy performed by
another candidate or surgeon. The dog will be going home after a sufficient recovery.

A trained technician will assist you, but you must communicate with the technician and
request assistance as needed. The examiner [I] will be evaluating your performance and
will be recording both positive and negative behaviors. Do not let the examiner’s [my]
writing affect your performance. The examiner [I] and the technicians cannot offer
feedback during or after the examination. The examiner [I] may stop the examination and
issue a fatal flaw if you commit an error that endangers the animal, yourself, or other
personnel in danger.

The examiner has [I have] returned your Anesthesia Record. After the timer has started,
you can recheck your drug calculations and the drugs supplied. Notify the examiner [me]
of any mistakes or changes you would like to make. Record all findings and other data on
the Anesthesia Record provided. Ensure your name/candidate ID is written on all pages
and sign the form on the final page when you have completed the examination.

The 100-minute timer will be started once your dog is brought to you. You must have the
dog ready for the surgeon and complete the following list of tasks from the Manual of
Administration within the 100 minutes:

1. Perform a preanesthetic physical examination of the dog;

2. Record examination findings on the Anesthesia Record;
3. Request blood work;
4. Assign a pre-anesthetic physical status based on your findings;

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 Anesthesia

5. Administer premedication drugs via intramuscular or subcutaneous injection in

accordance with your drug plan;
6. Assemble the anesthetic machine and breathing system, and check that it is working
properly;
7. Assemble all the equipment needed to place an IV catheter and intubate the trachea;
8. Place the IV catheter;
9. Induce anesthesia in the dog and begin inhalant anesthesia;
10. Start IV fluids;
11. Begin monitoring anesthesia and record your findings on the Anesthesia Record;
12. Finally, call for the surgery candidate.

Once you have completed all of the listed tasks, indicate that you are ready for the
surgery candidate and the timer will be stopped. Ensure you have completed all of the
tasks before calling for the surgery candidate and within 100 minutes or you will be
dismissed from this section and receive a failing score. You must determine how to
complete all these tasks efficiently and correctly. Please plan you time accordingly.

The examiner [I] will now show you where necessary supplies are available [show to
candidates]. If the specific item you request is not available, you will be asked to make
another choice from the equipment and supplies we have available here.

Once your dog is brought to you, start with the preanesthetic physical examination, and
record your findings. The patient’s weight will be provided. Request the laboratory tests
you deem appropriate and the examiner [I] will provide you the results of those tests that
were completed. Based on the physical examination and laboratory results, assign an
ASA preanesthetic physical status to the patient and record all the data on the Anesthesia
Record. You can make any adjustments to your drug plan that you deem appropriate once
you have this information by notifying the examiner [me].

You are not obliged to use the drug plan you developed yesterday—you can still make
changes based on the ASA status that you determine today during your preanesthetic
assessment. Please notify the examiner [me] of any changes you would like to make. If
you think there has been a mistake with drug calculations and the drugs given to you,
please notify the examiner [me].

Once you have pre-medicated your dog, you may leave your dog with the technician or
place it in a kennel and start to set up your station while the drugs take effect. Select
appropriate catheters, and intubation, fluid administration, and monitoring equipment,
and anesthetic breathing systems. Assemble the anesthetic machine and breathing system
and check that they are working properly and with no leaks. Please call an examiner over
when you are ready to show the anesthetic machine to an examiner [me] and describe the
function of the parts to the examiner [me].

When you are ready, you can [request or go get] your dog and insert an IV catheter and
secure it in place with help from your assistant. Notify the examiner [me] when you are
ready to administer the induction drug. The 5-minute time limit will begin at the moment

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 Anesthesia

the anesthetic induction drug is started. You must administer an appropriate amount of
induction drug to allow endotracheal intubation, secure and check the endotracheal tube,
inflate the cuff, and connect the endotracheal tube to the breathing system. Failure to
complete all these tasks within the 5-minute limit will result in dismissal and a failing
score.

Within 3 minutes from intubation, you must begin monitoring the cardiac and respiratory
status of your patient. Failure to begin monitoring within 3 minutes of intubation will
result in a fatal flaw. Following intubation, set the inhalant anesthetic and fresh gas flow
rates; start IV fluids at an appropriate rate. Begin monitoring your dog and record your
findings on the Anesthesia Record. Once you have completed all of these tasks, you
should notify the [examiner, technician or surgery candidate/examinee] that the
surgery candidate may begin the preparation for surgery, and this will signify the end of
the 100-minute time limit.

Maintain your dog at an appropriate plane of anesthesia and ensure that they are not
physically compromised. All required monitoring equipment (ECG leads, blood pressure
monitor, pulse oximeter, thermometer, and capnograph) should be placed as soon as
possible with attention to avoiding contamination of the surgical site. The equipment
should be working correctly and accurately. Notify the examiner if you believe
something is not functioning correctly so that the problem can be fixed. If you believe
that a piece of equipment did not work correctly and adversely impacted your assessment,
you must report the problem by filling out the Anesthesia equipment incident report at the
end of your exam. Monitor your dog throughout the surgical procedure, using both
monitoring equipment and physical parameters to maintain your dog at an appropriate
plane of anesthesia. Record your findings in a timely manner on your Anesthesia Record.
Failure to do so will result in a scoring penalty. Adjust the plane of anesthesia as
necessary and correct any physical abnormalities detected in your patient (e.g., low blood
pressure, low respiratory rate, low body temperature).

This section of the CPE will be finished when the last skin suture has been placed or the
surgery candidate’s allotted time has expired. Ensure your name/candidate ID is written
on all pages and sign the form on the final page when you have completed the
examination.

Remember that you must complete all necessary skills as spelled out in the Manual of
Administration from the preanesthetic examination to initiation of inhalant anesthesia and
patient monitoring within 100 minutes or prior to calling for the surgeon. A hard copy of
this standard script will be located [sites to indicate where] for you to reference as
needed during this section of the exam.

Assessment Sheet for Anesthesia (AN01)—Please see Assessment Sheet AN01 on the
following pages. Note: a FAILING evaluation for anyone (1) MAJOR skill or any combination of
four (4) MINOR skills will result in a FAILURE for the Anesthesia Section. A candidate that
commits a fatal flaw may be dismissed from the section and will also receive a FAILURE for the
Anesthesia Section.

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 Anesthesia

MASTER ASSESSMENT SHEET (PAGE 1)

ACTIVITY/SKILL CANDIDATE SCORE
Candidate is assessed on ability to correctly and
efficiently: Note: a FAILING evaluation for anyone (1) MAJOR skill
or any combination of four (4) MINOR skills will result in
a FAILURE for the Anesthesia Section. Candidates
committing a fatal flaw (see below & Appendix 1 in this
section of the MOA) will be immediately dismissed from,
and will receive a failing score for, this section of the
CPE.
Select appropriate premedication, induction, MINOR SKILL
maintenance, and pain management drugs and
write rationale for choosing drugs

Calculate the correct volume of drug(s) selected MAJOR SKILL

EXAMPLES OF FATAL FLAWS FOR THIS SKILL INCLUDE:

FATAL FLAW if candidate calculates a potentially
harmful overdose and does not correct it prior to
attempting to administer the drug. NOTE:
examiners/technicians must not allow a candidate to
administer a potentially harmful overdose of any drug.

Perform and record results of a preoperative MINOR SKILL

examination on a patient presented for elective
ovariohysterectomy

Request, record, and interpret results of minimum MINOR SKILL

required laboratory tests

Assign an appropriate preanesthetic physical status MINOR SKILL

to patient

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AN01 ASSESSMENT, Anesthetic Skills Anesthesia
Candidate Name/ID:
Date/Session/Site: Examiner:

ACTIVITY/SKILL CANDIDATE SCORE

Candidate is assessed on ability to correctly and
efficiently:
Administer premedication via intramuscular or MAJOR/MINOR SKILL
subcutaneous injection in a manner that is safe for the
patient and personnel, and that allows for actual
delivery of the drug to the patient • MINOR SKILL FAILURE if candidate administers a
dose above or below the appropriate range for
the animal but not likely to have serious
detrimental physiologic effects, or if candidate
injects premedication at a site or in a manner that
is inappropriate but unlikely to cause major harm
to the animal
• MAJOR SKILL FAILURE if candidate administers
an inappropriately high dose that would have
significant, but non-lethal, detrimental
physiologic effects.
• MINOR OR MAJOR SKILL FAILURE if candidate
injects, or attempts to inject, premedication in the
vicinity of a structure that might be damaged by
the injection (i.e., sciatic nerve, stifle joint).
• EXAMPLES OF FATAL FLAW INCLUDE if
candidate intends to administer a potentially
harmful overdose of any drug, candidate
administers premedications before examining the
patient.

Calculate appropriate fresh gas flow rates and explain MAJOR/MINOR SKILL
rationale for selecting a given rate for the breathing
system selected • MINOR SKILL FAILURE if candidate calculates
fresh gas flow too high.
MAJOR SKILL FAILURE if candidate calculates fresh
gas flow is too low.

Select appropriate breathing system and reservoir bag MINOR SKILL

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AN01 ASSESSMENT, Anesthetic Skills Anesthesia
Candidate Name/ID:
Date/Session/Site: Examiner:

ACTIVITY/SKILL CANDIDATE SCORE

Candidate is assessed on ability to correctly and
efficiently:
Assemble the anesthetic machine, connect and/or MAJOR SKILL
open oxygen supply, and breathing system

Explain assembly of anesthetic machine and MINOR SKILL

breathing system

Test anesthetic machine circuit for leaks

MAJOR/MINOR SKILL

• MINOR SKILL FAILURE .

MAJOR SKILL FAILURE

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AN01 ASSESSMENT, Anesthetic Skills Anesthesia
Candidate Name/ID:
Date/Session/Site: Examiner:

ACTIVITY/SKILL CANDIDATE SCORE

Candidate is assessed on ability to correctly and
efficiently:
Place and secure an IV catheter PLACE IV CATHETER
MAJOR/MINOR SKILL, WITH SCORE IMPACTED AS
Note: If either of the two scenarios below should INDICATED BELOW.
occur, the examiner or technician will place and
secure a new IV catheter and the time required to do
so will not count against the 100-minute time limit. • ONE MINOR SKILL FAILURES if candidate is unable to
1. If the candidate is unable to place the IV place the IV catheter in three attempts because of a
catheter in three attempts patient factor (e.g., dog is unruly or hypotensive).
2. If a correctly placed catheter becomes dislodged • TWO MINOR SKILL FAILURES if candidate correctly
following placement places the IV catheter in three attempts but it becomes
dislodged thereafter because they did not secure it
appropriately.
• TWO MINOR SKILL FAILURES if candidate is
unable to place the IV catheter in three attempts
because of poor technique or inability to locate an
appropriate vein.
• ONE MINOR SKILL FAILURE if candidate has
minor breaks in asepsis during placement of IV
catheter (e.g., minor touch of catheter hub).
• MAJOR SKILL FAILURE IF CANDIDATE DECLINES
ATTEMPTS AT CATHETER PLACEMENT
• EXAMPLES OF FATAL FLAW INCLUDE:
if candidate attempts to place or places the
catheter in a non-aseptic manner or commits gross
breaks in asepsis (e.g., placing opened catheter on
table)
IV FLUIDS
Set up and administer IV fluids MINOR SKILL OR FATAL FLAW, WITH SCORE
IMPACTED AS INDICATED BELOW.

• MINOR SKILL FAILURE if candidate does not connect

and administer IV fluids in an aseptic manner
• MINOR SKILL FAILURE if candidate sets an incorrect
fluid rate and animal’s health/life is not significantly
affected.
• FATAL FLAW if candidate sets an incorrect fluid rate
or fails to recognize that fluid administration has been
compromised and correct the error AND animal’s
health/life is significantly and negatively affected.

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AN01 ASSESSMENT, Anesthetic Skills Anesthesia
Candidate Name/ID:
Date/Session/Site: Examiner:

ACTIVITY/SKILL CANDIDATE SCORE

Candidate is assessed on ability to correctly and
efficiently:
Induce and intubate patient MINOR SKILL OR FATAL FLAW

• MINOR SKILL FAILURE if candidate fails to assess

catheter placement prior to injection of induction
agent.
EXAMPLES OF FATAL FLAW INCLUDES:
• FATAL FLAW if candidate intends to administer a
potentially harmful overdose of any drug.
• FATAL FLAW if candidate makes repeated
unsuccessful attempts at intubation in an
insufficiently anesthetized dog (i.e., a dog with
active laryngeal reflexes). Candidate will be
required to complete the following within 5 minutes
of initiation of administration of induction agent:
intubate the patient, assess that the tube is placed
correctly, appropriately inflate cuff, secure
endotracheal tube, and connect patient to the
anesthetic machine; failure to complete all those
tasks within the 5-minute limit is a fatal flaw.
• FATAL FLAW if candidate does not appropriately
intubate dog (e.g., tube too small or too large; cuff
not inflated appropriately (i.e., cuff does not prevent
leak up to 20 cm H2O); tube not secured
appropriately).
• FATAL FLAW if candidate fails to recognize
endotracheal tube is placed incorrectly and dog is
either not receiving gas because tube is in
esophagus; dog is being injured, in the examiner’s
opinion, because of excessive inflation of the cuff or
tube grossly too large; gas is being released because
tube is grossly too small, or cuff not inflated; or tube
dislodges because it was not secured appropriately.

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AN01 ASSESSMENT, Anesthetic Skills Anesthesia
Candidate Name/ID:
Date/Session/Site: Examiner:

ACTIVITY/SKILL CANDIDATE SCORE

Candidate is assessed on ability to correctly and
efficiently:
Set the anesthetic machine appropriately and assess FATAL FLAW
patient status within 3 minutes of intubation.
EXAMPLES OF FATAL FLAWS FOR THIS SKILL INCLUDE:
• FATAL FLAW if candidate leaves pop-off valve closed
until pop-off valve pressure reads 25 cm H2O.
• FATAL FLAW if candidate sets flow of oxygen at an
insufficient level such that dog either wakes up or
becomes apparently hypoxic.
• FATAL FLAW if candidate sets volatile anesthetic
agent flow rate too high for too long leading to loss
of peripheral pulses or prolonged (> 3 min) apnea.
• FATAL FLAW IF CANDIDATE FAILS TO ASSESS PULSE
AND RESPIRATION WITHIN 3 MINUTES OF
INTUBATION
• FATAL FLAW if candidate fails to recognize
prolonged (> 3 min) apnea.

Overall efficiency of anesthetic procedure FATAL FLAW

EXAMPLES OF FATAL FLAWS FOR THIS SKILL INCLUDE:

FATAL FLAW if candidate fails to have the dog ready
for the surgery candidate in the one-hundred-minute
time limit (“ready for surgery candidate” means all
tasks outlined in the MOA are complete and the dog is
intubated and anesthetized with IV fluids in place and
operational/running).

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AN01 ASSESSMENT, Anesthetic Skills Anesthesia
Candidate Name/ID:
Date/Session/Site: Examiner:

ACTIVITY/SKILL CANDIDATE SCORE

Candidate is assessed on ability to correctly and
efficiently:
Place ECG leads MINOR SKILL

Place/position Doppler or oscillometric blood MINOR SKILL

pressure monitor

Place/position pulse oximeter MINOR SKILL

Place/position capnograph MINOR SKILL

Transfer patient to surgery area MINOR SKILL

FATAL FLAW IF PATIENT WAKES UP DURING TRANSFER

AND CANDIDATE DOES NOT RESPOND APPROPRIATELY

Monitor / assess depth of Anesthesia and adjust MAJOR SKILL

anesthesia as necessary during the surgical
procedure EXAMPLES OF FATAL FLAW INCLUDE:
• Maintaining a volatile anesthetic agent flow rate
at a high level for extended period of time
leading to prolonged hypotension and/or
hypercapnea.

Failure to identify and correct a potentially life-

threatening or inhumane situation (e.g., patient wakes up
during anesthesia section or during the surgical
procedure and candidate does not respond to situation.

Provide adequate analgesia to the patient MAJOR SKILL

throughout the surgical procedure and
immediate post-operative period
Example of fatal flaw includes:
Candidate does not react to clinical signs of pain or
nociception (tachycardia, tachypnea, increase in
blood pressure, etc.) in a timely manner. If
examiner has to add any pain medication for a
humane reason, the candidate should be dismissed
from the exam.

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AN01 ASSESSMENT, Anesthetic Skills Anesthesia
Candidate Name/ID:
Date/Session/Site: Examiner:

ACTIVITY/SKILL CANDIDATE SCORE

Candidate is assessed on ability to correctly and
efficiently:
Monitor/assess and record patient’s cardiovascular MAJOR SKILL
and respiratory status, to include correcting any
significant abnormalities
EXAMPLE OF FATAL FLAW INCLUDES:
Candidate is unable to manage cardiovascular or
respiratory status in a timely fashion such that the
animal’s welfare may be adversely impacted ( e.g.,
Unresolved hypotension, significant arrhythmias,
unresolved hypercapnea)

Answer questions regarding specific values for MINOR SKILL

the patient from anesthetic or monitoring
equipment

Completely and appropriately fill out Anesthesia MINOR SKILL

Record

CANDIDATE IS ALSO ASSESSED ON: CANDIDATE SCORE

Humane handling of patient MAJOR SKILL

EXAMPLE OF FATAL FLAW INCLUDES:

Any act of omission or commission that puts an
animal into an inhumane or life-threatening
situation and the situation is not corrected by the
candidate

Ability to communicate with assistant(s) MINOR SKILL

FINAL ANESTHESIA SECTION SCORE (PASS OR FAIL): A FAILING evaluation for anyone (1) MAJOR
skill or any combination of four (4) MINOR skills will result in a FAILURE for the Anesthesia Section. Candidates
committing a fatal flaw will be immediately dismissed from, and will receive a failing score for, this section.

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AN01 ASSESSMENT, Anesthetic Skills Anesthesia
Candidate Name/ID:
Date/Session/Site: Examiner:

Primary examiner’s name, initials & signature (required on all assessment sheets regardless of
final score):

Name (print): ___________________________________________Initials: ________________

Signature: ______________________________________________

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 Anesthesia
Appendix 1

Anesthesia Appendices

Appendix 1—Fatal Flaw List

These are failing behaviors that potentially put the animal’s life at risk or personnel in
danger. All are behaviors that may require examiner intervention and will result in a failing
grade for the candidate and dismissal from this section of the CPE. The examiner will stop
the Anesthesia Section immediately if any one behavior from the following fatal flaw list is
observed (i.e., recognized by the examiner and confirmed by another examiner or observer):
1. Candidate calculates and intends to administer a potentially lethal overdose of any
drug.
2. Candidate administers premedications before examining the patient.
3. Candidate attempts to place or places the catheter in a non-aseptic manner or
commits gross breaks in asepsis (e.g., placing opened catheter on table)
4. Candidate makes repeated unsuccessful attempts at intubation in an insufficiently
anesthetized dog (i.e., a dog with active laryngeal reflexes). Candidate should be
able to intubate patient within five (5) minutes of initial administration of
induction agent; failure to do so is a fatal flaw.
5. Candidate places the endotracheal tube in the esophagus and fails to correct in a
timely fashion (i.e., before dog wakes or becomes apparently hypoxic).
6. Candidate leaves the pop-off closed until pop-off valve pressure reads 25 cm H2O
7. Candidate sets flow of oxygen at an insufficient level such that dog either
awakens or becomes apparently hypoxic
8. Candidate maintains volatile anesthetic agent flow rate at a high level for
extended period of time leading to loss of peripheral pulses (dorsal pedal or
lingual pulse) or prolonged (> 3 minutes) apnea.
9. Candidate fails to identify and correct a potentially life-threatening or inhumane
situation (e.g., patient wakes up during anesthesia section, transfer to surgery
suite, or during the surgical procedure and candidate does not respond to
situation; candidate does not attempt to correct problems associated with major
hemorrhage/hypovolemia).
10. Candidate fails to have all tasks completed with the dog ready for the surgery
candidate in the one-hundred-minute time limit (“ready for surgery candidate”
means all tasks outlined in the MOA are complete and the dog is intubated and
anesthetized with IV fluids in place and operating/running).
11. Candidate exhibits any other behavior that would put the dog’s life at risk. The
examiner must document the behavior.
12. Candidate fails to correctly assemble anesthetic machine to allow effective and
safe delivery of gas anesthetic.

All fatal flaws MUST be documented on the candidate’s assessment sheet by the examiner and
verified by a secondary examiner/CPE team member.

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 Anesthesia
Appendix 2

Appendix 2—Preanesthetic Physical Status

American Society of Anesthesiologists (ASA) Classification System

• ASA Status 1: Normal, healthy patient
• ASA Status 2: Mild systemic disease, well compensated
• ASA Status 3: Moderate systemic disease that is ongoing but compensated; some
functional limitations exist that increase the risk of anesthesia
• ASA Status 4: Severe systemic disease that is a constant threat to life, uncompensated
disease, high anesthetic risk because vital body systems involved
• ASA Status 5: Moribund patient not expected to live more than 24 hours with or without
surgery

CPE DATE/SESSION/SITE:

CANDIDATE NAME/NUMBER:
DOG ID:

INFORMATION TO BE PROVIDED TO CANDIDATE AT BEGINNING OF EXAM:

Weight of dog:

Approximate age (estimated by examiner/tech):

Pre-existing medication or medical conditions

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 Anesthesia
Appendix 3

Appendix 3—Anesthesia Record (Page 1)

CPE DATE/SESSION/SITE:
CANDIDATE NAME/NUMBER:
DOG ID:

PRE-ANESTHETIC ASSESSMENT (candidate to write findings below unless otherwise noted)

Weight (provided by examiner/tech):

HR: RR: MM color/CRT: Temp:

Other relevant preanesthetic PE findings, if any:

LABORATORY RESULTS:

PCV: TP: BUN:

Other relevant preanesthetic lab results, if any:

PRE-EXSISTING MEDICATION AND MEDICAL CONDITIONS (provided by examiner)

PREANESTHETIC PHYSICAL STATUS (as determined by candidate after completing preanesthetic

examination; circle one): 1 2 3 4 5

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 Anesthesia
Appendix 3

ANESTHESIA RECORD (Page 2)

CPE DATE/SESSION/SITE:

CANDIDATE NAME/NUMBER:

Anesthetic Drug Protocol Plan:

Write drug selections, dose (mg and volume), route of administration, and time administered below;
attach dose calculation scratch sheet as necessary:

Premed(s):
Drug: Concentration: Dose: Volume:
Route:
Drug: Concentration: Dose: Volume:
Route:
Drug: Concentration: Dose: Volume:
Route:
Induction agent(s):
Drug: Concentration: Dose: Volume:
Route:
Drug: Concentration: Dose: Volume:
Route:
Drug: Concentration: Dose: Volume:
Route:
Analgesics:
Drug: Concentration: Dose: Volume:
Route:
Drug: Concentration: Dose: Volume:
Route:
Drug: Concentration: Dose: Volume:
Route:
Intravenous Fluid Therapy:
Name: Rate:

Provide rationale for choosing the specific drugs (above) for your patient:

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 Anesthesia
Appendix 3

ANESTHESIA RECORD (Page 3)

CPE DATE/SESSION/SITE:

CANDIDATE NAME/NUMBER:

Circle appropriate number regarding sedation and induction of your patient, and provide
comments as appropriate:

Scale: 1=very poor; 5= excellent

Sedation quality: 1 2 3 4 5

Induction quality: 1 2 3 4 5

Comments:

Circle inhalant anesthetic agent used:

Isoflurane Sevoflurane

Circle anesthetic machine type used:

Rebreathing Non-rebreathing

Endotracheal tube used (write size):

Fresh gas flow rate used (write rate):

Candidate to complete all appropriate portions of anesthetic chart on next page.

Request additional pages as needed.

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 Anesthesia
Appendix 3

ANESTHESIA RECORD (Page 4)

ANESTHESIA RECORD CPE Site: DATE:
Perioperative Assessment Preanesthetic state Monitoring Candidate Name/Number:
PCV Temp □ anxious □ sedated Body Condition □ ECG □ P Oxi Nerve stimulator
TP P □ calm □ awake Score □ Capno □ peroneal
WBC RR □ uncooperative 1 2 3 4 5 BP: direct indirect □ facial
Gluc CRT IV catheter Location: Physical Status Art cat Location: □ ulnar
Weight MM 1 2 3 4 5 E
Preexisting medication and medical conditions

Relevant blood chemistry results

Premed: Dose: Rte: Time:

Dose: Rte: Time: Sedation: 1 2 3 4 5 EPIDURAL / SPINAL Time:
Induction: Dose: Rte: Time: Induction: 1 2 3 4 5 Local: Dose: mg
Dose: Rte: Time: Recovery: 1 2 3 4 5 Opioid: Dose: mg
□ ISOFLURANE □ SEVOFLURANE □ ET tube size mm ( guarded □ ) Scale 1: very poor 5: excellent Needle: GA L: in

START STOP Bodyposition Regional Anesthesia Attempts: Administrator:

Anesthesia □ Sternal □ Dorsal □ GA Drug: Volume: mLs Totalvolume: mLs
Procedure □ Lateral L R □ TIVA Location: Comments:
O2 Flow (L/min) FLUIDS / BLOOD PRODUCTS TOTAL
N2O (L/min) mL
TV / PIP mL
Temp BLOOD LOSS mL
Palpebral ref (+/-) URINE mL
Eye position (r/c) BREATHING SYSTEM
MONITORING

TOF count □ CIRCLE (S / L) □ BAIN □ T-piece

ET CO2 CPR STATUS □ DNR □ Basic □ Advanced
Pulse Oxi WARMING DEVICES
□ Water blankets □ Bair hugger
Vap Setting (%) □ Hot Dog □ Water bottles
□ Other:
ET Anesthetic REMARKS:
Fluids (mL/h)
CRIs
Time

SYMBOLS 220

•
Pulse 200

○
Respiration 180

○
V
PPV 160
>

SBP 140
−
MBP 120
>

DBP 100
0
Start Surgery 80

End Surgery 60

40

20

Time at :00 = Time of induction

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 Anesthesia
Appendix 3

ANESTHESIA RECORD (Page 5)

CPE DATE/SESSION/SITE:

CANDIDATE NAME/NUMBER:

(candidate to fill out each section below)

Complications noted and how corrected; if no complications noted, state so:

Fluids (write type used, flow rate, and total volume):

Recovery instructions, to include any instructions for use of analgesics:

Candidate Signature:

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 Anesthesia
Appendix 4

Appendix 4—Anesthesia Equipment Incident Report

Anesthesia Equipment Incident Report

Briefly describe any anesthesia equipment related incidents (i.e., malfunction) that occurred that
may have affected the outcome of your examination.

Candidate Notes:

Candidate Number:

Candidate signature, date:

Examiner Notes:

Examiner Name (print): Second Examiner Name:

Examiner signature, date: Second Examiner Signature:

EQUINE PRACTICE

Competencies
The equine portion will assess the candidate's ability to:
• Evaluate a clinical case (Station 1: Clinical Evaluation)
• Perform and/or discuss designated clinical techniques (Station 2: Clinical
Techniques)
• Evaluate lameness (Station 3: Lameness Evaluation)

Time
Maximum time, 2.25 hours (45 minutes per station)

Set-up Information
• Animal Requirements
a. Station 1: Clinical Evaluation: One horse of mild temperament, sedated as
necessary; the horse may or may not have abnormal clinical signs. If a healthy
horse is used, management advice will be sought on three of the following five
scenarios chosen by the examiner:
i. Feeding/housing

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 Equine Practice

ii. Vaccination
iii. Deworming
iv. Dental care
v. Foot care

b. Station 2: Clinical Techniques: One normal horse of mild temperament, sedated

as necessary
c. Station 3: Lameness Evaluation: One horse affected with a common lameness
(e.g., American Association of Equine Practitioners [AAEP] Grade 3/5).
Alternatively, a video of a horse with a lame limb may be used in combination
with a live horse for demonstration of physical examination skills and techniques.
Lameness must be detectable at a trot in a straight line

• People Requirements
a. One veterinary examiner per candidate at each station.
b. One assistant per candidate as needed. Please note: assistant means an unskilled
assistant. Candidate must direct activity of the unskilled assistant. The examiner
may act as an unskilled assistant where appropriate.

• Facilities and Equipment

a. 1 room/area for clinical evaluation station (Station 1)
b. 1 room/area for clinical techniques station (Station 2)
c. 1 area to evaluate a horse’s gait and to perform a lameness examination, or video
monitor to display pre-recorded videos of lame horses + room/area for physical
exam of live horse (Station 3)
d. Timing device visible from each station to track examination time. Whenever
possible, timers will be of the “count-down” variety to allow candidates and
examiners alike to clearly see time remaining in station or section.

• The candidate is expected to have the following supplies:

a. Stethoscope
b. Digital rectal thermometer
c. Penlight
d. Coveralls
e. Safety boots (i.e., appropriate footwear for equine work).

• All other items necessary to complete the exam will be provided by the examining
site, including the following:
a. Halter, lead rope, lead shank, assorted twitches, towels, tape measure.
b. Assortment of needles, syringes, vacutainers, and disinfectants (alcohol,
chlorhexidine, etc), gauze sponges.
c. Assorted dental rasps (floats), assorted mouth gags and speculae, flashlight.
d. Assorted nasogastric tubes, lubricant, bucket, mineral oil, funnel, dose syringe,
stomach pump.
e. Assorted bandages.

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 Equine Practice

f. Injectable saline, assorted sedatives, and dosages (xylazine, acepromazine,

detomidine, romifidine, etc)
g. Rebreathing bag, plexor, pleximeter, ophthalmoscope
h. Hoof pick, left- and right-handed hoof knives, assorted hoof testers

General Requirements of the Candidate

Candidates are expected to handle all animals in a humane and safe manner. If, in the opinion of
the examiner, the candidate does not handle the animal humanely or handles the animal in a
manner that is unsafe to them or other personnel the examiner may assess penalties ranging from
a reduction in score to dismissal of the candidate with a fatal flaw and a score of zero for the
station.

Candidates will not necessarily be informed of a fatal flaw unless their actions comprise an
immediate real threat to the health or safety of a live animal or person. In such instances, the
candidate’s performance will be terminated, and the candidate will be instructed to proceed to
the next skill or activity at that station. If the candidate’s actions constitute a repeated or ongoing
threat to an animals’ or persons’ well-being, the candidate may be dismissed from the station. In
instances where a candidate earns a fatal flaw for a plan or action that would likely cause serious
harm if it were followed but no immediate real threat to a live animal or person exists, the
candidate will be allowed to proceed without being informed of the fatal flaw. A candidate that
has been awarded a fatal flaw at any Station for the reasons described will fail the entire Equine
section but will not be prevented from taking the other stations of the Equine section.

Station One–Clinical Evaluation

Overview of Station One—The examiner will act as a client with an adult horse that is affected
with a condition commonly found in veterinary practice. The candidate should:

• Catch and restrain the horse in a box stall with a halter and lead rope. The examiner or
other assistant may assist the candidate, but the candidate must give specific instructions
for assistance
• question the client/examiner to determine the medical history of the patient
• perform a systematic distance examination and a physical examination
• develop an initial problem list and a differential diagnoses list
• request appropriate and reasonable diagnostic tests
• interpret the results of diagnostic tests
• determine the most likely diagnosis based upon history, physical examination, and
diagnostic test results
• develop a therapeutic and/or management plan specific for the patient and/or the herd
• develop a prognosis for the patient
• identify prevention and control issues
• orally communicate all of the above information to the client/examiner

(Note—See also the EQ01 assessment sheet that follows)

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 Equine Practice

Standard Script for Station One—Prior to beginning this station, the examiner should
read the following script (in quotes) to each candidate. The script may be modified to
meet specific facility or equipment restrictions at each site. Timing of the candidate’s
performance should not begin until all of the instructions have been given. “In this station
you will be the veterinarian called to examine the horse in front of you. I will be acting as
the client. Please obtain a complete history from me. Then, perform a complete physical
examination and explain all normal and abnormal findings to me. If you believe a rectal
examination is indicated, you may request one and I will provide you with any
information obtained from the rectal examination. You may record the history and
physical exam findings yourself, using this sheet but you should discuss your findings
with me as my assessment of your performance will not include what is written on this
form. Based upon the history and physical examination, you should generate a problem
list, create a list of differential diagnoses, and determine the most likely diagnosis. Then,
develop a diagnostic plan. You may request laboratory test results from me, and I will
supply those results if those tests were completed. Develop a complete therapeutic and/or
management plan for this animal (and/or the herd, if relevant) and discuss the plan and
any prevention or control issues with me that you feel are necessary. You may record
your findings and concerns on a sheet provided but the information recorded will be for
your use only. Your performance will be entirely assessed by your oral communication of
your findings and concerns with me (the client). You will have 45 minutes to complete
this station, and you are responsible for monitoring your time remaining.”

Assessment Sheet for Equine Practice—Station One (EQ01)

46
EQ01 ASSESSMENT, Clinical Evaluation Equine Practice
Candidate Name/ID:
Date/Session/Site: Examiner:

MAX CANDIDATE
Activity/Skill
POINTS SCORE
History 20

Restraint and Safety 5

Candidate is scored on ability to halter and restrain a horse, including physical
and/or chemical means if necessary. A candidate may receive assistance by
specifically instructing the client or technician on safe handling techniques.

Physical Examination 33
Candidate is scored on ability to accurately perform:

a. Distance examination
b. Body condition score

c. Objective measurements

d. Head and neck

e. Heart

f. Lungs and trachea

g. Gastrointestinal

h. Musculoskeletal

i. Integument

j. Perineum and external genitalia

k. Physical exam directly related to the presenting complaint

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EQ01 ASSESSMENT, Clinical Evaluation Equine Practice
Candidate Name/ID:
Date/Session/Site: Examiner:

Integration of Clinical Information 15

a. Correctly identify and communicate all problems, based upon history

and physical exam findings

b. Develop and communicate a rational differential diagnoses list based

upon history and physical exam

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EQ01 ASSESSMENT, Clinical Evaluation Equine Practice
Candidate Name/ID:
Date/Session/Site: Examiner:

MAX CANDIDATE
Activity/Skill
POINTS SCORE
Integration of Diagnostic Information 12

a. Develop a diagnostic plan - Order appropriate diagnostic tests and/or

necropsy

b. Interpret laboratory and/or necropsy results - Uses diagnostic test

results to refine the differential diagnoses list and describes how each
test is used to rule in or rule out a diagnosis

c. Arrive at the most likely diagnosis

Develop therapeutic or management plan for individual animal/herd (if 5

appropriate)
a. Developing a therapeutic plan specific for the patient (or herd), to 4
include addressing treatment and appropriate follow-up. The
candidate should also address prevention and control issues.

b. Developing the appropriate prognosis

Communication 10

a. Communicate clearly and effectively using language that might be

readily understood by a client

b. Answer all questions correctly and appropriately

TOTAL POINTS 100

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EQ01 ASSESSMENT, Clinical Evaluation Equine Practice
Candidate Name/ID:
Date/Session/Site: Examiner:

Primary examiner’s name, initials & signature (required on all assessment sheets regardless of
final score):Name (print): ___________________________________________Initials:
____________________

Signature: ______________________________________________.

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 Equine Practice

Station Two–Clinical Techniques

Overview of Station Two— Given a horse of mild temperament, the candidate will be expected
to complete 8 skills commonly utilized in equine practice.

Standard Script for Station Two—Prior to beginning this station, the examiner should read
the following script (in quotes) to each candidate. The script may be modified to meet
specific facility or equipment restrictions at each site. The time should not begin until all of
the instructions have been given. “In this Clinical Techniques Station, you will use this
horse to perform 8 standard equine clinical procedures. You should explain to me what you
are doing as you are demonstrating or performing these clinical techniques. You will have a
total of 45 minutes to complete all skills, so please plan accordingly.”

1. Completely auscultate the cardiorespiratory system, including use of a rebreathing bag.

2. Identify usual IM, IV, and SQ injection sites. Perform an intravenous and intramuscular
injection using injectable saline and discuss acceptable volumes that may be given at
each site of an IM and SQ of injection. Discuss route of injection volume and possible
complications for one of the following drugs to be randomly chosen: xylazine,
phenylbutazone, procaine penicillin, banamine (flunixin meglumine), acepromazine.
3. Discuss preparation for, and performance of, a dental exam in a horse including
estimation of the age of the horse. Discussion and demonstrate rasping (floating) of the
upper cheek teeth, using manual tools.
4. Place a support (aka standing, shipping, or stable) bandage on a forelimb.
5. Discuss how to safely perform a rectal examination and potential complications.
6. Perform a basic ophthalmic examination, including use of a direct scope.
7. Describe how to perform abdominocentesis, including selection of necessary
equipment, gross interpretation of sample, and possible complications.
8. Describe the horse for the purpose of identification for official forms such as equine
infectious anemia (EIA) testing or insurance enrollment

Assessment Sheet for Equine Practice—Station Two (EQ02)

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EQ02 ASSESSMENT, Clinical Techniques Equine Practice
Candidate Name/ID:
Date/Session/Site: Examiner:

MAX CANDIDATE
Activity/Skill
POINTS SCORE
Candidate is scored on ability to correctly and efficiently perform the eight
(8) skills:
i. Completely auscultate the cardiorespiratory system including use of 15
a rebreathing bag

ii. Identify usual IM, IV, and SQ injection sites and: 15

a. Perform an intravenous and intramuscular injection, using
injectable saline; and discuss acceptable volumes that may be
given at each site of an IM and SQ of injection
b. Discuss route of injection and possible complications of one of
the following drugs, (which is randomly selected by the
examiner): xylazine, phenylbutazone, procaine penicillin,
banamine (flunixin meglumine), acepromazine

Fatal Flaw: If a candidate fails to recognize an intracarotid insertion of

needle and attempts to proceed with intracarotid injection, the examiner will
stop the candidate and instruct them to proceed to the next skill.
iii. Discuss preparation for, and performance of, a dental exam in a 11
horse, including, estimation of the age; and discussion and
demonstration of rasping (floating) of upper cheek teeth

11
iv. Place a support (aka standing, shipping, or stable) bandage on a
forelimb

11
v. Discuss how to safely perform a rectal examination and potential
complications

11
vi. Perform a basic ophthalmic examination, including use of a direct
scope, and discuss techniques that might facilitate the exam

11
vii. Describe how to perform abdominocentesis, including selection of
necessary equipment; gross description of sample, and possible
complications
15
viii. Describe horse for the purpose of identification for official forms
such as Equine Infectious Anemia (EIA) testing or insurance
enrollment.

TOTAL POINTS 100

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EQ02 ASSESSMENT, Clinical Techniques Equine Practice
Candidate Name/ID:
Date/Session/Site: Examiner:

Primary examiner’s name, initials & signature (required on all assessment sheets regardless of final
score):
Name (print): ___________________________________________Initials: __________________

Signature: ______________________________________________.

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 Equine Practice

Station Three–Lameness Evaluation

Overview of Station Three—In this station, the candidate will work through a case involving a
lame horse. The candidate should obtain a history from the client/examiner and then observe
video clips of a horse at a walk and trot to determine the lame limb. The candidate will have to
ask what video clips (what gait and from what position) they would like to see, similar to what
they would ask a handler to do with the horse if the horse were being examined live. The
candidate should explain how they determined which limb was affected and discuss appropriate
general principles related to equine lameness (e.g., how to differentiate fore-limb vs hind-limb
lameness and how to determine left vs. right limb).

The candidate will then use a live horse to demonstrate examination of the limb identified as
lame in the video. Such an examination should usually include: characterization of digital pulses,
picking up and cleaning the foot, examination with hoof testers, detailed palpation of the limb,
and manipulation of joints.

The candidate may demonstrate flexion tests on the live horse that they would use to localize the
lameness of the horse in the video and discuss associated principles or should justify why flexion
tests are not appropriate for the case. The examiner will describe the affects of any flexion tests
that the candidate indicates would be appropriate for their video case.

The candidate will not be expected to perform any regional nerve blocks, but they will have to
describe how to perform palmar/plantar digital, abaxial sesamoid, and low and high volar nerve
blocks and associated principles (e.g., landmarks, preparation, technique, desensitized areas, etc),
regardless of the actual lameness in their patient. The candidate will then indicate what nerve
and/or joint block(s) would be appropriate to assist in diagnosing the specific lameness in the
horse they are examining. The examiner will provide the results of the nerve block(s) requested.
If the candidate believes no nerve/joint blocks are required, they should justify that decision.

The candidate will not be expected to perform imaging examinations but should indicate what
diagnostic imaging studies would be appropriate for their video case based upon the leg they
identified as being lame, results of flexion tests (if any), and nerve blocks (if any). If the
candidate believes no imaging is required, they should justify that decision. If the candidate
requests radiographic studies that are appropriate for the case, the examiner will provide either
film or digital images for the candidate to interpret.

The candidate should formulate a conclusion regarding the affected anatomical region leading to
lameness and communicate the source of the lameness to the examiner, and state what the likely
prognosis is for the condition.

During this station, the candidate will also be asked to locate 5 anatomical structures randomly
assigned from the 20 listed on the assessment sheet (EQ03).

Standard Script for Station Three—Prior to beginning this station, the examiner should
read the following script (in quotes) to each candidate. The script may be modified to
meet specific facility or equipment restrictions at each site. The time should not begin

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 Equine Practice

until all of the instructions have been given. “In this station you will be the veterinarian
called to examine a horse for a lameness problem. Video clips will be used for you to
identify which limb is affected, or in the case of bilateral lameness which limb is most
severely affected, and you will then use a live horse to demonstrate the physical exam
you would perform to localize the source of the lameness. I will be acting as the client,
and you should obtain a complete history from me. Our technician can provide
assistance, but ONLY according to your specific instructions.

You will have to specify what gait and direction you would like to see the horse moved in
a video clip just as you would if you were communicating with someone handling a live
horse for you. I will play whatever video clips you request if they are available. You will
need to correctly identify the lame limb of the horse observed in the video clips and
explain on what basis you made that conclusion (e.g., how to identify fore-vs. hind limb
lameness; how to differentiate left vs. right limb lameness; etc). Once you identify the
lame limb of the horse in the video, you will use this horse in front of you to demonstrate
the systematic examination of that limb to localize the lameness. You should also specify,
as well as demonstrate, any flexion tests of that lame limb that you think are indicated, or,
if you believe no flexion tests are necessary to localize the lameness, you should justify
why a flexion test is not appropriate. I will tell you the effect of any flexion tests that you
state are indicated.

You will not be required to perform regional anesthesia. However, you will need to
describe how to perform palmar/plantar digital, abaxial sesamoid, low volar, and high
volar nerve blocks, and discuss the associated principles (e.g., landmarks, preparation,
technique, desensitized areas, etc). You will then recommend to me what specific nerve
and/or joint block(s) are needed to assist in the /localization of the lameness in the horse
you are examining. Or, if you believe no nerve and/or joint blocks are required to
diagnose/localize the lameness, you should justify that decision. Results of the nerve and
joint blocks that you request for your specific patient will be provided to you.

You should then recommend what types of imaging studies are appropriate to diagnose
the lameness. Or, if you believe no imaging is required, you should justify that decision.
Results of radiographic studies that you request and that have been completed will be
provided to you.

After your examination is complete, you should communicate the source of the
lameness—that is the affected anatomical region—and the short- and long-term
prognoses for return of this horse to its intended use to me. You have 45 minutes to
complete this station. Once you have completed the lameness exam, I will ask you to
identify 5 randomly chosen anatomic structures.”

Assessment Sheet for Equine Practice—Station Three (EQ03)

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EQ03 ASSESSMENT, Lameness Evaluation Equine Practice
Candidate Name/ID:
Date/Session/Site: Examiner:

MAX CANDIDATE
Activity/Skill
POINTS SCORE
History
Candidate is assessed on ability to elicit following from client 5
(examiner):
Initial Characterization of Lameness Based on Walk/Trot of Horse in
35
Video Clips:
Candidate is assessed on ability to:
a. Identify the lame limb and explain reasons for diagnosing the
lameness in a specific limb in the patient provided. Points are only
awarded when the candidate correctly identifies the lame leg.
b. Describe how you used head or hip position to determine which limb
was affected
c. Describe normal/abnormal parts of stride (landing, length, sound,
symmetry) to determine which limb was affected
Lameness Examination
50
Candidate is assessed on ability to perform the following items:
a. Characterization of digital pulses
b. Picking up, examining the foot, and applying hoof testers
c. Detailed palpation of the limb for identification of effusions and
swellings, heat and pain
d. Manipulation of joints
e. Demonstrate flexion test(s) appropriate for the lameness presented
(examiners provide results of each flexion test requested for case
presented)
f. Describing how to do palmar/plantar digital, abaxial sesamoid, and
low and high volar nerve blocks, to include at minimum
identification of landmarks used to identify the injection site, how to
prepare the site, injection technique, appropriate drugs, and area
desensitized by each nerve block). Examiners provide results of
each nerve block for case presented.
g. Requesting appropriate imaging studies, or justification for not
requesting/performing any imaging
h. Identification of correct affected anatomical region based on results
of all examinations and tests conducted

i. Communicating recommended management & treatment of the

horse based upon the diagnosis and short and long-term prognosis
for return to intended use.

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EQ03 ASSESSMENT, Lameness Evaluation Equine Practice
Candidate Name/ID:
Date/Session/Site: Examiner:

MAX CANDIDATE
Activity/Skill
POINTS SCORE
Palpation
Candidate is assessed on ability to correctly identify five of the following 20
structures randomly selected by the examiner. Examiner must circle the
structures selected for each candidate. Candidate will be awarded a 10
maximum of three points for each structure correctly identified. (Note: limb
structures do not need to be identified on the lame leg; they can be identified
on any limb or on the limb indicated by the examiner)
a. Cannon bone (MC III)
b. Splint bones (MC II and MC IV)
c. Fetlock joint pouches (metacarpal-phalangeal joint)
d. Suspensory ligament
e. Superficial digital flexor/deep digital flexor tendon
f. Central sulcus of the frog
g. Scapulohumeral joint
h. Accessory carpal bone
i. Olecranon
j. Calcaneus
k. Patella
l. Medial patellar ligament
m. Coxofemoral joint
n. Greater trochanter
o. Carpus or tarsus
p. Tuber ischii
q. Tuber sacrale
r. Tuber coxae
s. Withers
t. Semitendinosus/semimembranosus muscles

TOTAL POINTS 100

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EQ03 ASSESSMENT, Lameness Evaluation Equine Practice
Candidate Name/ID:
Date/Session/Site: Examiner:

Primary examiner’s name, initials & signature (required on all assessment sheets regardless of
final score):

Name (print): ___________________________________________Initials: _________________

Signature: ______________________________________________

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 Equine Practice

Equine Practice Summary Score Sheet

Please see table below. This is the final summary score sheet.

EQ04 SCORE SHEET (Equine Practice Summary and Final Score Sheet)
Candidate ID: Date:

Raw Weighting Weighted

points points
awarded awarded

STATION 1; Clinical Evaluation, EQ01 40%

STATION 2; Clinical Techniques, EQ02 25%

STATION 3; Lameness Evaluation, EQ03 35%

FINAL SCORE (60 weighted points required to pass) 100%

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 Equine Practice
Appendix 1

Equine Practice Appendices

Appendix 1—Blank Page for Candidate Notes

Candidate Notes—Station 1—Equine Practice

This form is provided for candidates to use as they choose but information recorded on this sheet
is not used in the assessment of the candidate’s performance.

Candidate Name/Number

Date/Session (AM/PM)

CPE site

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 Food Animal Practice

FOOD ANIMAL PRACTICE

Competencies
The food animal practice portion will assess the candidate's ability to:
• Evaluate an adult bovine (> 6 months of age) clinical case, including evaluation of herd
health and regulatory issues (Station 1: clinical case, bovine station)
• Evaluate a bovine calf (< 6 months of age) or a caprine or ovine clinical case, including
evaluation of herd health and regulatory issues (Station 2: clinical case, other food animal
station)
• Perform designated clinical skill procedures (Station 3: clinical procedures station)
• Perform bovine reproductive procedures (Station 4: bovine theriogenology and public
health, food safety, and regulatory issues station)
• List drugs prohibited for extra-label use in food animals in the United States or Canada
(Station 4: bovine theriogenology and public health, food safety, and regulatory issues
station)

Time
Maximum time, 3 hours (break down of time given below; candidates will NOT be allowed
additional time for any station)
1. Clinical case, bovine station: 45 minutes maximum
2. Clinical case, other food animal station: 45 minutes maximum
3. Clinical procedures station: 2 areas; total time: 45 minutes maximum
4. Bovine theriogenology and public health, food safety, and regulatory issues station: 3
areas; total time for Area A: 10 minutes maximum (3 minutes for rectal palpation): total
time for Areas B and C combined: 35 minutes maximum

Set-up Information
1. Animal Requirements
a. Case stations
i. Station 1—One bovine animal > 6 months of age.
ii. Station 2—One bovine animal < 6 months of age OR one ovine OR one caprine
animal.
b. Procedures station
i. Station 3—One lactating cow.
c. Bovine theriogenology and public health, food safety, and regulatory issues station
i. Station 4, Part A—One sexually mature cow.

2. People Requirements
a. Clinical case, bovine station (Station 1): One veterinary examiner per candidate (45
minutes).
b. Clinical case, other food animal station (Station 2): One veterinary examiner per
candidate (45 minutes).
c. Clinical procedures station (Station 3): One veterinary examiner per candidate (45
minutes).
d. Bovine theriogenology and public health, food safety, and regulatory issues station
(Station 4): One veterinary examiner per candidate (45 minutes).

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 Food Animal Practice

3. Facilities and Equipment

a. 2 rooms/areas for restraining food animals (case presentations; Stations 1 and 2)
b. 1 room/area for restraining a bovine animal (procedures station; Station 3)
c. 1 room/area for restraining a bovine animal, placing an obstetric box, and writing a
brief list (bovine theriogenology and public health, food safety, and regulatory issues
station; Station 4)
d. Timing device visible from each station to track examination time. Whenever
possible, timers will be of the “count-down” variety to allow candidates and
examiners alike to clearly see time remaining in station or section.

4. Supplies/Information Provided by The Examiner

a. Bucket, water, towels, halter, mouth gag, nose tongs, stomach tube
b. Speculum, lubricant, container for ruminal fluid
c. Milk sample collection vials (for bacterial culture), milk sample
d. CMT (California Mastitis Test) paddle solution/reagent, assorted vacutainers
e. Container for urine sample, urine test sticks, product information and references,
clipboard
f. Rectal gloves and other gloves, standard bovine obstetrical equipment

5. Supplies Provided by The Candidate

a. Stethoscope, digital thermometer, and penlight
b. Coveralls and disinfectable footwear

General Requirements of the Candidate

Candidates are expected to handle all animals in a humane and safe manner. If, in the opinion of
the examiner, the candidate does not handle the animal humanely or handles the animal in a
manner that is unsafe to them or other personnel the examiner may assess penalties ranging from
a reduction in score to termination of the exam and dismissal of the candidate with a failing
score.

Candidates will not necessarily be informed of a fatal flaw unless their actions comprise an
immediate real threat to the health or safety of a live animal or person. In such instances, the
candidate’s performance will be terminated, and the candidate will be instructed to proceed to
the next skill or activity at that station. If the candidate’s actions constitute a repeated or ongoing
threat to an animals’ or persons’ well-being, the candidate may be dismissed from the station. In
instances where a candidate earns a fatal flaw for a plan or action that would likely cause serious
harm if it were followed but no immediate real threat to a live animal or person exists, the
candidate will be allowed to proceed without being informed of the fatal flaw. A candidate that
has been awarded a fatal flaw at any Station for the reasons described in the previous paragraphs
will fail the entire FAP section but will not be prevented from taking the other stations in the
FAP section.

Station One–Clinical Case, Bovine

Overview of Station One—The examiner will act as a client with an adult cow (> 6 mo. of age)
that is affected with a condition commonly found in veterinary practice. The candidate should:
• question the client/examiner to determine the medical history of the patient

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 Food Animal Practice

• perform a systematic distance examination and a physical examination

• develop an initial problem list and a differential diagnoses list
• request appropriate and reasonable initial diagnostic tests
• interpret the results of diagnostic tests
• determine the most likely diagnosis
• develop a therapeutic and control plans specific for the patient and/or the herd
• develop a prognosis for the patient
• identify and regulatory and public health implications
• orally communicate all of the above information to the client/examiner.

The candidate may request appropriate diagnostic tests from the examiner in conjunction with
the above case. The examiner will provide results (with normal values) of only those tests
completed.

Standard Script for Station One—Prior to beginning this station, the examiner should read the
following script (in quotes) to each candidate. The script may be modified to meet specific
facility or equipment restrictions at each site. The time should not begin until all of the
instructions have been given. “In this station you will be the veterinarian called to examine the
cow in front of you. I will be acting as the client. Please obtain a complete history from me. Then
perform a complete physical examination and describe abnormal and normal findings to me. If
you believe a rectal examination is indicated, you may request it and I will provide you with the
findings obtained from the rectal examination. You may record the history and physical exam
findings yourself, using this form [examiner: please refer to Appendix 1], but you should
discuss your findings with me as well. Then, based upon the history and physical examination,
you should generate a problem list, and create a list of differential diagnoses. Then, develop a
diagnostic plan. You may request appropriate diagnostic tests, as long as I, the client, agree to
spend the money for those tests. I will supply the results of only those laboratory tests that were
completed. At that point, you should communicate the most likely diagnosis to me. Develop a
complete therapeutic and management plan for this animal and/or the herd and discuss any
public health issues or regulatory concerns that you feel are necessary. Again, you may record
your findings and concerns on the form provided [examiner: please refer to Appendix 1] but
you must communicate those to me as we will not be grading anything written on that form them
to me. You will have 45 minutes to complete this station, and you are responsible for monitoring
your time remaining.” Assessment Sheet for Food Animal Practice—Station One (FAP01)

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FAP01 ASSESSMENT, Clinical Case, Adult Bovine Food Animal Practice
Candidate Name/ID:
Date/Session/Site: Examiner:

MAX CANDIDATE
Activity/Skill
POINTS SCORE
History: 15

Physical Examination:
25
a. Accurately perform a distance examination, to include body condition score
(Scale of 1–5, with 1 being very thin). Candidates should communicate
normal and abnormal findings to the examiner.

b. Accurately perform a complete physical examination. Candidates should

communicate normal and abnormal findings to the examiner.

c. Accurately interpret results of rectal examination, if appropriate

Note: discussion only with the examiner, rectal examination NOT performed by
candidate.

Integration of Clinical Information:

10
a. Correctly identify and communicate all problems, based on history and
physical examination

b. Develop and communicate rational differential diagnoses list based on

history and physical examination

Developing a Diagnostic Plan:

Note: The candidate will be assessed on the development of a diagnostic plan 10
towards differential diagnoses that are appropriate for the case.

a. Order appropriate diagnostic test and/or necropsy

Integration of Diagnostic Information:

15
a. Interpretation of test results

b. Use test results to appropriately rule in and rule out differential diagnoses

c. Arrive at the most likely diagnosis

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 FAP01 ASSESSMENT, Clinical Case, Adult Bovine Food Animal Practice
Candidate Name/ID:
Date/Session/Site: Examiner:

MAX CANDIDATE
Activity/Skill
POINTS SCORE
Therapeutic and Management Plan : 20
Note: The candidate will be assessed on the development and communication of a
therapeutic and management plan towards the most likely diagnosis appropriate for
the case. No points will be awarded for a therapeutic plan based on an incorrect
diagnosis.

a. Develop a correct therapeutic/management plan for individual animal

(and/or herd, if indicated)
b. Develop an appropriate prognosis
c. Competently discuss prevention and control issues
d. Competently discuss regulatory issues (e.g., notifying state/federal health
officials of reportable disease); public health issues (e.g., zoonotic
potential); food safety/slaughter for food issues (e.g., withdrawal times)
Communication:
5
Candidate is assessed based upon their ability to:
a. Communicate clearly and effectively using language that might be readily
understood by a client

b. Answer all questions correctly and appropriately

TOTAL POINTS 100

Primary examiner’s name, initials & signature (required on all assessment sheets regardless of final
score):

Name (print): ___________________________________________Initials: ___________________

Signature: ______________________________________________.

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 Food Animal Practice

Station Two—Clinical Case, Other Food Animal

Overview of Station Two—The examiner will act as a client with a calf or goat or sheep that is
affected with a condition commonly found in veterinary practice. The candidate should:
• question the client/examiner to determine the medical history of the patient
• perform a systematic distance examination and a physical examination
• develop an initial problem list and a differential diagnoses list
• request appropriate and reasonable initial diagnostic tests
• interpret the results of diagnostic tests
• determine the most likely diagnosis
• develop a therapeutic and control plans specific for the patient and/or the herd
• develop a prognosis for the patient
• identify and regulatory and public health implications
• orally communicate all of the above information to the client/examiner

When required and requested by the candidate, standard laboratory data for appropriate
diagnostic tests will be provided in written form with normal values.

(Note—See also example FAP02 assessment sheet on the following pages)

Standard Script for Station Two—Prior to beginning this station, the examiner should read the
following script (in quotes) to each candidate. The script may be modified to meet specific
facility or equipment restrictions at each site. The time should not begin until all of the
instructions have been given. “In this station, you will be the veterinarian called to examine the
animal in front of you. I will be acting as the client. Please obtain a complete history from me.
Then, perform a complete physical examination and describe abnormal and normal findings to
me. You may record your findings using this form [examiner: please refer to Appendix 1], but
you should discuss your findings with me as well. Then, based upon the history and physical
exam, you should generate a problem list, create a list of differential diagnoses, and select the
most likely diagnosis. Then, develop a diagnostic plan. You may request pertinent laboratory
data from me, as long as I, the client, agree to spend the money for those laboratory tests. You
will be supplied results of only those laboratory tests that were completed. Develop a therapeutic
and management plan for this animal and/or the herd and discuss any public health issues or
regulatory concerns that you feel are necessary. Again, you may record your findings and
concerns on the form provided [examiner: please refer to Appendix 1] but make sure to
communicate them to me as we will not use anything written on this page as part of your grade.
You will have 45 minutes to complete this station, and you are responsible for monitoring your
time remaining.” Assessment Sheet for Food Animal Practice—Station 2 (FAP02)

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FAP02 ASSESSMENT, Clinical Case, Other Food Animal Food Animal Practice
Candidate Name/ID:
Date/Session/Site: Examiner:

MAX CANDIDATE
Activity/Skill
POINTS SCORE
History:
15

Physical Examination:
25
a. Accurately perform a distance examination. Candidates should
communicate normal and abnormal findings to the examiner.

b. Accurately assign a body condition score (scale of 1-5, with 1 indicating

very thin).
c. Accurately perform a complete physical examination. Candidates should
communicate normal and abnormal findings to the examiner.
Integration of Clinical Information:
10
a. Correctly identify and communicate all problems, based on history and
physical examination

b. Develop and communicate a rational differential diagnoses list based on

history and physical examination

Developing a Diagnostic Plan: 10

Note: The candidate will be assessed on the development of a diagnostic plan
towards differential diagnoses that are appropriate for the case.

a. Order appropriate diagnostic test and/or necropsy

Integration of Diagnostic Information:

15
a. Interpretation of test results

b. Use test results to appropriately rule in and rule out differential diagnoses

c. Arrive at the most likely diagnosis

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FAP02 ASSESSMENT, Clinical Case, Other Food Animal Food Animal Practice
Candidate Name/ID:
Date/Session/Site: Examiner:

MAX CANDIDATE
Activity/Skill
POINTS SCORE
Therapeutic and Management Plan: 20
Note: The candidate will be assessed on the development and communication of a
therapeutic and management plan towards the most likely diagnosis appropriate for
the case. No points will be awarded for a therapeutic plan based on an incorrect
diagnosis.

a. Develop a correct therapeutic/management plan for individual animal

(and/or herd, if indicated)
b. Develop an appropriate prognosis
c. Competently discuss prevention and control issues
d. Competently discuss regulatory issues (e.g., notifying state/federal health
officials of reportable disease); public health issues (e.g., zoonotic
potential); food safety/slaughter for food issues (e.g., withdrawal times)

Communication:
5
Candidate is assessed based upon their ability to:
a. Communicate clearly and effectively using language that might be readily
understood by a client

b. Answer all questions correctly and appropriately

TOTAL POINTS 100

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FAP02 ASSESSMENT, Clinical Case, Other Food Animal Food Animal Practice
Candidate Name/ID:
Date/Session/Site: Examiner:

Primary examiner’s name, initials & signature (required on all assessment sheets regardless of
final score):
Name (print): ___________________________________________Initials: ________________

Signature: ______________________________________________.

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 Food Animal Practice

Station Three—Clinical Procedures

Overview of Station Three—

Part A: The candidate will perform the following procedures in order on a lactating cow:

1. Obtain a milk sample from each quarter, perform a California Mastitis Test (CMT) on the
samples, and interpret the test results.
2. Prepare the udder and obtain a milk sample for bacterial culture; interpret bacterial
culture results provided and communicate a therapeutic/management plan for the
dairyman based upon the culture results.
3. Place a halter on the cow and restrain the cow in a manner that would allow procedures to
be performed safely on the head or neck.

(Note—See also example FAP03 assessment sheet on the following pages)

Part B: The candidate will perform a total of five (5) procedures from the following list on an
adult cow. One (1) of those procedures will be randomly chosen from skills 1-2, one (1) of those
procedures will be randomly chosen from skills 3-4, and three (3) of those procedures will be
randomly chosen from skills 5-13.

1. Place a mouth gag and perform an examination of the oral cavity.

2. Pass a stomach tube, ensure it is placed correctly, and collect rumen fluid.
3. Select an appropriate vacutainer for a specified laboratory test and collect a blood sample
by coccygeal venipuncture.
4. Manually collect urine sample, describe the sample, perform a gross assessment and a
dipstick test, and interpret the results. Discuss the limitations of dipstick test.
5. Percuss and auscultate a cow to determine the presence of absence of a rumen gas cap,
left displaced abomasum, pneumoperitoneum, pneumocolon, and right displaced
abomasum. Discuss how these conditions are differentiated from each other.
6. Describe how to place and secure an intravenous catheter into the jugular vein for long-
term use. Candidate should select all materials and equipment; identify the landmarks/site
of catheterization; prepare the site of catheterization; describe the position and placement
of the catheter and describe how the catheter would be secured.
7. Describe how to perform a caudal epidural injection. Candidate should select all
materials and equipment; draw up the correct amount of local anesthetic; identify the
landmarks/site of injection; prepare the site of injection; and describe the position and
placement of the needle.
8. Describe how to restrain and examine a hind foot for suspected foot lameness.
9. Perform a speculum examination of the cervix.
10. Describe in detail how and where to inject 30ml of an antibiotic solution for both
subcutaneous and intramuscular routes.
11. Describe how to perform a cornual nerve block. Candidate should select all materials and
equipment; draw up the correct amount of local anesthetic; identify the landmarks/site of
injection; prepare the site of injection; and describe the position and placement of the
needle.

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12. Describe how to perform paravertebral anesthesia. Candidate should select all materials
and equipment; draw up the correct amount of local anesthetic; identify the
landmarks/sites of injection; prepare the site of injection; and describe the position and
placement of the needle.
13. Administer oral medication to the cow.

Standard Script for Station Three—Prior to beginning this station, the examiner should read
the following script (in quotes) to each candidate. The time should not begin until all of the
instructions have been given. “In front of you is a mature, lactating dairy cow that will be
used for both Part A and Part B of this Procedures Station. In Part A, you need to complete
the following 3 skills in order listed:
.
1) Obtain a milk sample from each quarter, perform a California Mastitis Test on the
samples, and interpret the test results.
2) Obtain a milk sample for bacterial culture. I will then provide bacterial culture results.
Based on your interpretation of the results, you will have to communicate a
therapeutic and management plan for the dairyman.
3) Place a halter on the cow and restrain her in a manner that would allow procedures to
be performed on the head and neck.

A list of these skills will be available for you to refer to as you proceed through this station.”

“In Part B, I would like you to perform 5 procedures printed on these index cards for your
reference.” “As you perform all of these skills, you must explain to me what you are doing.
You will have 45 minutes to complete both Part A and Part B, so plan accordingly. In front
of you is a clock [and/or timer] for your use to manage your own time.”

Assessment Sheet for Food Animal Practice—Station 3 (FAP03)

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FAP03 ASSESSMENT, Clinical Procedures Food Animal Practice
Candidate Name/ID:
Date/Session/Site: Examiner:

MAX CANDIDATE
Activity/Skill
POINTS SCORE
PART A
Candidate is scored on ability to correctly and efficiently: 35

a. Obtain a milk sample from each quarter, perform a California Mastitis

Test (CMT) on the samples, and interpret the test results.

b. Prepare the udder and obtain a milk sample for bacterial culture;
interpret bacterial culture results provided and communicate a
therapeutic/management plan for the dairyman based upon the culture
results.

c. Place a halter on the cow and restrain the cow in a manner that would
allow procedures to be performed safely on the head and neck

PART B
Candidate is scored on ability to perform correctly and efficiently 5 of the 65
following 13 skills:
NOTE: Candidates will perform one skill chosen from skills 1-2and one skill
from 3-4. Three skills will be chosen from 5-13.
i. Place a mouth gag and perform an examination of the oral cavity
(w/ or w/out gag) visual assessment & discussion of lesions
present (if any)
ii. Pass a stomach tube , ensure it is placed correctly via 1 acceptable
method , extraction of tube discuss collected rumen fluid
iii. Select an appropriate vacutainer for a specified laboratory test and
collect a blood sample by coccygeal venipuncture
a.
iv. Manually collect urine sample. Describe the sample, perform a
dipstick test, and interpret the result. Discuss the limitations of the
dipstick test.
Note: Points will not be deducted if use of correct procedure does not
yield a urine sample; examiner to supply urine sample in this case.

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FAP03 ASSESSMENT, Clinical Procedures Food Animal Practice
Candidate Name/ID:
Date/Session/Site: Examiner:

MAX CANDIDATE
Activity/Skill
POINTS SCORE
PART B (continued)
NOTE: Candidates will perform 3 skills to be chosen from v – xiii
v. Percuss and auscultate this cow to determine the presence or
absence of each of the following: LDA, rumen gas cap,
pneumoperitoneum, pneumocolon, and RDA. Discuss how to
differentiate between the above conditions

vi. Select an appropriate catheter for use long-term use in the jugular
vein; describe how to place, secure, and maintain the catheter.

vii. Describe how to perform a caudal epidural injection for the

purposes of analgesia during obstetrical manipulations

viii. Describe how to examine a hind foot for suspected foot lameness

ix. Perform a speculum examination to evaluate cervix and describe

findings

x. Describe in detail how and where to inject 30ml of an antibiotic

solution for both subcutaneous and intramuscular routes

xi. Describe how to perform a cornual nerve block

xii. Describe how to anesthetize the flank of a cow for abdominal

surgery

xiii. Administer oral medication to the cow

TOTAL POINTS 100

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FAP03 ASSESSMENT, Clinical Procedures Food Animal Practice
Candidate Name/ID:
Date/Session/Site: Examiner:

Primary examiner’s name, initials & signature (required on all assessment sheets regardless of
final score):

Name (print): ___________________________________________Initials: __________________

Signature: ______________________________________________.

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 Food Animal Practice

Station Four—Bovine theriogenology and public health, food safety, and regulatory issues

Overview of Station Four—

Part A: The examiner will act as a client with an adult female cow presented for a check of her
reproductive status. The candidate should:

• perform a rectal examination*

• determine if the cow is pregnant
• explain what that determination was based upon
• discuss what effect prostaglandin F2α administration would have on the cow’s
reproductive status.
*The actual rectal examination must be completed within 3 minutes. The examiner will stop the
rectal examination at 3 minutes if the candidate has not completed the examination.

(See also FAP04 assessment sheet on the following pages)

Part B: The candidate will be presented with an “obstetric box” model in which the fetus has
been placed in an abnormal position commonly associated with dystocia in cows. The candidate
should:
• ask the examiner/client questions to solicit any necessary additional history and
physical finding (e.g., straining, etc)
• describe how to prepare the cow for obstetrical examination
• describe the malpresentation, -position, or –posture of the fetus, using standard
terminology
• perform the necessary manipulation on the fetus in the obstetric box in order to
facilitate vaginal delivery
• place chains on the fetus in the obstetric box to facilitate delivery
• discuss how to determine whether vaginal delivery is possible in a calf with
dystocia
• describe possible alternatives to vaginal delivery.
(See also FAP04 assessment sheet on the following pages)

Part C: Using the FAP05 assessment sheet, the candidate will list five (5) of the drugs currently
(i.e., 1 week prior to examination date) prohibited for extralabel use in food animals in the
United States or Canada (answer for the country in which examination is taking place).
(Note–See also example FAP05 assessment sheet on the following pages)

Standard Script for Station Four, part A—Prior to beginning part A of this station, the
examiner should read the following script (in quotes) to each candidate.The script may be
modified to meet specific facility or equipment restrictions at each site. The time should
not begin until all of the instructions have been given.

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 Food Animal Practice

“This station will consist of three parts. In front of you is a sexually mature cow. This
cow will be used only for Part A. Over there is an obstetric box with a bovine fetus
placed inside; this will be used for Part B. Part C will require you to write an answer to a
single question; writing material is available over there. You will have a total of 45
minutes to complete this entire station, but Part A must be completed within 10 minutes.
Moreover, for humane reasons, the actual rectal examination must be completed within 3
minutes. If you have not completed the rectal examination in 3 minutes, I will stop that
portion of Part A, and you may complete the other portion. If you have not completed all
skills in Part A in 10 minutes, I will stop this portion of the examination and ask you to
move on.

In Part A, I would like you to perform a rectal examination on this sexually mature cow,
determine if she is pregnant, explain to me on what basis that determination was made,
and discuss with me the response of this cow’s reproductive tract to a therapeutic dose of
prostaglandin F2α. Please proceed with Part A. When you have completed this part, we
will move over to the obstetric box, and I will provide instructions for Parts B and C.”

Standard Script for Station Four, parts B and C—Prior to beginning parts B and C of
this station, the examiner should read the following script (in quotes) to each candidate.
The script may be modified to meet specific facility or equipment restrictions at each site.
The time should not begin until all of the instructions have been given.“You will have a
total of 35 minutes to complete the next two parts of this station, so please plan
accordingly. In Part B, we will be using this obstetric box to simulate a pregnant cow that
has been in labor for some hours. Consider yourself the veterinarian and I will be the
client. I will provide you with the presenting complaint, and you will solicit any
necessary additional history and physical findings (for example, signs of straining, etc)
from me. You will then describe how to prepare a cow for obstetrical examination. Next,
you will examine the fetus inside this obstetric box and describe the malpresentation, -
position, or -posture, using standard terminology. You will perform the necessary
manipulation on this fetus in order to facilitate vaginal delivery, including placing chains
or ropes. However, you are not required to—nor will you be assessed on—pulling the
fetus from the obstetric box. Finally, you will discuss with me possible alternatives to
vaginal delivery for this case, and communicate to me, the client, post-delivery cow and
calf (if appropriate) care.

For Part C, you will need to answer a single question regarding a list of drugs prohibited
by Federal law for extra-label use in food animals in the United States OR Canada
(answer for the country in which you are currently sitting this examination). You may
proceed now with either Part B or Part C, but remember you have 35 minutes to complete
both parts.”

Assessment Sheets for Food Animal Practice—Station 4 (FAP04/FAP05)

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FAP04 ASSESSMENT, Bovine Theriogenology Food Animal Practice
Candidate Name/ID:
Date/Session/Site: Examiner:

MAX CANDIDATE
Activity/Skill
POINTS SCORE
PART A 40
Points will be deducted if candidate does not complete the actual rectal
examination within 3minutes or the entire Part A within 10 minutes.

Candidate is scored on ability to correctly and efficiently:

a. Perform rectal examination of the cow’s reproductive tract and
determine pregnancy status .

b. Explain on what basis pregnancy status determination was made

c. Describe the effect on pregnancy and ovarian structures that
prostaglandin F2α administration will have on the cow being
examined.

PART B 60
Candidate is scored on ability to correctly and efficiently:
a. Elicit any additional necessary information from the client (examiner)
b. Describe how to perform an obstetrical examination, including
preparation of animal and self
c. Identify malpresentation, -posture, -position
d. Correct malpresentation, -posture, -position
e. Place chains/ropes
f. Discuss alternative delivery plans
g. Communicate to client/examiner post-delivery cow and calf care if
live or dead, ()

TOTAL POINTS 100

Primary examiner’s name, initials & signature (required on all assessment sheets regardless of
final score):

Name (print): ___________________________________________Initial: ________________

Signature: ______________________________________________

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FAP05 ASSESSMENT, Public Health, Food Safety, and Regulatory Food Animal Practice
Candidate Name/ID:
Date/Session/Site: Examiner:

MAX CANDIDATE
Activity/Skill
POINTS SCORE
PART C 100
Candidate must list 5 of the currently prohibited drugs (i.e., 1-week prior to
examination date) to receive credit. If candidate does not list 5 of the currently
prohibited drugs, or lists nonprohibited drugs, points will be deducted
Candidate is scored on ability to correctly:
List 5 drugs prohibited for extralabel use in food animals in the United
States or Canada.

TOTAL POINTS 100

Primary examiner’s name, initials & signature (required on all assessment sheets regardless of
final score):

Name (print): ___________________________________________Initials: _______________

Signature: ______________________________________________

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 Food Animal Practice

Food Animal Practice Summary Score Sheet

FAP06 SCORE SHEET (Food Animal Practice Section Summary and Final Score Sheet)
Candidate Name/ID: CPE Site/Date/Session:

Raw Points Weighting Weighted

STATION (area) Awarded Points
Awarded

STATION 1: Clinical Case, Bovine 30%

Total points from FAP01 Assessment

STATION 2: Clinical Case, Other Food Animal 30%

Total points from FAP02 Assessment

STATION 3: Clinical Procedures 20%

Total points from FAP03 Assessment

STATION 4; Parts A&B Bovine Theriogenology 15%

Total points from FAP04Assessment

STATION 5; Part C: Public Health, Food Safety, and 5%

Regulatory
Total points from FAP05 Assessment

FINAL SCORE (60 weighted points required to pass) 100%

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 Food Animal Practice
Appendix 1

Food Animal Practice Appendices

Appendix 1—Blank Page for Candidate Notes

Candidate Notes—Station 1 & 2 – FAP01 & FAP02

This form is provided for candidates to use as they choose but information recorded on this sheet
is not used in the assessment of the candidate’s performance.

Candidate Name/Number

Date/Session (AM/PM)

CPE site

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 Food Animal Practice
Appendix 2

Appendix 2—Candidate Answer Sheet—Food Animal Practice Station 4, Part C

CANDIDATE ANSWER SHEET—Food Animal Practice Section, Station 4, Part C

Public Health, Food Safety, and Regulatory

Candidate Name/ID:

Date/Session/Site:

List 5 drugs prohibited for extralabel use in food animals in the United States (if taking the CPE in the
USA) or Canada (if taking the CPE in Canada)

Candidate Signature:

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 Necropsy

NECROPSY
Competencies
The Necropsy section is a single station that will assess the candidate's ability to:
• perform a necropsy in an orderly manner, including using appropriate instruments safely
and adept and safe handling of all sharps
• dissect the heart under direct observation of an examiner
• describe findings as normal or abnormal in writing, and if abnormal, briefly listing what
the abnormality is, using the Necropsy Report Form provided as Appendix 2 to this
section of the MOA
• take tissue samples for histopathology; and remove the head for rabies testing.

Time
Maximum time: 90 minutes for performance of the necropsy plus an additional 15
minutes to complete the Necropsy Report Form (total of 105 minutes [1 hour and 45
minutes]). The Necropsy Report Form can be filled out while the candidate is performing
the necropsy; however, the necropsy itself must be completed within 90 minutes. This
means candidates will be told to stop the necropsy and set down all instruments at 90
minutes. An additional 15 minutes can then be used to complete the Necropsy Report
Form. Candidates are responsible for their own time management.

Set-up Information
1. Candidates must provide the following supplies:
a. Clean laboratory coat.

2. The following supplies/information will be provided by the examining site:

a. Facilities and instruments to perform a necropsy similar to what would be present
in veterinary practice (e.g., knives, scissors, bone cutters, etc).
b. Supplies required for collecting tissue specimens, to include marking pens and
labels.
c. Clipboard or other writing surface, Necropsy Report Form for documenting
findings (Appendix 2), writing utensils (pens/pencils).
d. Coveralls, boots, and gloves.
e. Safety equipment (gloves, aprons, goggles, etc).

3. Animal Requirements—Animal carcass (1 per candidate, carcass to be at least 2kg and

not more than 45 kg weight and selected from porcine, canine, feline, bovine, equine,
caprine, or ovine animals).

4. People Requirements—Minimum requirement: 1 veterinary examiner per 3 candidates

and 1 technical assistant or veterinary technician per 5 candidates.

5. Facilities and Equipment

a. 1 room/area suitable for conducting necropsies.
b. Timing device visible from each station to track examination time. Whenever
possible, timers will be of the “count-down” variety to allow candidates and
examiners alike to clearly see time remaining in station or section.

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 Necropsy

General Requirements of the Candidate

Candidates are expected to conduct the necropsy in a safe, orderly, and sanitary manner.
Candidates should report any self-injury promptly to the examiner. Accidental self-injury does
not necessarily result in automatic failure of the necropsy section, and it is important that any
injury be treated in a timely manner. Time taken to treat the injury will not be counted against
the candidate’s maximum time allotted for this section (i.e., the clock will be stopped to attend to
the injury). If, in the opinion of the examiner, the candidate is performing the necropsy in a
haphazard way or does something that is unsafe and of serious danger to them or other
personnel, the examiner may assess penalties ranging from a reduction in the NEC01 score to
termination of the NEC Section and dismissal of the candidate with a “zero” for Necropsy.

Examples of “fatal flaws” that might result in termination of the Necropsy section include, but
are not limited to:
• Using a knife in an inappropriate manner that is very unsafe.
• Lack of adeptness in using instruments that is apparent at multiple areas of the necropsy.
• Improper handling or disposal of sharps equipment.

Please also refer to Appendix 1 and the NEC01 Assessment sheet.

Overview of Necropsy Section

The candidate will be given an animal carcass (at least 2kg and not more than 45 kg in weight
and selected from porcine, canine, feline, bovine, equine, caprine or ovine animals) and an
appropriate environment for conducting a necropsy. The candidate must perform a complete
necropsy by completing the following tasks:
• Thoroughly examine an intact carcass, documenting body condition
• Open carcass, examine major cavities, remove viscera
• Examine major organs, to include palpating lungs for inflation and, with an examiner
observing, identifying specified cardiac structures (chambers, aorta, vena cava,
pulmonic trunk, valves, and myocardium)
• Examine muscles and joints (at least one each from a hind and fore limb)
• Examine endocrine glands and lymph nodes
• Remove the animals’ head at the atlanto-occipital joint as if to submit for rabies
examination

During the necropsy, the candidate must document, in writing on the Necropsy Report Form
(Appendix 2) provided, whether the organs and tissues examined have any abnormalities. If the
candidate assesses an organ or tissue as abnormal, the candidate must briefly list the change(s)
observed (e.g., if spleen is larger than normal, the candidate should simply state either
splenomegaly or enlarged spleen). The completed Necropsy Report Form will remain part of the
candidate’s record of examination and will be assessed after completion of this section.

In addition, the candidate must take and preserve a tissue section of the appropriate size/
thickness from each of the following organs for histopathology and document, on the Necropsy
Report Form, whether the section was taken from a normal or abnormal organ. All tissues are to

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 Necropsy

be collected in one container. Fixative or fixative substitute will be provided, and candidates will
need to add the appropriate volume of fixative for amount of tissue collected.
a. Heart
b. Lung
c. Liver
d. Small intestine
e. Colon
f. Stomach
g. Spleen
h. Pancreas
i. Kidney
j. Skeletal muscle
k. Thyroid gland
l. Adrenal gland
m. Internal lymph node
n. Peripheral lymph node

Standard Script for Necropsy Section - The examiner should read the following script
(in quotes) to each candidate. The script may be modified to meet specific facility or
equipment restrictions at each site. Time does not begin until all instructions have been
given. “There is a total of 105 minutes to for this section. You have 90 minutes to
perform a necropsy on the animal in front of you. You are responsible for monitoring
your own time. An assortment of instruments and equipment to perform the necropsy,
and a container to put samples in, are at your station. You should thoroughly examine the
intact carcass; open the carcass and examine the major cavities; remove the viscera; and
examine the major organs, muscles, joints, endocrine glands, and lymph nodes. At any
time during the exam, you may describe to the examiner what organ or tissue you are
looking at and observing . You will also be required to remove the animal’s head. You
are not required to open the skull. You should collect tissue samples for histopathology of
the organs and structures identified in Appendix 3. Before placing the samples in fixative
, you should place each specimen in order on the laminated copy provided to allow the
examiner to assess each specimen.

Before dissecting the heart, please call an examiner so that the examiner may observe as
you identify and examine the following structures:
• Chambers – right & left atrium, right & left ventricle
• Aorta
• Vena cava
• Pulmonic trunk
• Valves – aortic, pulmonic, mitral, tricuspid
• Myocardium
If an examiner is not immediately available, please do not begin dissection of the heart
but, instead, continue with the next step of your necropsy.

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 Necropsy

If the examiner is concerned that you are using an instrument or equipment in an unsafe
manner, they may notify you and you will need to correct yourself. If you injure yourself,
please report that promptly to the examiner. Accidental self-injury does not necessarily
result in automatic failure of the necropsy section, and it is important that any injury be
treated in a timely manner. Time taken to treat the injury will not be counted against the
time limit allotted for this section; that is, we will stop the clock to attend to any injury.
Additionally, you must dispose of all sharps properly at the completion of your exam.

Following the completion of the necropsy, you will be given an additional 15 minutes to
document in writing on the Necropsy Report Form whether the organs and tissues you
examine have any abnormalities. If you note any abnormality, you should provide a brief
description of the abnormality. For example, if you believe the liver is larger than normal,
you should simply write “hepatomegaly” or “enlarged liver.”

You must monitor your time as you work to ensure that you complete the Necropsy itself
within a time limit of 90 minutes. You may choose to begin filling out the Necropsy
Report Form while doing the necropsy, but please remember, you will be required to stop
the necropsy and set down your instruments at 90 minutes. You will then have what time
is remaining out of the 105 minutes to complete your Necropsy Report Form. Please
make sure your name and candidate ID are on all pages of the Necropsy Report Form and
leave your completed form on your table when you are done.

As you perform the necropsy, the examiner(s) will be making notes. Please do not let the
examiners’ writing affect your performance at any time during the Necropsy. Also, please
be aware that an examiner may nod or state “OK” to let you know that he has heard or
seen you; however, these do not mean the examiner is in agreement with what you have
said or done. Also, examiners cannot offer feedback on your performance during or after
the examination.”

Assessment Sheet for Necropsy (NEC01)—

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NEC01 ASSESSMENT, Necropsy Necropsy
Candidate Name/ID:
Date/Session Site: Examiner:

MAX CANDIDATE
Activity/Skill
POINTS SCORE
Perform a complete necropsy. Candidates will be assessed on their ability
to accurately, effectively, and efficiently perform a complete necropsy as 92
outlined on this assessment sheet
a. Thoroughly examines intact carcass, to include:
i. assessing general body condition (nutritional status, muscle mass)
and hydration (palpates body, head)
ii. examining skin/hair coat (dorsum/ventrum, etc.)
iii. examining head (eyes, ears, lips, oral cavity, external nares)
iv. examining limbs (visual evaluation, palpation, flexion of joints)
including feet (pads, toenails, hooves, etc., depending on species)
v. examining perianal and genital region and mammary gland
b. Opens carcass, examines major cavities, remove viscera and head, to
include:
i. opening carcass efficiently and in an orderly manner, using
instruments appropriately

ii. removing viscera in an orderly and adept manner

iii. removing head in an adept manner, using appropriate instruments

safely

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NEC01 ASSESSMENT, Necropsy Necropsy
Candidate Name/ID:
Date/Session/Site: Examiner:

MAX CANDIDATE
Activity/Skill
POINTS SCORE
c. Examines major organs in a systematic manner, which includes:
examining heart; opening chambers and identifying the left & right atria
and left & right ventricles
aorta, vena cava, pulmonic trunk
exposing and examining the aortic, pulmonic, mitral, and tricuspid valves
examining myocardium
opening larynx
esophagus
trachea and mainstem bronchi
sectioning lung
inspecting & palpating the lung for inflation status
examining liver and gallbladder checking bile duct patency into
duodenum
opening gallbladder
sectioning and inspecting at least 2 areas of the liver
examining stomach and intestines; inspecting omentum
opening and inspecting stomach
opening and inspecting representative levels of small intestine (duodenum,
jejunum, and ileum)
opening and inspecting colon
incising and inspecting pancreas
examining urogenital tract; sectioning kidneys and following ureters if
indicated
stripping renal capsule
opening bladder
examining reproductive tract; incising and inspecting testes or ovaries if
animal is sexually intact
examining spleen (palpates and sections)

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NEC01 ASSESSMENT, Necropsy Necropsy
Candidate Name/ID:
Date/Session/Site: Examiner:

MAX CANDIDATE
Activity/Skill
POINTS SCORE
d. Examines muscles and joints (at least one each from a hind and fore limb),
to include:
i. completely opening at least two joints; inspecting joint surfaces and
synovial membranes; using instruments in a safe and appropriate
manner
ii. incising and inspecting two or more major muscles; using
instruments in a safe and appropriate manner

e. Examines endocrine glands, lymph nodes, to include:

i. locating and inspecting thyroid glands
ii. locating and inspecting adrenal glands
iii. locating and inspecting lymph nodes (both peripheral and internal )

f. Documents on the Necropsy Report Form what, if any, abnormalities were

found during the Necropsy exam, to include whether the animal is sexually
intact or neutered
g. Overall approach to necropsy

Adept and safe handling of instruments appropriate for task

Systematic and thorough approach
Organization
Observation

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NEC01 ASSESSMENT, Necropsy Necropsy
Candidate Name/ID:
Date/Session/Site: Examiner:

MAX CANDIDATE
Activity/Skill
POINTS SCORE
Collect tissue specimens for histopathology. Candidates will be assessed on 8
collecting a complete tissue sample, with all relevant structures, in an
appropriate manner and of appropriate representative shape and thickness.
a. Heart
i. tissue of appropriate size, shape, and thickness for diagnostic
purposes
b. Lung
i. tissue of appropriate size, shape, and thickness for diagnostic
purposes
c. Liver
i. tissue of appropriate size, shape, and thickness for diagnostic
purposes
d. Small intestine
i. tissue of appropriate size, shape, and thickness for diagnostic
purposes
e. Colon
i. tissue of appropriate size, shape, and thickness for diagnostic
purposes
f. Stomach
i. tissue of appropriate size, shape, and thickness for diagnostic
purposes
g. Spleen
i. tissue of appropriate size, shape, and thickness for diagnostic
purposes

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NEC01 ASSESSMENT, Necropsy Necropsy
Candidate Name/ID:
Date/Session/Site: Examiner:

MAX CANDIDATE
Activity/Skill
POINTS SCORE
Collect tissue specimens for histopathology
(continued from previous page)
h. Pancreas
i. tissue of appropriate size, shape, and thickness for diagnostic
purposes
i. Skeletal muscle
i. tissue of appropriate size, shape, and thickness for diagnostic
purposes
j. Kidney
i. tissue of appropriate size, shape, and thickness for diagnostic
purposes
k. Thyroid gland
i. tissue of sufficient quality for diagnostic purposes
l. Adrenal gland
i. tissue of sufficient quality for diagnostic purposes
m. Internal lymph node
i. tissue of appropriate size, shape, and thickness for diagnostic
purposes
n. Peripheral lymph node
i. tissue of appropriate size, shape, and thickness for diagnostic
purposes
o. Appropriate volume of fixative for tissue

TOTAL POINTS for performing necropsy (92 maximum points possible) 100
and collecting tissue specimens (8 maximum points possible)
Candidates are also assessed on their ability to: Yes No
Complete Necropsy Exam in an appropriate and safe manner.
Final Score (indicate PASS or FAIL in the cell to the right): A total score
of 60 points or more plus a “yes” assessment on the above skill are required
to pass the Necropsy Section.

Primary examiner’s name, initials & signature (required on all assessment sheets regardless of
final score):

Name (print): ___________________________________________Initials:_________________

Signature: ______________________________________________

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 Necropsy
Appendix 1

Necropsy Appendices

Appendix 1—Fatal Flaw List

These are failing behaviors that potentially put the candidate or examination personnel in danger.
All are behaviors that may require examiner intervention and will result in a failing grade for the
candidate and dismissal from this section of the CPE.

The examiner will stop the Necropsy Section immediately if any one behavior from the
following fatal flaw list is observed (i.e., recognized by the examiner and confirmed by another
examiner or veterinary technician):

1. Candidate fails to practice safe handling of sharp instruments; such as cutting tissue
samples while holding them in the palm of the candidate’s hand leading to potential
laceration or placing an exposed blade in a place where it could accidently lacerate
someone or fall and stab someone.
2. Candidate does not dispose of sharps in the correctly designated area (i.e., a sharps
container).
3. Consistently uses instruments inappropriately, resulting in excessive tissue damage.
4. Candidate fails to protect him-/herself from possible exposure to zoonotic organisms
(e.g., not wearing the correct protective clothing/equipment, including not wearing gloves
or appropriate eye protection while handling tissues, touching one’s mucous membranes
with unwashed hands).
5. Candidate exhibits any other behavior that would put him-/herself or other exam
personnel at risk. The examiner must document the behavior.
6. Candidate refuses to perform any of the required skills listed.

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 Necropsy
Candidate Name/ID: Appendix 2
Date/Session/Site: Examiner:

Appendix 2—Necropsy Report Form (page ONE)

Animal provided for Necropsy Degree of Autolysis (circle one): Mild Moderate Severe

Species ______________________ Breed ____________________ Age ___________ Weight_______________

Each Candidate to Complete All Information Below and On Following Pages

Sex of animal___________ Neutered Yes / No Body Condition of animal ____________________

Is the organ system/structure If abnormal, please

Organ System or Structure
normal or abnormal? briefly list abnormalities.

Intact Carcass in general

Skin (e.g., including hair, external body orifices

and subcutis)

Thoracic and Abdominal Viscera, examined in situ

Cardiovascular System (e.g., myocardium,

pericardium, endocardium, valves, blood vessels)

Respiratory System (e.g., nasal cavity, larynx,

trachea, bronchi, lungs, pleura)

Digestive System (e.g., oral cavity, teeth, tongue,

salivary glands, tonsils, pharynx, esophagus,
stomach, small and large intestine, liver, pancreas,
peritoneal cavity)

Additional comments/remarks regarding above organ systems:

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 Necropsy
Candidate Name/ID: Appendix 2
Date/Session/Site:

Appendix 2—Necropsy Report Form (page TWO)

Is the organ system normal If abnormal, please

Organ System
or abnormal? briefly list abnormalities.

Urogenital System (e.g., kidneys, ureters, bladder,

urethra, ovaries, uterus, vagina, vasa deferentia,
seminal vesicles, prostate, penis, prepuce)

Hematopoietic System (e.g., spleen, lymph nodes)

Musculoskeletal System (e.g., muscles, bones,

joints):

Endocrine System (e.g., thyroids, parathyroids,

thymus, adrenals):

Additional comments/remarks regarding above organ systems:

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 Necropsy
Candidate Name/ID: Appendix 3
Date/Session/Site:

Appendix 3—Necropsy Tissue Samples

Sample collection for histopathology

Heart

Lung

Liver

Small intestine

Colon

Stomach

Spleen

Pancreas

Kidney

Skeletal muscle

Thyroid gland

Adrenal gland

Internal lymph node

Peripheral lymph node

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 Radiographic Positioning

RADIOGRAPHIC POSITIONING
Competencies
The Radiographic Positioning section is a single-station section that will assess the candidate's
ability to:
• determine anatomical structures and views necessary to radiographically diagnose a
clinical condition and produce diagnostic quality radiographic images of those structures

Time
Maximum time, 45 minutes

Set-up Information
1. Animal Requirements—Canine animal of mild temperament (sedated or anesthetized if
necessary).
2. People Requirements—1 veterinary examiner per candidate and 1 technical assistant or
veterinary technician per candidate
3. Facilities and Equipment
a. X-ray room/area with conventional or digital radiographic equipment Timing device
visible from each station to track examination time. Please note that, when possible,
timers will be of the “count-down” variety to allow candidates and examiners alike to
clearly see time remaining in station or section.
4. Supplies/Information Provided by The Examiner
a. Radiographic film and automated film processing equipment (not operated by
candidates) OR digital radiographic equipment.
b. Accessories and supplies for preparing radiographs.
c. Safety equipment (gloves, aprons, goggles, etc).
5. Supplies Provided by The Candidate
a. Clean laboratory coat.
b. Pens/pencils
c. Dosimeter (optional; if the candidate wishes to monitor personal levels of radiation
during the examination, the candidate will provide their own dosimeter).

General Requirements of the Candidate

Candidates are expected to handle all animals in a humane and safe manner. If, in the opinion of
the examiner, the candidate does not handle the animal humanely or handles the animal in a
manner that is unsafe to themselves or other personnel, the examiner may assess penalties
ranging from a reduction in score to termination of the exam and dismissal of the candidate with
a failure for the section.

All activities must be completed with the candidate practicing radiation safety. Failure to
use appropriate radiation safety precautions including, but not limited to, failure to use
mechanical restraint if necessary (leg ties, wedges, etc) and protective gear or shielding behind a
protective wall that results in exposing the candidate, the patient, the technician, the staff, or the
examiner to risk is considered a fatal flaw and the candidate will be dismissed from this station
and receive no points for the station.

Please also refer to the RAD01 Assessment sheet.

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 Radiographic Positioning

Overview of Radiographic Positioning Section

Part A: The candidate will be given a sedated or anesthetized canine animal, and an x-
ray machine (either digital or conventional), and all appropriate accessories. The
candidate will be provided with a suspected diagnosis for the animal, and the candidate
will position the animal using leg ties, wedges, etc., in order to produce appropriate
diagnostic quality radiographic images to confirm or rule out the suspected diagnosis.
The image(s) produced must be the appropriate views of the appropriate anatomic
structures/region and be of diagnostic quality.

Part B: Given a digital or conventional x-ray machine (KVP, Ma, time settings) and a
radiographic technique chart specific for that machine, the candidate will determine the
required settings for the above exposures, set the machine, employ radiation safety
measures, and take the required exposures to obtain appropriate diagnostic quality
radiographs. The candidate will be allowed to evaluate the quality of each initial
radiographic image and allowed to repeat each image only one time, if desired by
candidate. In any situation where images are repeated, the candidate is then allowed to
designate which of the two images should be scored.

(Note—A veterinary examiner will assess each candidate’s ability to position an animal and take
diagnostic quality radiographs)

(Note—See also RAD01 assessment sheet on the following pages)

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 Radiographic Positioning

Standard Script for Radiographic Positioning Section

The examiner should read the following script (in quotes) to each candidate. The script may be
modified to meet specific facility or equipment restrictions at each site. Time does not begin until
all instructions have been given.
“You will be presented with a dog with a suspected diagnosis of __________________
(Site to insert a fictitious suspected diagnosis which will then allow evaluation of the
candidate’s ability to determine appropriate structures / region to radiograph and
appropriate views). You are to determine the appropriate structures or anatomical region
to image and the appropriate views to take in order to confirm or rule out the suspected
diagnosis. The dog will be sedated or under general anesthesia. Using mechanical
restraint only (ties, wedges, sandbags, tape, etc.), you are to position the animal
appropriately, set the radiographic unit, and make diagnostic images. It will be necessary
to take at least two different orthogonal views to provide the best chance for diagnosis for
the structure/region in question.

You are not responsible for processing the film (where applicable) or inputting data onto
the digital image, but you are required to evaluate each film or digital image to determine
if it is of diagnostic quality. If you determine that your first radiographic image is not of
diagnostic quality (and you have enough time remaining), you may elect to repeat—one
time only—each of the two different views. If you have taken 2 images of the same view,
you should then designate which image should be assessed by the examiner. Only one
image of the same view may be submitted for scoring.

You are also responsible for ensuring appropriate radiation safety during this station.
Failure to use appropriate radiation safety precautions and exposing yourself, the
technician, the staff, the patient, or the examiner to unnecessary radiation is considered a
fatal flaw and will result in your dismissal from this station and a score of zero for this
station.

I am allowed to answer questions only if they relate to aspects of the radiographic

unit or associated equipment which I believe you would be unfamiliar. Throughout
this station, I will be recording notes pertaining to your behavior, both negative and
positive, and will be assessing you on your ability to effectively and succinctly
communicate with me. Please do not let my writing affect your performance. You
will have 45 minutes to complete this section.”

Assessment Sheet for Radiographic Positioning (RAD01)

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RAD01 ASSESSMENT, Radiographic Positioning Radiographic Positioning
Candidate Name/ID:
Date/Session/Site: Examiner:

MAX CANDIDATE
Activity/Skill
POINTS SCORE
Part A: Candidate is assessed on their ability to position patient and
40
use of proper radiographic techniques, including selection of
appropriate views and structures/ regions.
Part A—First view:
A Fatal flaw may be issued if radiographs submitted by candidate
do not include correct anatomic region for the suspected diagnosis

Part A—Second view

A Fatal flaw may be issued if radiographs submitted by candidate
do not include correct anatomic region for the suspected diagnosis

Part B: Images designated by candidates are assessed for clarity of the

60
visualization of the area of interest and for evidence of the use of
appropriate radiographic techniques:
a. First view
b. Second view

Part C: Radiation safety Used rad. Did not use

safety radiation safety
Failure of the candidate to use appropriate radiation safety (to include
but not limited to failure to use mechanical restraint if necessary (leg
ties, wedges, etc) and failure to use protective gear or shielding behind
protective wall, exposing the candidate, the animal, the technician, the
staff, or the examiner to risk is considered a fatal flaw and the candidate
will be dismissed from, and receive a score of zero for, this section. If
radiation safety precautions are observed, it should be so noted here, but
no additional points will be provided.

TOTAL 100

Primary examiner’s name, initials & signature (required on all assessment sheets regardless of
final score):

Name (print): ___________________________________________Initials: ________________

Signature: ______________________________________________.

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 Small Animal Medicine

SMALL ANIMAL MEDICINE

Competencies
The Small Animal Medicine section will assess the candidate's ability to:
• evaluate a clinical small animal (canine or feline patient) medicine case (Station 1:
Clinical Evaluation)
• write medical management plans and a prescription for a selected drug based on a case
description of a hospitalized canine or feline patient and orally communicate treatment
plans (Station 2: Medical Management)
• describe and/or perform clinical techniques commonly used in small animal veterinary
practice (Station 3: Clinical Techniques)

Time
SAM01, SAM02, and SAM03 stations are allotted 45 minutes each.

For SAM Station 2 (Medical Management), the 45 minutes are allotted to a written and an oral
portion of the exam as follows:
• The candidate will have 35 minutes to complete the written portion and 10 minutes to
complete the oral portion of the exam.
• Candidates who are ready for the oral portion prior to 35 minutes may notify the
examiner directly and begin the oral portion at that time.

Set-up Information
1. Animal Requirements
a. Canine or feline animal affected by a common clinical condition (Station 1).
b. Live animals are not used at Station 2 (Medical Management). A written record of a
dog or cat hospitalized with a common clinical condition will be provided. The
candidate will be assessed on their ability to write an appropriate medical
management plan for the patient for the next 12 hours and orally communicate those
treatment plans to a veterinary technician.
c. Both live animals and models will be used at Station 3 (Clinical Techniques)

2. People Requirements
a. One veterinary examiner per candidate at Station 1
b. One veterinary examiner at Station 2
c. One veterinary examiner per candidate at Station 3

3. Facilities and Equipment

a. 1 small animal examining room for Station 1.
b. 1 room/area for Station 2 with appropriate space to allow for reading and writing of
medical records.
c. 1 room for Station 3

Timing device visible from each station to track examination time. Please note that, when
possible, timers will be of the “count-down” variety to allow candidates and examiners alike to
clearly see time remaining in station or section.

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 Small Animal Medicine

4. The Candidate Must Have the Following Supplies:

a. Stethoscope, penlight, clean laboratory coat, pen
b. Wristwatch with second hand

5. The Following Supplies Will Be Provided by The Examining Site

a. Instruments/supplies appropriate for the case and commonly found in examination
rooms in a typical US or Canadian veterinary practice (e.g., microscope, view box or
computer for digital radiographs, otoscope, ophthalmoscope, thermometer).

General Requirements of the Candidate

Candidates are expected to handle all animals in a humane and safe manner. If, in the opinion of
the examiner, the candidate does not handle an animal humanely or performs in a manner that is
unsafe to the animal, himself/herself or other personnel, the examiner may assess penalties
ranging from a reduction in their score to termination of the station and dismissal of the
candidate with a “zero” (i.e., Fatal Flaw).

The candidate will be awarded a “fatal flaw” with a “zero” for the station if, in the professional
judgement of the examiner:
• the candidate jeopardizes the health and well-being of the animal patient in SAM01
(Clinical Evaluation) either through action or inaction, OR
• in SAM02 (Medical Management), the candidate prescribes a treatment or
management plan that, if this were a real patient, would result in serious harm to, or
potentially death of, the patient.
• in SAM03 (Clinical Techniques), the candidate describes or performs a procedure in
such a way that would result in serious harm or potential death to an animal patient,
regardless of whether the station is using a live animal or a model.
Candidates will not necessarily be informed of a fatal flaw unless their actions comprise an
immediate real threat to the health or safety of a live animal or person. In such instances, the
candidate’s performance will be terminated, and the candidate will be instructed to proceed to
the next skill or activity at that station. If the candidate’s actions constitute a repeated or ongoing
threat to an animals’ or persons’ well-being, the candidate may be dismissed from the station. In
instances where a candidate earns a fatal flaw for a plan or action that would likely cause serious
harm if it were followed but no immediate real threat to a live animal or person exists, the
candidate will be allowed to proceed without being informed of the fatal flaw. A candidate that
has been awarded a fatal flaw at any Station for the reasons described in the previous paragraphs
will fail the entire SAM section but will not be prevented from taking the other stations.

Station One–Clinical Evaluation

Overview of Station One

The examiner will act as a client with a dog or cat that is affected with a condition commonly
found in veterinary practice. The candidate should:
• question the client/examiner to determine the medical history of the patient
• perform a systematic physical examination

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• record the results of the history and physical examination on the provided form (see
Appendix One—Small Animal Medicine)
• develop an initial problem list, differential diagnoses list, and a diagnostic plan,
while explaining their reasoning to the examiner, who is acting as a client
• request appropriate and reasonable initial diagnostic tests – examiners will provide
test results (along with normal values) if those tests were completed.
• interpret the results of diagnostic tests
• refine the differential diagnoses list based upon the findings and determine the most
likely diagnosis, while explaining their reasoning to the examiner, who is acting as
a client
• develop a therapeutic plan specific for the patient
• develop a prognosis for the patient
• orally communicate all of the above information to the client/examiner

(Note—See also the SAM01 assessment sheet that follows)

To ensure that all examiners at all sites assess the same competencies during this station,
a history and physical examination form is available in the MOA as Appendix 1 to the
Small Animal Medicine section. Examiners must provide these forms to each candidate,
and this form maybe used by all candidates to record the history and physical
examination findings. Candidates will also need to discuss/describe findings with/to the
examiner.

Standard Script for Station One - The examiner should read the following script (in
quotes) The script may be modified to meet specific facility or equipment restrictions at
each site. Time does not begin until all instructions have been given.“I will be acting as a
client presenting a patient for your evaluation. You will need to take a complete history
from me and perform a complete physical examination of the patient. You will need to
explain all normal and abnormal findings to me. I may ask questions that might be
expected of a client; you will need to respond appropriately to those questions and will be
assessed on your communication abilities.

You may record your history and physical examination findings on the form provided.
Then, communicate an initial problem list, create a list of differential diagnoses for the
most relevant problems identified, and develop an initial diagnostic plan. You can request
relevant diagnostic tests and you will be provided with results if those tests were
performed. At that point, you will need to refine your initial problem and differential
diagnoses lists by ruling in or ruling out diagnoses. You may request additional relevant
diagnostic exams if necessary. You will also need to tell me what you believe is the most
likely diagnosis after which you will need to develop a therapeutic plan. You should also
assign an appropriate prognosis for the case. Please note that points will be deducted if
you record/describe physical examination findings that are not actually present or if you
order tests that are not necessary or are inappropriate for the specific patient.

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Please remember to tell me your rationale for the tests you are doing and clinical
decisions you are making. Remember, because I am playing the role of the animal owner,
I may ask you questions expected of a client.

Throughout this station, I will be assessing you on your ability to perform the skills
outlined in the Manual and to communicate effectively. Please do not let my note writing
affect your performance as I will be recording positive, as well as negative, observations.
If I should nod my head or state “OK,” this only means I have heard what you have said
or seen what you have done. It is not a reflection of the assessment. In addition, I may ask
questions that a client might ask during the exam to better ascertain where you are in the
process of your diagnostic work-up.

You will have 45 minutes to complete this station.”

Assessment Sheet for Small Animal Medicine—Station One (SAM01)

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SAM01 ASSESSMENT, Clinical Evaluation Small Animal Medicine
Candidate Name/ID:
Date/Session/Site: Examiner:

MAX CANDIDATE
Activity/Skill
POINTS SCORE
History taking
Candidates will be assessed on their ability to accurately, effectively, and efficiently 15
communicate with the client/examiner to elicit a complete history of the patient

Physical examination
15
a. Performing a visual distance examination, including assessment of body
condition
b. Performing a thorough and systematic hands-on examination appropriate
for the presenting complaint and any other abnormalities specific to the
animal used
c. Appropriate handling of the patient
d. Accurately assessing the patient (e.g., determining correct heart and
respiratory rate, temperature, respiratory pattern, etc). Candidate may lose
points for recording a finding that is not actually present.
Integration of Clinical Information
14
a. Identifies patient problems based on history and physical examination
b. Develops a rational and comprehensive differential diagnoses list for most
relevant problems identified
Diagnostic Approach (logically ordering and justifying diagnostic tests
relevant to the problems identified) 13

a. Comprehensively orders diagnostic tests

b. Efficiently orders diagnostic tests
c. Orders diagnostic tests in a logical progression
d. Justifies the rationale for each diagnostic test requested
Integration of diagnostic information
18
a. Interprets diagnostic test results accurately
b. Uses diagnostic test results to refine the differential diagnoses list and
describes how each test result is used to rule in or rule out diagnoses
c. Arrives at the most likely diagnosis

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SAM01 ASSESSMENT, Clinical Evaluation Small Animal Medicine
Candidate Name/ID:
Date/Session/Site: Examiner:

MAX CANDIDATE
Activity/Skill
POINTS SCORE
Developing therapeutic plan
Note: points will be deducted for developing a correct therapeutic plan for a set of 15
differentials that does not include the correct diagnosis.

a. Developing a therapeutic plan specific for the patient, to include

addressing treatment and appropriate follow-up. The candidate should
also address prevention and control issues.

b. Developing the appropriate prognosis for the case presented

Communication skills
10
a. Candidate communicates clearly and effectively with the client/examiner
throughout the case

b. Effectively answering the client/examiner’s questions

TOTAL 100

Primary examiner’s name, initials & signature (required on all assessment sheets regardless of final
score):

Name (print): ___________________________________________Initials: ________________

Signature: ______________________________________________.

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 Small Animal Medicine

Station Two–Medical Management

Overview of Station Two

The candidate will have 35 minutes to complete the written portion and 10 minutes to complete
the oral portion of the exam. The written portion will last no more than 35 minutes. Each
candidate must manage their time to ensure they have sufficient time to write the medical record,
treatment orders, and prescription within the 35-minute period. Candidates who are ready for the
oral portion prior to 35 minutes may notify the examiner directly and begin the oral portion at
that time. This station will end no more than 45 minutes after the station began.

The candidate will be given a written clinical case scenario (e.g., signalment, history, initial
physical examination findings, and initial diagnostic test results) for a hospitalized canine or
feline patient. The candidate will use the Medical Management and Treatment Order Form (see
Appendix 3 of this section of the MOA) to write a summary assessment of the patient and an
initial management plan for the patient. The candidate will have 35 minutes to complete a
written summary assessment and initial management plan which should include the following: an
initial summary assessment and a problem list, a differential diagnosis list, a tentative initial
diagnosis, a tentative prognosis, additional diagnostic tests required for the next 12 hours, and a
therapeutic plan for the next 12 hours that includes any drug dosages and fluid rates. The
candidate will also write orders (e.g., treatment orders, monitoring parameters, additional
diagnostic tests, and contingency plans) for a veterinary technician who will be monitoring the
patient for the next 12-hour time period. The candidate will also write a prescription appropriate
for management of the case using the Prescription Form (see Appendix 2 of this section of the
MOA). Once the written medical record, treatment orders, and prescription are complete, the
candidate will have 10 minutes to orally communicate their assessment and written orders to a
veterinary technician who will be caring for the patient for the next 12 hours and answer
questions related to those orders. (The examiner will be acting as the veterinary technician who
will be caring for the patient).

When required and requested by the candidate, standard laboratory data for appropriate
diagnostic tests will be provided in written form with normal values.

Written records/orders may include any or all of the following:

• a summary assessment of the findings listed on the medical management and
treatment order form
• an initial differential diagnoses list
• a tentative/initial diagnosis
• additional diagnostic tests required
• a treatment plan to include any drug dosages or fluid rates
• physiological parameters to be monitored by the veterinary technician and how often
• actions to be taken by the veterinary technician if monitored parameters fall outside
of an acceptable range or if the animal displays abnormal signs specified by the
candidate
• initial prognosis
• other relevant case information or treatment orders

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Candidates will not be scored on writing quality or simple spelling errors, but the written
records/ treatment orders must be legible, coherent, and recorded in a logical and systematic
manner.

Standard Script for Station Two - The examiner should read the following script (in
quotes) to each candidate. The script may be modified to meet specific facility or
equipment restrictions at each site. Time does not begin until all instructions have been
given.“You will be given a written clinical case scenario (signalment, history, initial
physical examination findings, and any initial diagnostic test results already completed)
for a hospitalized canine or feline patient. Based upon this written information, you will
have 35 minutes to develop and write a summary assessment and initial management plan
for the patient, to include treatment orders and a prescription.

Please assume you are writing medical records, which are considered legal documents.
Also assume you are caring for a real patient. If you prescribe a treatment or management
plan that would result in serious harm to, or death of, a real patient, you may receive a
“fatal flaw,” resulting in a score of zero for this station of the SAM section.

Your written assessment and management plan should include any or all of the following:
an initial assessment and problem list, a differential diagnosis list, a tentative initial
diagnosis, a tentative prognosis, additional diagnostic tests required for the next 12 hours,
a therapeutic plan for the next 12 hours that includes any drug dosages and fluid rates,
and one prescription to be written on the supplied form for a prescribed drug appropriate
for the patient. A formulary is available for your use.

In addition to the initial assessment and management plan, you will need to record
treatments ordered for the next 12-hour time period on the final page of the Medical
Management and Treatment Order Form. Treatment orders should be specific for timing,
dosages, and routes of administration as they pertain to additional diagnostic tests,
monitoring parameters, and medications so that the orders can easily be understood by a
veterinary technician who will be carrying out your orders.

You will not be scored on writing quality or spelling per se, but your initial assessment
and management plan, treatment orders, and prescription must be legible, coherent, and
recorded in a logical and systematic order.

If you complete the written portion before 35 minutes and wish to begin the oral
communication, please notify me. I will be waiting [sites must specify where the
examiner will be so that the candidate does not waste any time notifying them; e.g.,
inside or right outside the room where the candidate is writing the record].
Otherwise, we will start the oral communication part of the assessment with 10 minutes
remaining at this station.

During the oral portion, I will be acting as the veterinary technician who will be caring
for the case for the next 12 hours. You will need to discuss with me your summary of the

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patient, explain your treatment orders, and answer any questions I might have regarding
the record or orders.
It is your responsibility to manage your time so that you can complete both the written
and oral portion for this station. Again, the written portion of the exam will last no longer
than 35 minutes, followed by a 10-minute oral communication portion of the exam for a
total of 45 minutes at this Station.”

Assessment Sheet for Small Animal Medicine—Station Two (SAM02)

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SAM 02 ASSESSMENT Small Animal Medicine
Candidate Name/ID:
Date/Session/Site: Examiner:

MAX CANDIDATE
Activity/Skill
POINTS SCORE
Written record
Candidates will be assessed on their ability to write a medical record 80
accurately and logically, which may include the following:
a. Accurately writing a concise assessment using case information
provided including providing a problem list , a list of the top 3
differential diagnoses , a tentative diagnosis , a tentative
prognosis ; and recording a management plan including
therapeutics and any further diagnostic tests necessary .
b. Accurately recording treatment orders that reflect the
management plan.
c. Accurately writing an example of a legal prescription appropriate
for the case/patient.

Oral communication
Candidates will be assessed on the following competencies: 20
a. Communicating the treatment plan and any relevant information
from the medical record to the examiner acting as the veterinary
technician.
b. Concisely answering questions that the examiner, acting as the
veterinary technician, may have regarding the written assessment
or treatment orders developed by the candidate.

TOTAL 100

Primary examiner’s name, initials & signature (required on all assessment sheets regardless of
final score):

Name (print): ___________________________________________Initials: _____________

Signature: ______________________________________________

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 Small Animal Medicine

Station Three–Clinical Techniques

Overview of Station Three— The candidate will be expected to complete 7 randomly selected
skills – 2 skills from Part A and 5 skills from Part B.

Standard Script for Station Three—Prior to beginning this station, the examiner should
read the following script (in quotes) to each candidate. The script may be modified to
meet specific facility or equipment restrictions at each site. The time should not begin
until all of the instructions have been given. “In this Clinical Techniques Station, you will
perform 7 common veterinary clinical procedures, which you may randomly select by
picking 2 of the 4 laminated cards for Part A skills and 5 of the 13 laminated cards for
Part B skills. You may refer back to your selected cards as you progress through this
station, so you do not have to memorize the skills you are required to perform. Some of
the skills will involve the use of live animals, while you will use models to demonstrate
some of the other skills. You should explain to me what you are doing as you are
demonstrating or performing these clinical techniques. You may complete the skills in
any order. You will have a total of 45 minutes to complete all 7 skills, so please plan
accordingly.”

Part A Skills:
1. Gather the necessary equipment for, and demonstrate how to perform,
cystocentesis.
2. Gather the necessary equipment for, and demonstrate how to perform,
thoracocentesis.
3. Gather the necessary equipment for, and demonstrate how to perform,
abdominocentesis.
4. Gather the necessary equipment for, and demonstrate how to perform, urinary
catheterization of a male dog.
Part B Skills:
1. Listen to and interpret 2 cardiac sounds and describe as normal or abnormal. If
abnormal, describe the abnormality (i.e., type of murmur or arrhythmia).
2. Gather the necessary equipment for, and demonstrate how to perform, jugular
venipuncture.
3. Calculate and draw-up the correct dosage of an antibiotic, given the dose and the
size of the animal
4. Perform an evaluation of the integrity of the cranial cruciate ligament on a dog for
suspected ruptured ligament.
5. Perform a urine specific gravity and determine if a cat’s kidneys are concentrating
the urine appropriately.
6. Starting with a blood sample in an EDTA tube, describe how to determine a
packed cell volume (PCV) and total protein (TP), and determine the PCV and TP
of a prepared hematocrit tube.
7. Perform a patellar reflex evaluation and describe how it could be affected by a
spinal lesion.
8. Perform a skin scraping for suspected demodex using live animal and model

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 Small Animal Medicine

9. Perform one of the following cranial nerve examinations, describe the expected
response to the procedure and state which cranial nerves are being tested:
Menace Response, Facial Sensation, Gag Reflex, Pupillary Light Reflex.
10. Perform a fine needle aspirate on a fruit model and prepare a slide for analysis.
11. Perform a Schirmer tear test and interpret the results.
12. Perform a Fluorescein stain and interpret the results.
13. Perform a proprioceptive examination and interpret the results.

Assessment Sheet for Small Animal Practice—Station Three (SAM03)

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SAM03 ASSESSMENT, Clinical Techniques Small Animal Medicine
Candidate Name/ID:
Date/Session Site: Examiner:

MAX CANDIDATE
Activity/Skill
POINTS SCORE
PART A 40
Candidate is scored on ability to perform correctly and efficiently 2 of the
following 4 skills:

1. Gather the necessary equipment for and describe/demonstrate how to

locate the bladder and perform a cystocentesis on a live animal. The
actual cystocentesis will be performed on a stuffed animal model.

2. Gather the necessary equipment for, and describe how to perform,

thoracocentesis on a live animal. Demonstrate the technique on a stuffed
animal model.

3. Gather the necessary equipment for, and describe how to perform,

abdominocentesis on a live animal. Demonstrate the technique on a
stuffed animal model.

4. Gather the necessary equipment for, and describe how to perform,

urinary catheterization of a male dog. Demonstrate passage of a catheter
on a suction tube model.

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SAM03 ASSESSMENT, Clinical Techniques Small Animal Medicine
Candidate Name/ID:
Date/Session Site: Examiner:

MAX CANDIDATE
Activity/Skill
POINTS SCORE
PART B 60
Candidate is scored on ability to correctly and efficiently perform 5 of the
following 13 skills:

5. Calculate and draw-up a correct dose of an antibiotic, given the dosage

and the size of the animal.

6. Perform evaluation of integrity of cranial cruciate ligament on a dog for

suspected ruptured ligament.

7. Perform a urine specific gravity and determine if a cat’s kidneys are

concentrating the urine appropriately.

8. Starting with a blood sample, in an EDTA tube, describe how to

determine PCV and TP, and determine the PCV and TP of a prepared
sample.

9. Perform a patellar reflex evaluation and describe how it could be

affected by a spinal lesion.

10. Perform a skin scraping for suspected demodex using live animal and
model

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SAM03 ASSESSMENT, Clinical Techniques Small Animal Medicine
Candidate Name/ID:
Date/Session/Site: Examiner:

MAX CANDIDATE
Activity/Skill
POINTS SCORE
PART B - Continued

11. Perform one of the following cranial nerve examinations. Describe the
expected response to the procedure and state which cranial nerves are
being tested.
i. Menace Response

ii. Facial Sensation

iii. Gag reflex

iv. Pupillary light reflex

12. Perform a fine needle aspirate and prepare a slide for analysis using a
fruit model.

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SAM03 ASSESSMENT, Clinical Techniques Small Animal Medicine
Candidate Name/ID:
Date/Session/Site: Examiner:

MAX CANDIDATE
Activity/Skill
POINTS SCORE
PART B - Continued

13. Perform a Schirmer tear test and interpret results

14. Perform a fluorescein stain and interpret results

15. Perform a proprioceptive examination and interpret results

16. Listen to and interpret two (2) cardiac sounds

17. Gather the necessary equipment for, and demonstrate how to perform,
jugular venipuncture.

TOTAL POINTS 100

Primary examiner’s name, initials & signature (required on all assessment sheets regardless of
final score):

Name (print): ___________________________________________Initials: ___________________

Signature: ______________________________________________

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 Small Animal Medicine
Small Animal Medicine Summary Score Sheet

Small Animal Medicine Summary and Final Score Sheet Candidate Name/ID:
Date/Session/Site:

Raw Points Weighted

STATION Awarded Weighting Points
Awarded

STATION 1: Clinical Evaluation 40%

Total points awarded from SAM01 Assessment

STATION 2: Medical Management 40%

Total points awarded from SAM02 Assessment

STATION 3: Clinical Techniques 20%

Total points awarded from SAM03 Assessment

FINAL SCORE (60 weighted points required to pass) 100%

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Appendix 1

Small Animal Medicine Appendices

Appendix 1—History and Physical Examination Form

Candidate Name: CPE Site/Date/Session (AM/PM)

Patient Species:

Date:

Presenting Complaint:

RECORDING GUIDE
1. Presenting Complaint
2. History of present illness
3. Past History
a) medical
b) surgical
c) trauma
d) vaccinations
4. Husbandry
5. Systems Review
a) integumentary
b) ophthalmic
c) otic
d) respiratory
e) cardiovascular
f) gastro-intestinal
g) urinary
h) reproductive
i) musculoskeletal
j) lymphatic
k) nervous
6. Signature

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Appendix 1

Candidate Name: CPE Site/Date/Session (AM/PM)

Patient Species:

Date:

Presenting Complaint:

CHECK ABNORMAL AND DESCRIBE BELOW

1. General Appearance
2. Cardiovascular
3. Respiratory
4. Nervous
5. Musculoskeletal
6. Integumentary
7. Urinary
8. Reproductive
9. Gastro-intestinal
10. Lymphatics
11. Ophthalmic
12. Otic
13. Mucous
14. Membranes
15. Oral Cavity
16. Other

Temperature

Pulse

Respiration

Weight

Temperament

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Appendix 2

Appendix 2—Prescription Form

Candidate Name: CPE Site/Date/Session (AM/PM):

Client name:

Client Address: 123 Main St, Columbus, Ohio

Client phone number: 432-123-4567

Animal name:

Species: ____________________________________________________________

Rx

Nonrefillable Refillable ( times through [date])

DVM name: DEA/Reg Number: 12345

DVM signature: Date:

DVM Address: Animal Care Clinic, Columbus, Ohio

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Appendix 3

Appendix 3—Medical Management and Treatment Order Form

-Page 1-
CPE SITE/DATE/SESSION (AM/PM):
CANDIDATE Name/ID

PATIENT INFORMATION (to be completed by the site)

SPECIES/BREED: AGE:
NAME: SEX:
WEIGHT: DATE ADMITTED:
OWNER NAME: OWNER PHONE:
OWNER ADDRESS:

ADMISSION HISTORY AND PHYSICAL EXAMINATION FINDINGS (provided by the

site)

CANDIDATE’S INITIAL ASSESSMENT AND MANAGEMENT PLAN WRITTEN IN

AN ORDERLY FORMAT

NOTE: Candidate must also complete treatment orders (final page of this form) and attach a
completed prescription form (Appendix 2) for one appropriate prescribed drug

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 Small Animal Medicine
Appendix 3

Appendix 3— Medical Management and Treatment Order Form

-Page 2-
DATE: CANDIDATE NAME/ ID:

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Appendix 3

Appendix 3— Medical Management and Treatment Order Form

-Page 3-
DATE: CANDIDATE NAME/ ID:

CANDIDATE’S WRITTEN RECORDS (continued)

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Appendix 3

Appendix 3— Medical Management and Treatment Order Form

-Page 4-
DATE: CANDIDATE NAME/ID:

CANDIDATE’S WRITTEN RECORDS (continued)

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Appendix 3

Appendix 3— Medical Management and Treatment Order Form

PATIENT TREATMENT ORDERS—PAGE 1 (assume a veterinary technician is taking over care and monitoring of patient from 5 pm-5
am)
Client Last Name: TENTATIVE DIAGNOSIS

Pet Name:

Signalment:

Doctor (Candidate) Name:

Date:

MONITORING PARAMETERS 5p 6p 7p 8p 9p 10 p 11 p 12 a 1a 2a 3a 4a 5a

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 Small Animal Medicine
Appendix 3

FLUID TYPE AND RATE

MEDICATIONS AND OTHER

THERAPIES (including concentration, 5p 6p 7p 8p 9p 10 p 11 p 12 a 1a 2a 3a 4a 5a
volume, and route of administration)

DIAGNOSTIC TESTS

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Appendix 3

Appendix 3— Medical Management and Treatment Order Form

PATIENT TREATMENT ORDERS—PAGE 2 (assume a veterinary technician is taking over care and monitoring of patient from 5 pm-5
am)
Doctor (Candidate) Name:

Date:

ADDITIONAL INFORMATION (eg, When to contact the doctor in charge, etc):

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 Surgery

SURGERY
Competencies
The surgery portion will assess the candidate's ability to:
• prepare the patient for a surgical procedure,
• prepare himself/herself for a surgical procedure,
• perform the surgical procedure.
ECFVG candidates may find it helpful to review small animal surgery techniques as described in
up-to-date standard textbooks such as:
• Fossum TW, Hedlund CS, Hulse DA, et al. Small Animal Surgery, 5th ed. (2018), Mosby
Year Book.
• Slatter D. Textbook of Small Animal Surgery, 3rd ed. (2004), Saunders.

Time
Maximum time: 2.5 hours from initiation of patient preparation and transfer of the patient to the
surgery room to completion of surgical procedure (placement of final skin suture) – including
time required for extra instruments or suture material requested, or for changing gown and
gloves. Candidates not completing the surgical procedure in this time period will fail the Surgery
Section of the CPE. However, at the examiner’s sole discretion, a candidates’ clock might be
stopped as appropriate during an excessive delay that is preventing the candidate from
continuing with the procedure.

Set-up Information
1. Animal Requirements: One female dog per candidate, 6-28kg (BCS within 2-4 out of 5),
not visibly or palpably pregnant, not visibly in heat (i.e., no visible external evidence of
bloody vaginal discharge), acceptable anesthetic risk based on physical examination.

Extreme care will be made to ensure dogs used in this section are sexually intact.
However, should a candidate discover after opening the abdomen that an
ovariohysterectomy had previously been performed, the candidate will indicate this to the
examiner by identifying and demonstrating the ovarian pedicles and the uterine stump.
The examiner will then evaluate the candidate’s skill in closing the surgical site. No
additional time will be added.
2. Minimum Personnel Requirements
a. One veterinary examiner per no more than 3 candidates
b. One technical assistant or veterinary technician per no more than 4 candidates
3. Facilities and Equipment
a. Rooms (or areas) equipped for the preparation of animals for surgery
b. Rooms (or areas) equipped to carry out the required surgical procedures
c. Timing device visible from each station to track examination time. Please note that,
when possible, timers will be of the “count-down” variety to allow candidates and
examiners alike to clearly see time remaining in station or section.
4. Supplies/Information Provided by The Examiner
a. Surgical supplies and clothing commonly used for the teaching of undergraduate
veterinary surgery, including an assortment of suture materials, gloves, masks, caps,
etc.

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 Surgery

b. Sterile surgical gown pack; use of/gowning with to be demonstrated during

orientation.

There will be variation in the type of supplies available for surgery. Candidates will need to have
some flexibility in the selection of appropriate material. Candidates may be asked to use either
standard gowns or wrap-around gowns.

5. Supplies Provided by The Candidate

a. Stethoscope, rectal thermometer, penlight, clean laboratory coat, surgical scrubs

General Requirements of the Candidate

Candidates are expected to handle all animals in a humane and safe manner. If, in the opinion of
the examiner, the candidate does not handle the animal humanely or handles the animal in a
manner that is unsafe to them or other personnel the examiner may assess penalties ranging from
a skill failure to dismissal of the candidate with a fatal flaw and a ‘fail’ for the Surgery Section of
the CPE. The exam will also be terminated, and the candidate dismissed if, in the opinion of the
examiner, the candidate is jeopardizing the health and well-being of the animal patient.

The Surgery and Anesthesia sections of the CPE will be administered at the same time. An
anesthesia candidate will anesthetize, stabilize, and monitor the animal while a surgery candidate
performs the surgical procedure.

The Surgery section of the CPE will be scored on a pass/fail basis. No numerical score will be
given. A “pass” equates with at least a minimally competent performance of surgical skills
expected of an entry-level veterinarian. The examiner will use the surgical skills assessment
sheet (SU01) as a checklist to record comments regarding each candidate’s performance. The
examiner will note both positive and negative observations but will not provide the candidate
with any feedback except in the case of a fatal flaw (see Surgery Appendix 1).

Should a candidate receive an “inadequate behavior/low risk to patient” assessment (column on

the SU01 assessment sheet marked with a +) for three or more skills, they will be allowed to
complete the Surgery section (unless the cumulative errors put the animal’s life in danger) but
will receive a failing grade for this section.

Candidates who receive an “INADEQUATE/HIGH RISK TO PATIENT OR DID NOT PERFORM AT

ALL” assessment (corresponds to the column on the SU01 assessment sheet marked with an *)
for any one skill will fail the Surgery section but may be allowed to continue. Alternatively, the
examiner MAY stop the candidate from continuing in the Surgery Section; then identify, verify
with a second examiner/observer, record, and correct a fatal flaw; and award the candidate a
FAILING GRADE for the Surgery Section. Candidates awarded a fatal flaw will be dismissed and
not be allowed to complete the Surgery Section.

Fatal flaws are failing behaviors that potentially put the animal’s life at risk or personnel in
danger. Examples of common fatal flaws are shown in Appendix 1 of this section.

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 Surgery

It is imperative that candidates maintain aseptic technique throughout the procedure. If, at any
time during the preparation, gowning and gloving, or draping of the patient, the candidate
accidentally contaminates themselves or the surgical field, the candidate should immediately
notify a technician or an examiner and will be given the opportunity to correct the situation. If a
break in aseptic technique during these stages is observed by a technician or examiner and the
candidate does not recognize or indicate that that has happened, they will be informed that they
have contaminated themselves or the surgical field, given a warning, and allowed to correct the
situation. Candidates who break aseptic technique a second time without recognizing it
themselves and informing the technician or examiner will be given a fatal flaw and dismissed
from the remainder of the procedure.

Once the surgical incision is made (i.e., the surgical procedure has begun), candidates are not
given one warning for a break in aseptic technique that they do not recognize. During the
surgical procedure, candidates must recognize any break in aseptic technique, inform the
examiner that they need to correct the situation, and then appropriately and completely address
the break in asepsis. If, in the examiner’s opinion, the candidate fails to appropriately and
completely address the break, the candidate will be given a fatal flaw and dismissed from the
remainder of the procedure. Additionally, if the examiners or technicians observe a candidate
break aseptic technique during the surgical procedure and the candidate does not recognize or
take proper steps to correct it, the candidate will be issued a fatal flaw for putting the animal’s
life at risk.

Please note that there are many factors that go into the pass/fail decision in this section.
Successful entry-level performance of the skills assessed in the Surgery Section involves much
more than having the patient survive the surgery—in other words, more than getting through the
procedure without being dismissed for committing a fatal flaw. Candidates are also reminded
that the ECFVG is evaluating clinical procedures on a living animal that may result in
deleterious, even fatal consequences to that animal. Therefore, the assessment of the adequacy of
the surgical procedure can be affected by the discovery of clinical changes after the procedure is
completed that can be ultimately traced to errors made by the candidate surgeon leading to
awarding of a fatal flaw after the surgical procedure has been completed. Candidates should be
aware that the final score for the surgery section is not determined until 24 hours after
completion of the surgery. Complications arising from surgical error within the initial 24-hour
post-operative period will adversely affect their score for the surgery section. Examples of such
complications include, but are not limited to, intraabdominal haemorrhage due to inadequate
vascular ligation or herniation or dehiscence of abdominal contents due to inadequate abdominal
wall closure.

Overview of the Surgery Section

The candidate will perform an elective ovariohysterectomy on a dog anesthetized by another

candidate or an anesthetist. A veterinary technician will be available to provide materials but
must be instructed by the candidate in all actions to perform. Candidates should assume that
surgery is being performed on a client-owned animal that will be going home after a sufficient
recovery period within the veterinary hospital.

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Once the dog is anesthetized, the candidate will prepare the dog for ovariohysterectomy, prepare
him or herself to perform the surgery aseptically; and perform the ovariohysterectomy. As the
candidate progresses through the surgery, there are several points at which the candidate must
ask the examiner to check the patient before continuing with the procedure. First, candidates
must demonstrate each ovarian pedicle and the uterine body ligatures to the examiner prior to
releasing those structures into the abdomen and leave the excised reproductive tract on the
instrument tray so that the examiner can assess the tract as time permits. Second, candidates must
inform the examiner when they are ready to start the abdominal wall closure and must also state
the size and type of suture material they will use during the closure. Finally, candidates must
announce to the examiner when they have completed the abdominal wall closure and must wait
for the examiner to check the closure before continuing on with closure of the skin and
subcutaneous layers. If a candidate must wait for the examiner to evaluate the ligatures, the
surgical site before beginning the abdominal wall closure, or the completion of the abdominal
wall closure, the time spent waiting will be added to the candidate’s total allowed time (i.e., time
spent waiting for the examiner will not count against the candidate’s total allowed time for this
section).

(Note—See also SU01 Assessment Sheet on the following pages)

Standard Script for Surgery Section - The examiner should read the following script (in quotes)
to each candidate. The script may be modified to meet specific facility or equipment restrictions
at each site. Time should not begin until all instructions have been read.

“In this section, you will be the veterinary surgeon. A technician will be available to
assist you, but only at your request and direction. We will be evaluating your
performance and will be recording both positive and negative behaviors. Please do not let
our writing affect your performance. We cannot offer feedback during or after the
examination, but we may interrupt and stop the examination if you commit an error that
places the animal in a potentially life-threatening situation or yourself or other personnel
in danger. If you are excused, please understand that it is not a personal decision, and you
will be required to leave the area immediately. Trying to discuss the situation may detract
from the examiner’s ability to evaluate other candidates and place them at a disadvantage.

You will be performing an elective ovariohysterectomy on a dog. Please assume the

surgery is being performed on a client-owned animal that will be going home after a
sufficient recovery period within your hospital.

Once the dog is anesthetized, you will be required to prepare the dog for
ovariohysterectomy, prepare yourself to perform the surgery aseptically; and perform the
ovariohysterectomy.

You will need to request supplies or equipment as needed for surgical preparation and the
surgical procedure. If the specific supply or equipment you request is not available, you
will be asked to make another choice from the equipment and supplies we have available
here.

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 Surgery

It is imperative that you maintain aseptic technique throughout the procedure. If, at any
time during the preparation, gowning and gloving, or draping of the patient you
accidentally contaminate yourself or the surgical field, you should immediately notify a
technician, or an examiner and you will be given the opportunity to correct the situation.
If a break in aseptic technique during these stages is observed by a technician or
examiner and you do not recognize or indicate that that has happened, you will be
informed that you have contaminated yourself or the surgical field, given a warning, and
allowed to correct the situation. Candidates who break aseptic technique a second time
without recognizing it themselves and informing the technician or examiner will be given
a fatal flaw and dismissed from the remainder of the procedure.

Once the surgical incision is made (i.e., the surgical procedure has begun), candidates are
not given one warning for a non-recognized break in aseptic technique. During the
surgical procedure, candidates must recognize any break in aseptic technique, inform the
examiner that they need to correct the situation, and then appropriately and completely
address the break in asepsis. If, in the examiner’s opinion, the candidate fails to
appropriately and completely address the break, the candidate will be given a fatal flaw
and dismissed from the remainder of the procedure. Additionally, if the examiners or
technicians observe a candidate break aseptic technique during the surgical procedure and
the candidate does not recognize or take proper steps to correct it, the candidate will be
issued a fatal flaw for putting the animal’s life at risk.

During the surgical procedure, once you have ligated the ovarian pedicles and uterine
body, you must demonstrate the ligatures to the examiner prior to releasing them into the
abdomen. Failure to do so may result in a considerable time delay as you retrieve the
ovarian pedicles and uterine stump for examiner evaluation. Once you have excised the
reproductive tract, please leave it on the instrument tray so that the examiner can assess
the reproductive tract as time permits.

When you are ready to start the abdominal wall closure, you must inform the examiner
and you must tell the examiner the size and type of suture material you plan to use for the
closure. After you have completed the abdominal wall closure, you will need to have the
examiner come over to assess your closure before proceeding. Any time spent waiting for
the examiner for any of the above assessment points will not be counted against your
total time allowed for this section.

We have made every attempt to ensure all dogs used in this section are sexually intact.
However, if you discover your patient has already been spayed, you will be required to
identify and demonstrate the ovarian pedicles and uterine stump to the examiner prior to
closing the incision.

You have 2.5 hours to complete this section of the CPE from initiation of patient preparation to
placement of the final skin suture. Please plan your time accordingly.” Assessment Sheet for
Surgery (SU01)

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 Surgery

Skills to be assessed include those involved in:

a. Patient and surgeon preparation;
b. Performing an ovariohysterectomy.

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SU01 Assessment, Surgical Skills Surgery
Candidate Name/ID:
Date/Session/Site: Examiner:

Patient Preparation—Candidates will be assessed Adequate/ †Inadequate *Inadequate

on their ability to prepare the patient’s surgical Pass with low risk with high risk to
site for aseptic surgery : to patient patient OR did
not perform task
at all (fatal flaw)
HAIR REMOVAL

SKIN PREPARATION

PATIENT POSITIONING

DRAPING

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SU01 Assessment, Surgical Skills Surgery
Candidate Name/ID:
Date/Session/Site: Examiner:

Surgeon Preparation—Candidates will be Adequate / †Inadequate *Inadequate

assessed on their ability to prepare themselves for Pass with low risk with high risk to
an aseptic surgery : to patient patient
OR did not
perform task at
all (fatal flaw)
ATTIRE & SCRUBBING

GOWNING/GLOVING

Ovariohysterectomy—Candidates will be assessed Adequate / †Inadequate *Inadequate with

on following skills : Pass with low risk high risk to patient
to patient OR did not
perform task at all
SURGICAL INCISION

EXCISION OF OVARIES

Ovariohysterectomy—Candidate assessed on Adequate / †Inadequate *Inadequate

following skills (continued) : Pass with low risk with high risk
to patient to patient OR
did not
perform task
at all
REMOVES MAJORITY OF UTERUS

ABDOMINAL WALL CLOSURE

Ovariohysterectomy—Candidate assessed on Adequate / †Inadequate *Inadequate with

following skills (continued) : Pass with low risk high risk to patient
to patient OR did not
perform task at all

CREATES SECURE SUBCUTANEOUS AND SKIN

CLOSURE

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SU01 Assessment, Surgical Skills Surgery
Candidate Name/ID:
Date/Session/Site: Examiner:

Ovariohysterectomy—Candidate assessed on Adequate / †Inadequate *Inadequate

following skills (continued) : Pass with low risk with high risk to
to patient patient OR did
not perform task
at all
TISSUE HANDLING

HEMOSTASIS

KNOT TYING AND LIGATURES

PREVIOUSLY SPAYED ANIMAL

Ovariohysterectomy—Candidate assessed on Adequate / †Inadequate *Inadequate with

following skills (continued) : Pass with low risk high risk to patient
to patient OR did not
perform task at all
OVERALL SURGICAL EFFICIENCY

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SU01 Assessment, Surgical Skills Surgery
Candidate Name/ID:
Date/Session/Site: Examiner:

Receiving three (3) or more “Inadequate with Low Risk to patient” assessments or one (1)
“Inadequate with High Risk to patient” assessment will result in failure of the surgery section.

FINAL SURGERY SECTION SCORE (PASS OR FAIL)

Primary examiner’s name, initials & signature (required on all assessment sheets regardless of
final score):

Name (print): ___________________________________________Initials: _______________

Signature: ______________________________________________.

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 Surgery
Appendix 1
Surgery Appendices

Appendix 1—Fatal Flaw List

These are failing behaviors that potentially put the animal’s life at risk or personnel in danger. All are
behaviors that may require examiner intervention and will result in a failing grade for the candidate and
dismissal from this section of the CPE.

The examiner will stop the Surgery Section immediately if any one behavior from the following fatal
flaw list is observed (i.e., recognized by the examiner and confirmed by another examiner or observer):

1. Candidate fails to control significant hemorrhage.

2. Candidate fails to create a secure closure of the abdominal wall.
3. Candidate is unable to achieve and maintain an aseptic field (to include patient and surgeon
preparation).
4. Candidate causes significant damage to other tissues/organs (e.g., clamping or tying off one or
both ureters).
5. Candidate exhibits any other behavior that would put the animal’s life at risk. The examiner must
document the behavior (e.g., leaving instrument/sponge/ other surgical equipment in animal)

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