Clinical Proficiency Examination (CPE)

Registration Procedure

An applicant who is required to sit the CPE and who has successfully completed the BCSE (or the old Parts A and B of the NEB Examination) and the PSA, or a graduate of an accredited veterinary school who required more than three attempts to pass the NAVLE and has passed the PSA, will be able to register for the CPE in the NEB Candidate Portal. The planned dates and sites of the next available sessions of the CPE will be announced as soon as they become available. To register candidates must complete the following:

1. Registration in the NEB Candidate Portal;
2. Payment of the appropriate Examination Fee in the NEB Candidate Portal;
3. Submit Surgical Experience Documentation (for candidates who registered with the NEB after January 1st, 2015 only)

Candidates should note that while every attempt will be made to accommodate a candidate’s choice of site and date, because of the restricted numbers for the CPE sessions, a candidate may be required to accept an alternate site, or wait until a later date for the chosen site. (For an explanation of the priority given to candidates for the CPE, see Availability of the Examinations)

Surgical Experience Documentation

Candidates who enroll into the NEB program on or after January 1, 2015, must submit validated Surgical Experience Documentation forms as proof of having performed, in the five-year period prior to date of CPE, at least one (1) ovariohysterectomy as the primary surgeon and at least five (5) additional surgical procedures as either the primary or the assistant surgeon. The 5 additional procedures may be ovariohysterectomies or other surgical procedures, but each documented surgery should involve all elements of an aseptic surgical procedure, including gowning & gloving, draping of the patient, and use of sterile instrumentation, and be performed under direct observation by the veterinarian(s) attesting to the surgery. Validation of surgery experience can be provided by one or more veterinarians licensed to practice veterinary medicine in any international jurisdiction. Candidates must confirm with the appropriate regulatory authorities in the jurisdiction where they are obtaining surgical experience from to ascertain whether licensure in that jurisdiction is required before performing surgery. Please note that candidates who enrolled into the NEB program on or after January 1, 2015, will be eligible to register for the full CPE only when the required documentation is received in its entirety in the NEB office and processed by NEB staff. The NEB reserves the right to verify the documents received. Candidates are reminded that falsification of documents would be a violation of the Rules of Conduct and can resolve in disciplinary actions up to and including dismissal from the program. Candidates who successfully fulfill this eligibility requirement will be notified of their eligibility to take the CPE by e-mail and will be able to register and apply for CPE through the CVMA website.

This CPE eligibility requirement does not apply to candidates enrolled in the NEB program prior to January 1, 2015. However, the NEB strongly recommends that all candidates have the experience described above prior to attempting the surgical section of the CPE.

Please submit surgical experience documentation via email to neb-bne@cvma-acmv.org or the NEB Candidate portal.

Preliminary Surgical Examination (PSA)

Passing the PSA is mandatory for all candidates that wish to take the CPE in Canada after January 1st, 2017.

Clinical Proficiency Examination (CPE)

The Clinical Proficiency Examination (CPE) consists of seven (7) sections. Each section requires between 45 minutes to four hours to complete, with the entire exam administered over a period of several days, depending on the exam administration site.

In each of the major topic areas, the candidate will be evaluated on the clinical skills and behaviour appropriate to that subject/discipline. Throughout the CPE there are frequent requirements of the candidate to communicate with a client (a role played by the Examiner), to demonstrate the ability to take a history by asking relevant questions and to communicate a clinical message. The major topic areas are: Anaesthesia, Equine Practice, Food Animal Practice, Necropsy, Radiographic Positioning, Small Animal Medicine and Surgery.

The rationale for the Anaesthesia and Surgery sections is that surgery is a major therapeutic measure in veterinary medicine. At entry level a veterinarian should have basic surgical and anaesthesia skills and the ability to perform routine procedures. The species involved is usually canine. The estimated total time for the Anaesthesia section is approximately 4 hours, whereas the total time for the Surgery section is 2.5 hours.

The Equine Practice section rationale is that veterinarians providing health care must be able to utilize a variety of knowledge and skills to define and correct medical problems. The estimated time for this section is 2.25 hours.

The Food Animal Practice section rationale is that veterinarians providing animal health care must be able to utilize a variety of knowledge and skills to define and correct medical problems. Veterinarians practicing economic animal medicine are expected to have clinical and management knowledge to detect and prevent diseases in populations of animals and to enhance the efficiency of food animal production units. The species involved may be bovine, caprine, ovine and/or porcine. The estimated duration of this section is 3 hours.

The Necropsy is a single station section. The rationale is that practicing veterinarians are expected to perform and interpret routine tests and procedures in order to provide comprehensive health care. The candidate will be expected to perform a complete necropsy using an acceptable procedure and collect tissue samples for histopathology. Species involved may be bovine, canine, equine, feline, ovine, porcine and/or caprine. The estimated time for the Necropsy section is 1 hour and 30 minutes.

The Radiographic Positioning section also comprises a single station. Candidates will be required to determine anatomical structures and views, and produce diagnostic quality radiographic images of thereof. The estimated total time for this station is 45 minutes.

The Small Animal Medicine section rationale is that veterinarians providing animal health care must be able to utilize a variety of knowledge and skills to define and correct medical problems. Veterinarians are also expected to provide medical care to animals in life-threatening and emergency situations. They must be able to recognize the need to take appropriate action in dealing with zoonotic diseases, including those that must be reported to public health and disease control officials. Species involved may be canine and/or feline. This section lasts 2.25 hours.

CPE Manual of Administration (MOA) 2024

The 2024 CPE MOA is used for exams administered in 2024.

It is your responsibility to read the entire Manual of Administration to ensure that you understand what will be expected of you during the 2024 CPE.

Should you have any questions regarding the new CPE Manual of Administration, please contact the NEB office via e-mail at neb-bne@cvma-acmv.org.

• 2024 Manual of Administration Candidate Version
• 2024 Manual of Administration Candidate Version French

Self Assessment Tool for the Clinical Proficiency Exam

This tool is designed to help you evaluate your preparedness for the Clinical Proficiency Exam. It should not be interpreted as an exclusive or comprehensive summary of required learning for successful completion of the Clinical Proficiency Exam.

Candidates are advised to refer to the Manual of Administration for the Clinical Proficiency Exam (link available on this website) for a detailed look at each of the seven sections of the Clinical Proficiency Exam.

In North America, readiness for practice is based on demonstration of competency in the following areas.

• Clinical Reasoning and Decision-making
• Individual Animal Care and Management (including surgery)
• Animal Population Care and Management
• Public Health
• Communication
• Collaboration
• Professionalism and Professional Identity
• Financial and Practice Management
• Scholarship

To maximize the likelihood of success in your performance in the Clinical Proficiency Exam, the following questions are designed to help you self-assess your readiness to take the CPE.

Can you perform each of the tasks asked in the following questions?

Anesthesia

1. Can you formulate, calculate, and implement a sedation, induction and anesthesia protocol for a companion animal?
2. Can you list several different drugs used in pre-anesthetic protocols and explain how each drug fits into a multi-modal anesthetic protocol?
3. Can you calculate drug dosages given that you know the weight of the patient both in pounds and in kilograms?
4. Can you calculate appropriate fluid administration rates for maintenance, surgery, and replacement of fluid deficits?
5. Do you know how to select an appropriately sized endotracheal tube for your patient?
6. Do you know how to calculate and choose an appropriately sized rebreathing bag for your patient?
7. Can you name all the parts of an anesthetic machine and check the system for integrity and safety?
8. Can you describe which physiologic parameter is measured by each piece of anesthetic monitoring equipment?
9. Can you consistently place and secure an intravenous catheter, using the appropriate level of sterile technique, in a variety of species?
10. Are you able to adjust the anesthetic plan based on changing physiologic parameters?

Small Animal Medicine, Radiology and Pharmacology

1. Can you collect a complete medical history?
2. Can you safely conduct a physical exam on a variety of species?
3. Do you know normal physiologic parameters and how they relate to each other in the patient?
4. Are you able to explain changes in physiologic parameters in healthy vs anesthetized vs sick patients?
5. Can you generate a problem list and differential diagnoses list for a variety of clinical findings?
6. Can you explain your findings and plan with the animal's owner and provide options for further assessment and care?
7. Can you generate an appropriate diagnostic plan and describe why each test has been chosen?
8. Can you perform basic diagnostic testing and sample collection? For example: Hematocrit, Urine specific gravity, preparing a diagnostic blood smear, serum total protein?
9. Can you position a companion animal to make diagnostic quality radiographs?
10. Can you evaluate thoracic and abdominal radiographs in companion animals?
11. Can you use the data collected to generate a working diagnosis?
12. Can you design and implement a treatment plan and justify the rationale for each part of the plan?
13. Can you explain your rationale for the working diagnosis to the owner, providing options for further care?
14. Can you write hospital orders that are easily readable and understood by other staff caregivers that describe how to monitor and respond to a hospitalized patient?
15. Can you write an appropriate and complete prescription for a veterinary patient?

Surgery

1. Can you identify and perform all the steps in the preparation of a surgical site for an ovariohysterectomy in a dog?
2. Can you maintain a sterile field?
3. Are you able to gown and glove using open and closed gloving techniques?
4. Can you describe the anatomic position of abdominal structures in dogs, cats, horses, and cattle?
5. Can you choose type and size of suture for different procedures, and be able to explain your rationale for your choice?
6. Can you open an abdominal cavity safely using good tissue handling procedures?
7. Can you appropriately close an abdominal incision using multiple layers of closure and appropriately spaced sutures applied with appropriate tension?

Equine Practice

1. Can you perform a lameness exam and assess lameness in a horse?
2. Can you make and evaluate equine limb x rays?
3. Can you use proper anatomical nomenclature in English or French?
4. Can you effectively communicate instruction to support staff for assistance in diagnostic and treatment procedures?
5. Can you give several examples of causes of colic in a horse, and the diagnostic procedures to differentiate them?
6. Describe different treatment regimes for different types of colic?
7. Can you effectively use a rebreathing bag to assess lung function in a horse? Can you instruct an assistant appropriately to help with this test?

Food Animal Practice

1. Can you name the drugs which are prohibited from use in food producing animals?
2. Can you name public health and food health issues that might be a concern in North America, and can you communicate those risks to a client?
3. Can you name 4 zoonotic disease process that are a concern in North America?
4. Can you perform a variety of diagnostic and treatment procedures in ruminant patients including but not limited to : passing a stomach tube, assessing a displaced abomasum, a rectal palpation for pregnancy evaluation?
5. Can you evaluate the health status of a variety of ruminant species, of any age, including herd health and regulatory issues?
6. Can you generate an initial problem list and differential diagnoses, identify reasonable initial diagnostic tests, and interpret their results?
7. Can you determine the most likely diagnosis and develop a therapeutic plan for the animal and/or the herd?
8. Can you estimate the prognosis for the patient and identify regulatory and public health implications?

Necropsy

1. Can you select appropriate equipment, supplies and personal protective equipment needed to perform a systematic necropsy in a safe manner?
2. Are you are able to collect and preserve sections of appropriate size and thickness from a variety of organs?
3. Can you accurately document what you have found on examination of the intact carcass and the open carcass, including normal and abnormal findings of the organs, musculature, joints, glands, and lymph nodes?
4. Are you able to remove the animal’s head for rabies examination?
5. Can you remove and dissect the heart using appropriate technique to identify all its major structures?