Mastering the Necropsy Section of the CPE Exam: A Comprehensive Guide

The Clinical Proficiency Exam (CPE) is a crucial step for internationally trained veterinarians seeking licensure in the United States. Among its many practical components, the Necropsy section evaluates a candidate’s ability to perform a thorough and systematic post-mortem examination. This skill is essential for diagnosing disease, understanding pathophysiology, and contributing to veterinary forensic investigations.

If you’re preparing for the CPE, here’s everything you need to know about the Necropsy section to ensure you approach it with confidence and precision.

Understanding the Importance of Necropsy in Veterinary Medicine

Necropsy, or animal autopsy, is a vital diagnostic tool in veterinary medicine. It allows veterinarians to:

• Determine the cause of death in companion animals, livestock, and wildlife.

• Identify infectious diseases that could impact animal populations or public health.

• Assess the effectiveness of treatments or medical interventions.

• Contribute to forensic investigations in cases of suspected animal abuse or poisoning.

Because of its importance, the CPE ensures that candidates demonstrate proficiency in performing a structured and meticulous necropsy.

What to Expect in the CPE Necropsy Section

During the Necropsy portion of the exam, candidates will be required to:

1. Conduct a Thorough External Examination

2. Perform a Systematic Internal Examination

3. Collect and Handle Tissue Samples and Sharps Handling Safety

4. Perform the Cardiac Dissection with your Examiner Present

5. Record and Communicate Findings

Essential Skills and Best Practices for Success

1. Develop a Systematic Approach

Consistency is key in necropsy procedures. Always follow a step-by-step method to ensure you don’t overlook critical findings. A recommended sequence includes:

• External examination

• Opening the thoracic and abdominal cavities

• Examining the major organs systematically in situ, with the examiner witnessing the heart dissection

• Examining the major organs systematically, individually 

• Heart dissection with the examiner present

• Remove the head from the carcass (cut the soft tissues around the throat and occiput, then twist! Observe CSF 

2. Sharpen Your Dissection Technique

• Use precise, controlled incisions to avoid unnecessary tissue damage. For example, use the larger knife for skinning but small scissors for the heart dissection, cut away from your hands and trunk for safety, never cut using your hand as a surface

• Handle organs gently to prevent distortion of pathological findings, and sample prior to manipulation.

• Maintain proper instrument safety throughout the procedure, remove your blade immediately when the timer rings, and safely dispose of it in the sharps container (fatal flaw to forget)

3. Improve Your Observational Skills

• Compare affected and unaffected areas to distinguish pathological from normal findings.

• Practice describing lesions in a clear, detailed manner.

• Prepare for commonly asked questions: patency of the bile duct, origin of muscle samples, purpose of observation of the diaphragmatic penetration.

4. Master Sample Collection and Preservation

• Ensure clean and contamination-free collection of tissues.

• Select appropriate sample sizes and storage methods based on diagnostic needs.

• Accurately label samples with relevant case details.

5. Practice Clear and Professional Documentation

• Use standard veterinary terminology to describe lesions.

• Be concise yet thorough in your descriptions.

• Ensure your notes are structured logically and easy to interpret.

Common Mistakes to Avoid

🚫 Skipping the External Exam: Many candidates rush into the internal examination and miss critical external findings. Practice describing the external examination out loud to a family member or a colleague. (TIP: imagine it is a regular physical exam minus the vitals, look at everything!)

🚫 Poor Dissection Technique: Unsafe sharp handling, accidental penetration of the chest. Failure to examine both of the paired organs, failure to open, separate, and inspect everything (must separate esophagus from trachea, cut into both, open larynx, open smaller bronchi, etc)

🚫 Inadequate Explanation: Don’t underestimate the importance of your oral presentation! Practice describing the process and the findings out loud. Thoroughly review your anatomy knowledge. Be prepared to identify any structure or organ

🚫 Ignoring Sample Collection Guidelines: Too small a sample size can cost you many points. Remember to cut small organs in half, such as the adrenal or thyroid. Strip the kidneys out of their capsule and slice open like a sandwich bun. Describe the medulla to cortex ration, take a wedge sample

How to Prepare for the CPE Necropsy Section

🔹 Hands-on Practice: Perform practice necropsies whenever possible. Once you establish a trusted rapport with a clinic or a shelter you can ask for permission to practice necropsies on stray animals that had to be euthanized. Buy chicken hearts to practice the heart dissection (they are the appropriate difficulty level). Consider booking an in-person training course. Look for formalin specimens sold for teaching purposes online.

🔹 Study Pathology References: It can be helpful to read pathology reports to familiarize yourself with the language, but don’t worry about diagnosing cases!

🔹 Watch Demonstration Videos: There are several videos on Youtube that have served as a gold standard for years. Check them out and memorize every step. Then practice as if it was your exam day!

🔹 Review Sample Reports: Practice writing structured and professional necropsy reports based on the form provided in the MOA. Study the instructions in the MOA; they provide a lot of helpful details on how your performance is graded

Final Thoughts

The Necropsy section of the CPE may seem daunting, but with the right preparation and practice, you can confidently showcase your skills. Approach the exam methodically, stay focused, and remember that clarity, precision, and professionalism are key. By mastering this essential veterinary skill, you’re not just passing an exam—you’re building a foundation for excellence in your veterinary career.

If you’re looking for step-by-step guidance, demonstrations, and detailed section descriptions, join the CPE Online Academy! We have twelve detailed instructional videos dedicated to the Necropsy section of the CPE, as well as other study tools to get you up to speed on everything you need to pass the CPE the FIRST time! Enroll now at https://app.cpeonlineacademy.com/