Understanding Grading and Feedback for the CPE

The Clinical Proficiency Exam (CPE) is a comprehensive assessment of a veterinarian’s ability to practice safely and competently in the United States. Beyond preparation and technical skill, understanding how the CPE is graded and how feedback is provided is essential for candidates. This blog breaks down the grading system, scoring standards, and feedback mechanisms established by the ECFVG.

How the CPE Is Scored

The CPE is divided into seven sections, each with its own grading rubric outlined in the CPE Manual of Administration (MOA). These rubrics specify the knowledge and technical skills—collectively called clinical proficiency skills—that will be assessed. Examiners evaluate candidates primarily through:

• Direct observation of procedures

• Written descriptions of findings or clinical conclusions, in some cases

Efficiency

In some sections, efficiency is a key component of competency. This refers to the candidate’s ability to:

• Complete a procedure in a timely manner

• Use resources effectively

If a candidate takes an unreasonable amount of time such that the procedure’s outcome is jeopardized, they may be penalized in points. In extreme cases, inability to complete a skill within the maximum allowed time may result in no points awarded for that station or section.

Communication Skills

Effective communication is highly valued in U.S. veterinary practice. Throughout the CPE, candidates are often required to:

• Communicate with clients (role-played by examiners)

• Take an accurate history

• Deliver clinical messages clearly

A candidate’s English communication skills are evaluated. Inadequate communication may negatively impact performance and overall scoring.

Safety Considerations

Candidate and animal safety is paramount during the CPE:

• Examiners may intervene if a candidate compromises their own safety or that of others, e.g., handling a horse incorrectly.

• Procedures may be terminated, and penalties applied, depending on the severity.

• Any act of omission or commission that places an animal in an inhumane or life-threatening situation will result in the section being scored as unsatisfactory (fail), regardless of points earned at the time.

Passing Standards and Score Reporting

Minimum Passing Standards

To pass the CPE, candidates must demonstrate competency expected of a minimally competent new graduate from an AVMA-accredited veterinary school:

• All sections except anesthesia and surgery: Minimum score of 60 points out of 100

• Anesthesia and surgery sections: Scored as pass (minimally competent) or fail

Candidates must achieve at least 60 points or a pass in each section to pass the overall exam.

Score Reporting

• Scores are reported as pass or fail for each section

• Reports are delivered via email and ECFVG Online within 20 business days of the exam’s final day

• Scores cannot be released by fax or phone

• Candidates must ensure their contact information is current in the ECFVG system to receive timely results

Extended Score Reports

For candidates who do not pass, an extended score report can be requested to provide more detailed feedback:

• Identifies areas where knowledge or technical proficiency was deficient

• Intended to guide overall career preparation, not to selectively practice specific skills to retake

• Requests must be submitted within 14 days of receiving the CPE score report

• Reports are sent via email within 15 business days of receipt

• Requests must be made through the ECFVG Candidate Portal (or NEB office in Canada)

• Examiners are prohibited from giving additional feedback directly to candidates during or after the exam

Candidates planning to appeal a failing score must request the extended report before initiating the ECFVG Appeal Process.

Final Thoughts

Understanding the CPE grading system and feedback mechanisms can help candidates focus their preparation effectively:

• Aim for competency across all clinical skills

• Prioritize efficiency, safety, and communication

• Use extended score reports as a tool for long-term professional development

By being aware of how performance is evaluated and how feedback is provided, candidates can approach the CPE with clarity and confidence, ultimately improving their chances of success.