Should You Get Board Certified in Oncology Pharmacy?
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What is Board Certification?
The Board of Pharmacy Specialties (BPS) was created over 40 years ago and offers board certification for pharmacists in 14 specialties. Interestingly, our physician colleagues developed their first board certification in 1917, in ophthalmology no less!
There are currently 4,263 board-certified oncology pharmacists (BCOP) as of 12/2023, which makes it the 4th largest board-certified pharmacy specialty (BCCCP is getting very close to taking over 4th with 4,234).
The purpose of the BCOP certification, according to BPS, is:
To validate that the pharmacist has the advanced knowledge and experience to optimize outcomes for patients with malignant diseases by recommending, designing, implementing, monitoring, and modifying pharmacotherapeutic plans; reducing medication errors; and recognizing and responding to adverse physical and emotional issues that may arise during treatment and when providing education and counseling.
Board certification is a marker of baseline competency. Here is one pharmacist’s view of her BCOP certification.
Should I strive for BCOP?
This is a question asked often - is BCOP worth it? Do employers prefer/require it? Does it actually hold value in the job market?
Each of us is on our own professional journey so I can only speak to my experiences. In oncology jobs I have held or pursued, BCOP is an expectation. If you don’t have it when you start, you are expected to achieve it when eligible. I was in the job market in early 2020 and saw that BCOP was either required or strongly preferred for traditional oncology pharmacist roles. It definitely gives an advantage to those that have it, and it is even more important for those that have not completed residency training as it communicates a baseline competency.
Interestingly, I have found BCOP also holds value, and arguably more value, in non-traditional roles. This is because the vast majority of people outside of healthcare (and even many in healthcare) don’t understand the value of a pharmacist or exactly what services we can provide. When they hear the term “board-certified” it resonates as something they can wrap their head around. They’ve likely heard the term in relation to physicians and it implies competence. I have used it as an additional descriptor of what I am capable of and what skills I bring to a position.
Additionally, I know how difficult oncology can be so when I come across another BCOP I have an instant level of respect for their knowledge and experience.
BCOP Eligibility
Not all pharmacists are eligible to take the BCOP examination. This is one of the most common assumptions people make so let’s outline what the BPS requirements are to sit for the exam. Of note, these can change so always refer back to the BPS website for the most up to date information.
There are 2 buckets of eligibility criteria.
You have to be a licensed (active) pharmacist that graduated from an accredited program
If you are a foreign graduate or are licensed in another jurisdiction, you likely still qualify. In fact, there are many BCOP pharmacists across the world, with Spain leading the charge!
With the increasing prevalence of non-traditional pharmacist roles that don’t require a pharmacist license, there is talk about not maintaining active licensure. If you are striving for board certification and plan to maintain it, you cannot let your license lapse.
You have to have oncology practice experience
This makes sense but what about if you wanted to study and learn the material without having worked in oncology? BPS indicates that this component is required to “assure practical application of components of the specialty knowledge being certified”.
The devil is in the details here. There are 3 paths that BPS recognizes for this practice experience.
You completed a PGY2 oncology residency
Of note, this path does NOT include our colleagues that complete other PGY2 programs. I have worked with pharmacists that completed PGY1/2 programs in pharmacotherapy but they cannot meet eligibility via this path.
You completed a PGY1 pharmacy practice residency AND you have 2+ years of recent (within 7 years) pharmacist experience working in an area where >50% of your time was in oncology
You have not completed residency training but have 4+ years of recent (within 7 years) pharmacist experience working in an area where >50% of your time was in oncology
If you have not completed a PGY2 residency, your practice experience must be attested to by your employer. This attestation must indicate you have spent 50% or more of your time in the domains described in the Oncology Pharmacy Content Outline.
This is where it can get a little fuzzy on exactly what kind of experience counts. They don’t specify it has to be direct patient care. There is a clinical trial and research domain so presumably pharmacists in those area qualify. What about those in the pharmaceutical industry? It isn’t clear but the outline they provide covers a lot of bases so I imagine you could make your case for your experience. Yes, they are here to promote the recognition and value of specialized training, knowledge, and skills in pharmacy but they also generate a lot of revenue from that endeavor. So read the outline and make your case!
*Of note, as of January 1, 2022, programs accredited by the Canadian Pharmacy Residency Board meet the qualifications.
How costly is BCOP?
(Pricing as of 12/2023)
In the grand scheme of your professional development, not that expensive in my opinion. You need to consider the up front costs and the maintenance costs; maintenance costs are dramatically different depending on which recertification path you take. Here are factors to consider:
First Time Exam Fees
The fee to take the initial exam is $600. If you fail, you can retake it again within a year for $300.
Maintenance Fees
Once you become board certified, you pay $125 annually in years 1-6 to maintain it. If you are one of those people that collects BPS certifications, you are only assessed one maintenance fee per year, not one per certification - good news for all the overachievers!
Do not forget to pay this fee! I would HIGHLY recommend setting up autopay and to give BPS your personal email account (not your employer’s) so you don’t miss any notifications if you change jobs.
Recertification fees
In your recertification year (year 7), you pay a recertification fee of $400 regardless of your method of recertification (continuing education or exam). This replaces the usual $125/year maintenance fee for this year. If you recertify by exam and fail, you can retake it again for $200.
Continuing education (CE) fees
This is where the majority of your fees will come from after you initially become certified. To maintain your certification, you need to either retake an exam or accumulate 100 hours of BCOP CE credit every 7 years (more on choosing between these below). Of note, for new certification cycles beginning Jan 2024, you will need 80 hours of BCOP CE credit and 20 hours of CPD (Continuing Professional Development) credit - see the BPS FAQ page for more info.
If you opt to go the CE route, be ready for sticker shock.
There are currently only 2 CE providers that are accredited to provide BCOP credit - HOPA and the ASHP/ACCP partnership.
HOPA’s program offers 28 BCOP hours for $495 if you’re a member and $644 for non-members. ASHP/ACCP’s course offers 25.75 hours for $475/$675 (members/non-members).
There are a few ways to get the remaining hours.
HOPA offers BCOP study bundles that have various amount of credits. You can also purchase individual topics (usually priced at $35/1 hr credit) but it’s less expense per credit hour to bundle them. Due to expiring CE credits, pay close attention to the website for which programs to purchase.
ASHP/ACCP’s has a few offerings that change. Check out their website for more information.
ASHP has an innovative monthly program for recertification CE credit, but unfortunately they don’t offer oncology yet (not sure if they will, it’s been a while…). Something to keep an eye on if you’ll head down the CE path.
The cost of CE qucikly adds up; $495 per recertification cycle for the review course, not including their annual membership fees ($175/yr), and that is barely a quarter of the 100 hours you need. And this is assuming you pass all the post-activity tests; you only get one chance to pass and if you don’t you’ll lose that BCOP credit. Accounting for the remaining credits needed based on HOPA’s per credit cost, you’ll spend over $3000 to recertify by CE over the 7 year cycle, not including the BPS recertification fee.
How do I study for the BCOP exam?
PGY2 oncology residents have a leg up in preparing for the exam as their residency year is structured around almost all the content that is tested.
But if you aren’t residency trained, don’t worry! If pharmacists are skilled at anything it’s being a self-learner. This content can be learned with a structured plan and the right mindset!
Start with the BPS content outline. This is not my favorite way to structure this information but it’s a place to start and includes what content will be on the exam and the percentage of the exam is attributed to each section. The breakdowns for the initial exam are:
Oncology Diagnosis and Testing (23%)
Therapeutics and Patient Management (49%)
Professional Practice (28%)
There are 150 total questions which includes 25 unscored questions that represent new questions they are testing for future exams. They don’t break down which categories those fall into.
For the initial exam, you have 3 hours and 45 minutes to achieve a score of at least 500 (max score is 800).
All the information you need to study for the exam is available on the vast world wide web. But if you are taking BCOP for the first time, I can’t imagine curating the content yourself - there is just so much of it!
Enjoy Learning Oncology (ELO) is a robust training program that combines curated content, access to oncology pharmacy experts to ask questions, a community of your peers, practice cases and questions, and the Oncology Pharmacy Question Bank, which includes >350 questions written and reviewed by board certified pharmacists working in each oncology area.
There are a few other places to purchase information:
ASHP’s recertification course provides a lot of information - and by a lot I mean endless pages of PDFs on each disease state and topic covered on the exam. I’m not going to lie - it’s overwhelming because it’s intended for those that already have a baseline knowledge. It’s actually overwhelming for me and I have a baseline knowledge 😅. This can be used for ACPE credit if you’re studying for the first exam.
HOPA has a Core Competency program that covers basics but does not go into detail on specific diseases. For that information, you can purchase a variety of BCOP materials.
HOPA also has other educational activities on their site you can review as individual topics.
High Yield Med Reviews offers a BCOP study package that has a question bank. They also have some lectures and an eBook, although these are focused more on statistics. I have purchased this myself in the past and was underwhelmed with the content and the platform.
StatPearls has exam questions also but it’s unclear to me from their website who writes them as they offer education for many healthcare professions.
Since high quality practice questions are a great way to prepare for the BCOP exam, the Oncology Pharmacy Question Bank was created to give you access to >350 questions written and reviewed by board certified pharmacists working in each oncology area. You can even add on disease specific practice cases!
All of these other methods rely on you, the individual, to learn on your own with little to no guidance from anyone who can answer questions, which is particularly challenging in oncology. The ELO program provides the support you need when learning oncology as a newer oncology pharmacist.
Should you recertify by CE or exam?
Once you pass the initial exam, you’ll need to maintain your certification.
Years ago, as a newly minted as a BCOP fresh out of residency, I received advice to recertify by exam. I was still learning the process and it came from an experienced clinician so I took the advice to heart.
Recertification by exam sounds like a fantastic idea for about 6 years until it’s time to take said exam 😅
BPS posts certification and recertification results by specialty. This will tell you pass rates and how many people recertify by exam. For BCOP, the initial exam pass rate for spring 2023 was 54% (was 57% in fall 2022). Those that recertified by exam had a 65% pass rate (down from 75%). Granted, this was out of only 23 pharmacists so that tells you how popular (or unpopular) recertification by exam is.
2020 was my first recertification cycle. Since certifications are valid through the end of the year, my strategy was to take the exam in the spring and to retake it in the fall if I didn’t pass. The pandemic threw quite a few wrenches in those plans. At the time, you had to register for the exams pretty early (months ahead of time) so I couldn’t have imagined how COVID would impact the exams or life in general. I had great intentions of being studious and feeling prepared but that didn’t happen. Then exams got pushed out because the testing centers were closed due to the pandemic. This meant results would be delayed and would run into the fall testing window.
BPS was very responsive and flexible, in my opinion, in response to COVID. They reduced retake fees, presumably because they thought the fail rate would be higher having to take a high stakes exam during a pandemic. They also indicated they would make special registration windows for those that didn’t pass the spring exam and needed to register for fall past the usual registration window. Additionally, they gave a one-time 1 year extension you can take advantage of if you aren’t able to meet the requirements before the end of you expiration year.
Thankfully, I didn’t need to take BPS up on their flexible terms as I passed the spring exam but I think it says a lot about this organization and how they are willing to accommodate our profession in unique circumstances.
If you are deciding which path is for you, you might want to first review the BPS recertification guide. They have also published infographics for a quick glance of recertification requirements for domestic and international pharmacists.
If you recertify by exam, one great perk is that the exam is only 100 questions (versus 150 in the initial exam). Less time in the Fort Knox testing center is always a perk!
So, will I recertify by exam again?
Yes! The recertification exam taught me that experience holds a lot of weight. I may be in non-traditional roles these days, but years of practice experience have taught me more than enough to have that minimum competence level. Plus, I’m okay with a little testing anxiety in year 7 versus the ongoing task list of getting enough BCOP credits every year.
If you need support on your BCOP journey, I would love to be your guide! My ELO program is a structured way to prepare for the exam. Plus, with the ELO Certificate and ELO Collaborative tiers there is a BCOP guarantee!
About The Author
Kelley is a board-certified oncology pharmacist that strongly believes oncology is the best specialty for pharmacists and that anyone can learn it. She founded the ELO (Enjoy Learning Oncology) Program, the only private member network exclusively for oncology pharmacists.
Do you want to get a structured content plan and personalized support to take your oncology knowledge and career to the next level?
