The 2023 BCACP Exam looks to have some consistency with the previous year. The last major change to the content outline was in 2020. I would anticipate that we may see some changes in 2024 or 2025 as these exam outlines tend to get reviewed and updated every 3-5 years. I think this is generally a good thing for 2023 candidates. (Note: If you are considering taking BCGP in 2023, be sure you look at this post. Critical Care, Oncology, Pediatric, and Solid Organ Transplantation are also changing.)

2022 BCACP Pass Rates

Pass rates for fall 2022 have been officially reported by the Board of Pharmacy Specialties (BPS). What’s the verdict for BCACP exam takers? Consistency. The overall pass rate remains in the low 60% range. In the most recent exam testing period (September/October 2022), the pass rate was 63%. What’s the takeaway here? The BCACP exam is challenging with low pass rates. Preparation is a must. I would anticipate similar pass rates for the 2023 BCACP Exam.

Why Do People Fail The BCACP Exam?

I receive feedback from customers and review information readily posted online about the exam. Here are my major reasons that candidates don’t pass this exam.

1. While I think most candidates are prepared to perform adequately on the clinical content, candidates who do not pass routinely feel unprepared for the amount of ambulatory care practice questions, statistics questions, and regulatory questions. Don’t be caught off guard by this. We’ve worked hard and gone through the content outline line by line to ensure that we have covered everything in the non-clinical related topics. You’ll find a ton of this information in our Regulatory and Statistics Study Guide PDFs which are included in our 6-month and 1 year All Access Passes.

To prove my point, here is a list of items we’ve included in our study packages that show up DIRECTLY in the BCACP content outline from BPS.

• Interpretation of clinical and/or statistical significance (e.g., relative risk, number needed to treat, confidence intervals, p-values, clinical vs. statistical significance)
• Research methodology to interpret internal and external validity (e.g., population selection, blinding, intervention)
• Strengths and limitations of study design and/or literature source
• Interpretation of study results as applied to patient care
• Methodology and endpoints used in pharmaco-economics
• Principles of statistical analysis and study design for quality improvement projects and
• research
• Regulatory and ethical requirements for the conduct of research
• Population Health
• CMS, NCQA
• Educational strategies, including but not limited to cognitive learning levels (e.g., Bloom’s taxonomy), learning styles (e.g., visual, auditory, read/write, kinesthetic), and precepting roles (e.g., direct instruction, modeling, coaching, facilitation)
• Techniques and/or strategies for effective feedback
• Academic detailing
• Establish, manage, and/or advance an ambulatory care practice or service
• Elements of a sustainable business model (e.g., SWOT analysis, compensation strategies, funding sources)
• PDSA, Six Sigma

Many don’t realize how not knowing some of this terminology will prevent you from passing.

2. I still occasionally hear from individuals that they ran out of time and didn’t get through all the questions. You will be punished with an incorrect answer for any questions that do not have a response. Whether it is through our study materials or someone else’s, I must emphasize the importance of doing a practice exam and/or practice questions to ensure that you have enough time to finish. The exam is 175 questions and you have 4 hours and 23 minutes to complete it. That’s 1 minute and 30 seconds per question. In my experience, doing a practice exam and ensuring you are setting a good pace is critical. I recommend a target of one minute per question to give you some buffer time at the end. 

3. Some candidates don’t put in the time necessary to master the content. No one can guarantee that you pass the exam, but anyone knows you are going to increase your chances with more study time. I recommend 3-6 months for most pharmacists. Hopefully, you can average 1-2 hours per day of study time. If it has been years since you have taken an exam, you may want to target the 6-12 month range. In my estimation, it will take most candidates between 60-100 hours to get through all the content in our study materials one time.

4. Inappropriate focus. A question I get asked quite a bit is, “Do I need to know doses?” In theory, BPS could ask you about the max dose of ropinirole, hydralazine, baclofen, or gabapentin. But will they? I don’t think this would be a useful question. I’m not a huge advocate for memorizing dosages. In general, I think most pharmacists who have been practicing will be able to recognize a big dose of gabapentin versus a small dose. What I have focused on in my preparations for board certifications are situations where the dosing may vary based on the indication. For instance, the dosing of apixaban changes when we are using it for DVT prophylaxis versus treatment. The dosing of semaglutide changes when we are using it for weight management versus diabetes. Another relevant situation involving dosing may involve how to adjust/hold warfarin dosing based on an INR.

5. Panic during the exam. THERE WILL BE QUESTIONS YOU DON’T KNOW THE ANSWER TO. DON’T FREAK OUT. Unless you actually wrote the BCACP exam, there will be questions that you just aren’t sure about. When I run into questions like this, I try very hard to narrow the answer down to the two best answers. When I do this, it allows me to feel like I at least have a 50% shot at getting the answer correct. That isn’t terrible odds compared to a 1/4 chance.

Youtube Summary of BCACP Exam Information

If you are more of a visual listener/learner and want more information about the BCACP exam in 2023, this video should still be applicable as the content outline hasn’t changed since I release this video.

2023 BCACP Exam – Frequently Asked Questions

Is it too late to register?	Maybe or maybe you are too early? – See here for the registration windows for 2023
How many times can I take it if I fail?	There is no limit that I’m aware of
Can I take another exam (BCPS, BCGP, BCOP, etc.) in the same testing period as the BCPS exam (i.e. band-aid method of just getting what I want done)?	No, you can only take one exam per registration period (i.e. fall/spring)
There was a specific guideline change recently, do I have to know it?	It depends. If taking in Spring, the cutoff for finalizing the BCACP exam questions is January 1st. If taking in the Fall, the cutoff is July 1st.
Primary format of the exam?	Multiple choice, 1 answer
Number of questions?	175
Do I need to memorize brand names?	No (generic names are used in exams)
Are the Meded101 BCACP Study Materials up to date for 2023?	Yes
I’m a slow test taker, how much time do I have?	4 hours and 23 minutes. That’s 1 minute and 30 seconds per question. In my experience, doing a practice exam and ensuring you are setting a good pace is critical. I recommend a target of one minute per question to give you some buffer time at the end.
How does the BCACP exam compare to the NAPLEX?	From my own personal experience and feedback from customers – significantly more clinical decision-making type questions; significantly more statistics and regulatory type questions. There will be occasional questions on the BCACP exam that you have no idea which answer is correct. Don’t panic, no one thinks they crushed this exam after they take it.
I think I feel ok about the clinical side of things, do you cover Statistics and Regulatory topics in your study materials?	Yes. Our PDF Regulatory study guide is now up to over 40 pages. Our PDF Statistics study guide is 35 pages with a good number of practice questions included. I still hear from candidates that they were not prepared for these questions. Don’t make that mistake! Both PDFs are contained within the 6-month or 1-year All Access Pass but NOT the BCACP Question Bank Only Options.
Do I have to be a pharmacist in the United States of America to take the BCACP exam?	No. BPS has a link of tips for international candidates. Find that here.
How do I contact you?	Email: [email protected]

I hope this information provides a level of comfort with the 2023 BCACP exam and application process! If you have any more questions, feel free to shoot me an email at [email protected]

Our BCACP Study Materials for 2023 can be found here.

Best wishes in 2023!

Eric Christianson, PharmD, BCPS, BCGP