100+ Free ABPath Forensic Pathology Practice Questions

The ABPath Forensic Pathology subspecialty exam is a board certification administered by the American Board of Pathology for pathologists with advanced training in the medicolegal investigation of death. It validates expertise in scene investigation, medicolegal autopsy, trauma interpretation, postmortem toxicology, sudden and unexpected natural deaths, pediatric forensic pathology (including SIDS/SUDI and child abuse), and death certification. Board-certified forensic pathologists serve as medical examiners and coroners' physicians.

The exam is a one-day, computer-based examination with 275 total questions — 225 Written/Practical questions in 3 hours 45 minutes plus 50 Virtual Microscopy questions in 2 hours 56 minutes. Microscopy questions are often supplemented by scene photographs, gross photographs, and radiographs. All questions are multiple-choice, single-best-answer format. The 2026 exam window runs September 8 – September 28, 2026 at Pearson VUE.

The exam uses a criterion-referenced passing standard set by the Forensic Pathology Test Committee via a modified Angoff standard-setting process. Score reports provide pass/fail plus diagnostic performance by content domain. Historical first-time pass rates at ABPath subspecialty exams are approximately 80-90% for Forensic Pathology.

Candidates must (1) hold ABPath primary certification in Anatomic Pathology (AP) or AP/Clinical Pathology (AP/CP); (2) successfully complete an ACGME-accredited Forensic Pathology fellowship of at least 12 months; and (3) maintain an active, unrestricted medical or osteopathic license. Applications are accepted February 16 – May 15, 2026 for the Fall 2026 administration, with exam scheduling opening in July 2026.

The 2026 ABPath subspecialty certification fee is $2,100, which includes a non-refundable $200 administrative fee. Candidates who fail must reapply and pay the full fee again for the next annual cycle. The application window is February 16 – May 15, 2026. Pearson VUE may charge separate test-center fees in some regions.

Cause of death is the medical reason a person died (the underlying disease or injury that initiated a chain of events leading to death — e.g., 'gunshot wound of head' or 'atherosclerotic cardiovascular disease'). Manner of death is a medicolegal classification describing the circumstances — the five NAME-recommended manners are natural (disease only), accident (unintentional injury), suicide (self-inflicted intentional), homicide (death at the hands of another regardless of intent), and undetermined (insufficient information). Mechanism of death (e.g., 'exsanguination,' 'cardiac arrest') is a physiologic derangement and should NOT appear as the cause of death on a certificate.

Trauma and injury patterns (35%) dominate — master gunshot wound ranges (contact stellate on bone, close with soot within 6 inches, intermediate with stippling/powder tattooing 6-24 inches, distant), Waddell triad for pediatric pedestrians (head + chest/abdomen + lower extremity in auto-ped), asphyxia (petechiae, hanging groove pattern, ligature vs manual strangulation), and blunt-force classification. Natural disease (20%) emphasizes sudden cardiac death (HCM myocyte disarray with fibrosis, ARVC fibrofatty RV replacement, ion channelopathies, commotio cordis). Toxicology (15%) covers fentanyl/opioid deaths, CO cherry-red livor (>50% COHb lethal), ethanol (vitreous-to-blood ratio), and cyanide. Death certification (10%) and investigation (20%) balance the remainder.

Use a 6-9 month structured plan during or after your Forensic Pathology fellowship. Start with autopsy technique and death investigation (NAME standards, scene investigation, time of death, postmortem changes). Move to trauma patterns — master firearms by range, sharp/blunt force classification, Waddell triad, asphyxia, and transportation mechanisms. Cover sudden cardiac death pathology (HCM, ARVC, channelopathies), pulmonary embolism, aortic dissection, and pediatric sudden death (SIDS/SUDI rule-outs). Master toxicology (fentanyl, CO, ethanol) and postmortem chemistry. Review death certification (cause vs manner vs mechanism) and jurisprudence (Daubert). Use Spitz and Fisher, DiMaio and DiMaio, and NAME resources. Take at least two timed full-length practice exams.