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Exam Review

Key Facts: MPLS Exam

100

Exam Questions

ABPLA

Pass/Fail

Board Review

ABPLA

6 hours

Exam Duration

ABPLA 1-day

$2,000-$3,000

Exam Fee

ABPLA (app + exam)

5 years

Experience Required

ABPLA eligibility

5 years

Certification Validity

Recertification required

The ABPLA Medical Professional Liability Specialist exam is a one-day 6-hour written examination with approximately 100 essay and multiple-choice questions. Pass/fail determined by ABPLA Board based on total performance. Candidates must have a JD, active bar membership, 5+ years of practice, 25%+ of practice devoted to medical professional liability matters, documented trial experience, CLE, and peer references. Certification is valid 5 years; recertification via peer review and CLE. Fee: $2,000-$3,000.

Sample MPLS Practice Questions

Try these sample questions to review concepts for the MPLS exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1The four elements of medical malpractice are:
A.Duty, breach of the standard of care, causation, and damages
B.Fault, injury, money
C.Intent, act, injury, foreseeability
D.Contract, breach, causation, damages
Explanation: Medical malpractice is a negligence tort requiring plaintiff to prove: (1) Duty — physician-patient relationship establishing duty of care; (2) Breach — departure from the applicable standard of care; (3) Causation — the breach was the actual (but-for) and proximate cause of injury; (4) Damages — actual harm (economic and/or non-economic). Each element must be proven by a preponderance of the evidence, typically requiring expert medical testimony.
2A physician-patient relationship (the duty element) typically arises when:
A.The physician affirmatively undertakes to provide medical care, or a consensual relationship is otherwise established
B.A patient sees any doctor
C.A patient pays for care
D.The patient enters the hospital
Explanation: A physician-patient relationship is a prerequisite to malpractice liability — the physician must owe a duty of care. Relationship generally arises from: (1) affirmative undertaking to treat; (2) consultation formally accepted; (3) on-call coverage with direct patient contact. Courts generally do NOT find a relationship for: informal/curbside consultations between physicians; peer review; IME examinations (some exceptions for actionable IME negligence). The emergency department context often creates relationships by ostensible agency theories.
3The standard of care for medical malpractice is:
A.That level of care a reasonably prudent physician in the same or similar circumstances, with similar training, would exercise
B.Best possible care
C.Perfect care
D.Any care
Explanation: The standard of care is the 'reasonably prudent physician' standard — what a physician of ordinary skill and training in the same or similar circumstances would do. NOT perfect care, NOT the best care, NOT what a specialist would do (unless the defendant is a specialist). Proof requires expert testimony absent common knowledge exception. Increasingly a NATIONAL standard of care rather than strict locality, though some rural practice still maintains locality rule modifications.
4The historical 'locality rule' provided that:
A.Physicians were held to the standard of care prevailing in their geographic community — now largely replaced by national standards
B.Only local doctors could testify
C.Standard varied by malpractice insurance
D.No expert testimony needed
Explanation: The locality rule (19th century origin) held physicians to the standard of their specific community or similar communities — acknowledging differences in training, resources, technology. Modern trend: most jurisdictions apply a NATIONAL STANDARD for specialists (board certification, uniform training) and for general practitioners with exceptions for rare resource/training differences. Some rural states retain modified locality rule. ABPLA exam candidates must know both historical and modern approaches.
5Proof of causation in medical malpractice typically requires:
A.Both cause-in-fact (but-for) and proximate cause, supported by expert testimony to reasonable medical probability
B.Only but-for causation
C.Only circumstantial evidence
D.No causation proof
Explanation: Causation has two prongs: (1) cause-in-fact or 'but-for' causation — but for the negligence, harm would not have occurred; (2) proximate/legal cause — foreseeable consequence of negligence. Most jurisdictions require expert testimony establishing causation 'to a reasonable degree of medical probability' (typically interpreted as >50% or 'more likely than not'). Complex causation in multi-physician cases and pre-existing conditions requires careful expert work.
6The 'loss of chance' doctrine:
A.Allows recovery when negligence reduces the patient's chance of survival or better outcome, even if original prognosis was unfavorable — recognized in some but not all jurisdictions
B.Standard everywhere
C.Applies only to cancer
D.Replaces but-for causation
Explanation: Loss of chance doctrine addresses causation when patient had pre-existing adverse condition. Traditional but-for causation may fail when patient's chance of survival was <50% before negligence. Loss of chance theory: plaintiff may recover for the REDUCTION in chance (e.g., from 40% to 20% = 20% of full damages in proportional recovery jurisdictions). Recognized in approximately 20+ states. Rejected in others requiring >50% pre-negligence probability. Alberts v. Shultz (New Mexico) leading opinion; Matsuyama v. Birnbaum (Massachusetts) also influential.
7Canterbury v. Spence (DC Cir. 1972) established:
A.Patient-centered objective standard for informed consent materiality — what a reasonable patient would consider material to the decision
B.Physician-based standard
C.No informed consent
D.Only for surgery
Explanation: Canterbury v. Spence shifted informed consent from physician-based ('what other physicians disclose') to patient-based ('what a reasonable patient would want to know'). Objective reasonable-patient standard in most states. Subjective standard (this particular patient) in minority. Physician-based standard (what reasonable physicians disclose) still applies in some states. Key requirement: disclosure of material risks (probability × severity), benefits, alternatives, nature of procedure.
8Informed consent elements typically include:
A.Nature of the procedure; material risks and their probabilities; benefits; alternatives (including no treatment); and the patient's competence and voluntariness
B.Risks only
C.Name of doctor only
D.Written consent form only
Explanation: Full informed consent requires disclosure of: (1) nature of procedure; (2) material risks and probability; (3) expected benefits; (4) reasonable alternatives including no treatment; (5) consequences of declining. Patient must be competent, informed, and voluntary. Written consent form is evidence but not dispositive — conversation matters more. Exceptions: emergency, therapeutic privilege (rarely invoked), patient waiver, incapacity requiring surrogate consent.
9Causation in informed consent cases typically requires proof that:
A.A reasonable person in the patient's position, properly informed, would have declined the treatment (objective) OR this specific patient would have declined (subjective)
B.Any risk materialized
C.Doctor failed to explain
D.Patient regrets decision
Explanation: Informed consent causation: patient must prove the undisclosed risk materialized AND a reasonable person (objective) or this patient (subjective) would have declined treatment if properly informed. Most jurisdictions use objective standard (avoiding hindsight bias and self-serving testimony). Subjective standard may be more plaintiff-favorable but requires sympathetic patient testimony. Some states use hybrid. Often the key battleground in informed consent litigation.
10A procedure performed without any consent may constitute:
A.Battery (intentional unauthorized touching) — separate from negligence claim for inadequate consent
B.Negligence only
C.No tort
D.Criminal assault only
Explanation: If a physician performs a procedure entirely without consent, it's BATTERY — an intentional unauthorized touching. Battery carries different elements and damages (including punitive) than negligence. If consent was obtained but inadequate disclosure provided — typically NEGLIGENCE (informed consent). Important distinction: battery may have longer statute of limitations, no expert testimony required, and insurance coverage issues. Common in cases where surgery differs substantially from consented-to procedure.

About the MPLS Exam

The ABPLA Medical Professional Liability Specialist credential is an ABA-accredited board certification for attorneys whose practice is focused on medical malpractice and medical professional liability. The 6-hour written examination tests mastery of medical negligence elements, standard of care proof, informed consent, common malpractice scenarios, vicarious liability theories, defenses, damages caps, procedural requirements, and trial practice unique to med mal cases.

Exam sponsor: American Board of Professional Liability Attorneys (ABPLA). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Questions

100 questions

Time Limit

6 hours (1-day written exam)

Passing Score

Pass per board review

Exam / Certification Fees

$2,000-$3,000

Exam sponsor website

Reported exam pass rate: ~55-65%. for experienced med mal attorneys (ABPLA estimate) This describes exam candidates, not OpenExamPrep users or results from using our resources. Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

25%

Elements of Medical Malpractice

Duty (physician-patient relationship), breach (standard of care), causation (but-for, substantial factor, loss of chance), damages (economic, non-economic, punitive)

20%

Standard of Care & Expert Testimony

Reasonably prudent physician standard, locality rule vs. national standard, specialist standard, learned intermediary, Daubert vs. Frye for experts

15%

Common Malpractice Scenarios

Failure to diagnose (cancer, MI, stroke), surgical errors (wrong-site, retained objects), birth injuries (HIE, shoulder dystocia, cerebral palsy), medication errors

10%

Informed Consent

Elements (risks, benefits, alternatives), objective vs. subjective materiality, battery vs. negligence, exceptions (emergency, therapeutic privilege)

10%

Vicarious Liability & Corporate Negligence

Respondeat superior, ostensible agency for ED/hospital physicians, independent contractor defense, corporate negligence (credentialing, supervision)

10%

Defenses, Damages Caps & Immunity

Contributory/comparative negligence, assumption of risk, Good Samaritan, res ipsa loquitur, MICRA caps, charitable immunity, collateral source rule

10%

Statutes, Procedural & Trial Practice

Discovery rule, continuous treatment, foreign object cases, certificates of merit, medical review panels, trial bifurcation, peer review privilege

Preparing for the MPLS Exam

What You Need to Know

  • Passing score: Pass per board review
  • Exam length: 100 questions
  • Time limit: 6 hours (1-day written exam)
  • Exam / certification fees: $2,000-$3,000 Official sources

Using Our Practice Resources

  • Work through all 100 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

MPLS: Suggested Study Strategy

1Master the four elements: duty, breach, causation (both but-for and proximate), damages — every case traces to these
2Understand the standard of care evolution from locality rule to modern national/specialty standard
3Know Canterbury v. Spence (1972) and the shift from physician-based to patient-based informed consent materiality standards
4Study MICRA ($250,000 non-economic cap for California, similar state analogs) — which caps have been upheld vs. declared unconstitutional
5Master loss of chance doctrine — recognized in some jurisdictions, not others; impacts causation analysis in cancer and heart attack cases
6Understand ostensible agency doctrine for ED physicians — often the key liability theory for hospitals
7Know peer review privilege under federal HCQIA and state analogs, and its limits on discovery

Frequently Asked Questions

What is the ABPLA Medical Professional Liability Specialist exam?

The ABPLA credential is a board certification administered by the American Board of Professional Liability Attorneys, an ABA-accredited body. The 6-hour written examination tests mastery of medical malpractice elements, standard of care, informed consent, common malpractice scenarios, damages, and trial practice unique to med mal cases.

What are the eligibility requirements?

Candidates must hold a JD, be active bar members in good standing, have 5+ years of law practice with at least 25% devoted to medical professional liability matters, document substantial trial experience, complete CLE, and provide peer references from judges and attorneys.

How many questions are on the exam?

The exam contains approximately 100 essay and multiple-choice questions over a 6-hour session (1-day exam). Pass/fail determined by ABPLA Board based on total performance.

How much does certification cost?

Application and examination fees typically total $2,000-$3,000. Recertification fees apply every 5 years.

How long is the certification valid?

ABPLA certification is valid for 5 years. Recertification requires continued substantial medical malpractice practice, CLE, updated peer references, and board review.

How should I prepare?

Plan for 80-150 hours of study over 3-4 months. Review medical malpractice elements, standard of care cases (Helling v. Carey, TJ Hooper analogue), Daubert challenges in medical context, MICRA/state caps, informed consent cases (Canterbury v. Spence), and key procedural requirements (certificates of merit, medical review panels).