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2026 Statistics

Key Facts: Cert ID(SA) Path Exam

2 components

Written + oral/OSCE

CMSA Regulations

50% each

Subminimum per component

CMSA Regulations

R24 650

Exam Fee

CMSA 2026 Fee Schedule

50% overall

Pass Mark

CMSA Regulations

CMSA

Exam Body

College of Pathologists of SA

The Cert ID(SA) Path is a comprehensive two-component sub-specialty exit examination (written short-answer papers plus an oral/OSCE/clinical component, each 50%) assessing advanced clinical microbiology, molecular pathology, AST, IPC, and outbreak stewardship for specialist pathologists in South Africa. This bank provides 100 practice MCQs as a study aid.

Sample Cert ID(SA) Path Practice Questions

Try these sample questions to test your Cert ID(SA) Path exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 54-year-old splenectomised man presents with overwhelming sepsis 3 days after sustaining a minor dog bite. Blood cultures flag positive for fusiform, spindle-shaped gram-negative bacilli that demonstrate gliding motility on agar. Which organism is the most likely cause?

A.Pasteurella multocida

B.Eikenella corrodens

C.Streptobacillus moniliformis

D.Capnocytophaga canimorsus

Explanation: Capnocytophaga canimorsus is a capnophilic, spindle-shaped (fusiform) gram-negative bacillus residing in the oral flora of dogs and cats. It causes fulminant sepsis, purpura fulminans, and DIC particularly in splenectomised or immunocompromised patients following canine bites or scratches. Gliding motility on agar and requirement for CO2 are key laboratory characteristics.

2Which combination of phenotypic characteristics is most characteristic of Candida auris when evaluated in a clinical diagnostic mycology laboratory?

A.Failure to produce pseudohyphae on Cornmeal agar, thermotolerance at 42°C, and growth in 10% NaCl broth

B.Rapid urease positive, capsule formation on India ink, and phenoloxidase positive on Niger seed agar

C.Germ tube positive, chlamydospore production on Cornmeal agar, and pink colonies on CHROMagar

D.Arthroconidia formation on Cornmeal agar, urease positive, and failure to grow at 37°C

Explanation: Candida auris typically grows as yeast cells that fail to form pseudohyphae or hyphae on Cornmeal agar (unlike C. albicans or C. tropicalis). It is distinctive for its thermotolerance (grows well at 40-42°C) and osmotolerance (grows in broth containing 10% NaCl and high glucose), properties used in selective enrichment media.

3A cerebrospinal fluid (CSF) specimen from an HIV-infected patient with subacute meningitis reveals encapsulated budding yeast cells. Which histochemical stain specifically highlights the mucopolysaccharide capsule of Cryptococcus neoformans in red?

A.Mayer's mucicarmine stain

B.Ziehl-Neelsen stain

C.Grocott's methenamine silver (GMS) stain

D.Periodic acid-Schiff (PAS) stain

Explanation: Mayer's mucicarmine stain specifically binds to acidic mucopolysaccharides in the capsule of Cryptococcus neoformans and Cryptococcus gattii, staining the capsule bright rose-red to magenta. This distinguishes Cryptococcus from other non-capsulated yeasts in tissue sections.

4Microscopic examination of a mold culture incubated at 25°C from a bone marrow biopsy specimen shows delicate hyphae with large, round, thick-walled tuberculate macroconidia. What is the identity of this dimorphic fungus?

A.Paracoccidioides brasiliensis

B.Histoplasma capsulatum

C.Blastomyces dermatitidis

D.Coccidioides immitis

Explanation: At 25°C (mold phase), Histoplasma capsulatum produces characteristic large (8-15 µm), spherical, thick-walled macroconidia with finger-like projections (tuberculate macroconidia), alongside small microconidia (2-4 µm). In tissue or at 37°C, it converts to small intracellular oval yeast cells (2-4 µm).

5A 6-year-old child presents with intense perianal pruritus, particularly at night. Which is the diagnostic method of choice to detect the causative parasite?

A.Duodenal aspirate microscopy for trophozoites

B.Microscopic examination of a perianal cellulose tape (Scotch tape) swab collected early in the morning

C.Formol-ether concentration of a routine stool sample for ova and parasites

D.Serological detection of specific IgE antibodies in serum

Explanation: Enterobius vermicularis (pinworm) female worms migrate to the perianal area at night to deposit asymmetrical, flattened-on-one-side eggs. Direct stool examination is insensitive (<5-10% yield). The cellulose tape (Scotch tape) test applied to the perianal skin upon waking in the morning is the gold standard diagnostic method.

6Legionella pneumophila fails to grow on standard Blood agar or Chocolate agar. What essential nutritional component provided in Buffered Charcoal Yeast Extract (BCYE) agar is mandatory for its growth?

A.NAD (Factor V) and hemin (Factor X)

B.Sodium desoxycholate and colistin

C.L-cysteine and ferric pyrophosphate

D.Vitamins B12 and folic acid

Explanation: Legionella pneumophila is an obligate fastidious gram-negative bacterium that requires L-cysteine and soluble iron (ferric pyrophosphate) for growth. BCYE agar supplies these essential nutrients while activated charcoal neutralizes toxic peroxides and fatty acids.

7Bronchoalveolar lavage (BAL) fluid from an advanced HIV patient with hypoxic respiratory failure is stained with Grocott's methenamine silver (GMS). Which microscopic morphology confirms Pneumocystis jirovecii?

A.Narrow-based budding oval yeast cells surrounded by a clear unstained halo

B.Broad-based budding yeasts with double-contoured walls

C.Thick-walled non-septate hyphae branching at 90-degree right angles

D.Black-stained, round to cup-shaped cysts (4-6 µm) often with central dark dots, occurring in clusters

Explanation: GMS stain selectively colors the cell walls of Pneumocystis jirovecii cysts black. They appear as round, crushed-ball or cup-shaped cysts measuring 4-6 µm in diameter, frequently featuring a characteristic dark focal thickening ('parentheses' or central spot).

8Microscopic examination of a smoky green fungal colony isolated from a lung biopsy demonstrates septate hyphae, uniseriate phialides covering the upper two-thirds of the vesicle, and 45-degree dichotomous branching. Which Aspergillus species is identified?

A.Aspergillus fumigatus

B.Aspergillus terreus

C.Aspergillus niger

D.Aspergillus flavus

Explanation: Aspergillus fumigatus is characterized morphologically by columnar conidial heads with uniseriate phialides arising directly from the upper two-thirds of a dome-shaped vesicle. Tissue sections display hyaline, septate hyphae branching dichotomously at acute (45-degree) angles.

9A fresh stool sample from a patient undergoing immunosuppressive chemotherapy reveals active, motile larvae with a short buccal cavity and prominent genital primordium. Which parasite is present?

A.Hookworm (Ancylostoma duodenale) rhabditiform larva

B.Strongyloides stercoralis rhabditiform larva

C.Trichuris trichiura larva

D.Ascaris lumbricoides larva

Explanation: Strongyloides stercoralis is unique among intestinal nematodes because eggs hatch into rhabditiform (L1) larvae within the intestinal lumen. Stool microscopy shows motile larvae featuring a short buccal capsule/cavity and a large, prominent genital primordium (distinguishing them from hookworm larvae, which have a long buccal cavity and indistinct genital primordium).

10A 9-year-old child presents with a pseudomembranous pharyngitis. A Corynebacterium diphtheriae isolate is recovered on Tinsdale agar (black colonies with brown halos). Which laboratory test is required to confirm toxigenicity of the isolate?

A.X and V factor requirement test

B.Elek immunodiffusion test (or diphtheria toxin PCR)

C.CAMP test

D.Nagler reaction

Explanation: Not all isolates of Corynebacterium diphtheriae carry the tox gene (introduced by a lysogenic beta-bacteriophage). Phenotypic verification of diphtheria toxin production requires the Elek immunodiffusion test (precipitin lines formed between antitoxin strip and growing strain) or detection of the tox gene via PCR.

About the Cert ID(SA) Path Exam

The CMSA Sub-specialty Certificate in Infectious Diseases [Cert ID(SA) Path] is the sub-specialty board credentialing examination for specialist pathologists in South Africa. The exam tests expert diagnostic microbiology, phenotypic and molecular antimicrobial resistance characterization, molecular infectious disease diagnostics, hospital infection prevention and control (IPC), and outbreak investigation.

Assessment

Two components each contributing 50%: a written component (short-answer written papers) and an oral/OSCE/OSPE/clinical component. Content spans 5 core domain areas: Clinical Microbiology & Diagnostic Mycology/Parasitology (30%), Antimicrobial Resistance Mechanisms & AST (25%), Molecular Diagnostics in Infectious Diseases (20%), Hospital Infection Prevention & Control (15%), and Outbreak Investigation & Diagnostic Stewardship (10%).

Time Limit

Written short-answer papers plus an OSCE and viva component.

Passing Score

Overall pass mark 50% with a 50% subminimum in each of the two components (written and oral/OSCE/OSPE/clinical).

Exam Fee

R24 650 (Colleges of Medicine of South Africa (CMSA), College of Pathologists)

Cert ID(SA) Path Exam Content Outline

30%

Clinical Microbiology & Diagnostic Mycology/Parasitology

Identification, culture, morphologic characterization, MALDI-TOF MS, diagnostic mycology, and diagnostic parasitology.

25%

Antimicrobial Resistance Mechanisms & Susceptibility Testing

Phenotypic and genotypic AST methods (EUCAST/CLSI), beta-lactamases, carbapenemases, glycopeptide resistance, and antifungal/antiviral resistance.

20%

Molecular Diagnostics in Infectious Diseases

PCR, multiplex syndromic panels, GeneXpert MTB/RIF Ultra, line probe assays, WGS, mNGS, and laboratory quality assurance.

15%

Hospital Infection Prevention & Control (IPC)

HAI surveillance (CLABSI, CAUTI, SSI, VAP), isolation precautions, environmental microbiology, disinfection/sterilization, and hand hygiene.

10%

Outbreak Investigation & Diagnostic Stewardship

Laboratory outbreak techniques, genomic epidemiology, selective AST reporting, diagnostic algorithms, and utilization management.

How to Pass the Cert ID(SA) Path Exam

What You Need to Know

Passing score: Overall pass mark 50% with a 50% subminimum in each of the two components (written and oral/OSCE/OSPE/clinical).
Assessment: Two components each contributing 50%: a written component (short-answer written papers) and an oral/OSCE/OSPE/clinical component. Content spans 5 core domain areas: Clinical Microbiology & Diagnostic Mycology/Parasitology (30%), Antimicrobial Resistance Mechanisms & AST (25%), Molecular Diagnostics in Infectious Diseases (20%), Hospital Infection Prevention & Control (15%), and Outbreak Investigation & Diagnostic Stewardship (10%).
Time limit: Written short-answer papers plus an OSCE and viva component.
Exam fee: R24 650

Keys to Passing

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

Cert ID(SA) Path Study Tips from Top Performers

1Review EUCAST breakpoint tables and expert rules for resistance mechanism inference (e.g., screening for AmpC vs ESBL, carbapenemase classification).

2Understand line probe assays (LPA) like Hain Lifescience GenoType MTBDRplus / MTBDRsl, GeneXpert MTB/RIF Ultra (including trace call interpretation), and targeted sequencing.

3Master HAI surveillance definitions (CDC NHSN / SA NICD), outbreak cluster investigation tools (WGS SNP thresholding vs MLST), and diagnostic stewardship principles.

Frequently Asked Questions

What is the format of the CMSA Cert ID(SA) Path examination?

The exit examination has two components, each contributing 50%: a written component (short-answer written papers) and an oral/OSCE/OSPE/clinical component. Candidates must achieve an overall 50% with a 50% subminimum in each component. This free question bank provides 100 practice MCQs as a study aid and does not replicate the official format.

What are the eligibility requirements for the Cert ID(SA) Path?

Candidates must hold an FC Path(SA) (Microbiol), FC Path(SA) (Viro), or equivalent specialist qualification in Pathology, be registered with the HPCSA as a Specialist Pathologist, and have completed accredited sub-specialty training in Infectious Diseases.

What is the passing criteria for the examination?

Candidates must achieve an overall pass mark of 50%, with a 50% subminimum in each of the two components (the written component and the oral/OSCE/OSPE/clinical component).