Initial Certification / Residency

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    Family Medicine Certification Examination

    Candidates seeking certification must meet the eligibility criteria specified by the American Board of Family Medicine (ABFM). All primary exams administered by the ABFM are referred to as the "Family Medicine Certification Examination" regardless of whether a physician is certifying for the first time or continuously certifying after having been previously certified. The examination for residents seeking initial certification is administered in April and November.

    For those physicians who started family medicine residency training prior to June 1, 2012, the following must be obtained to become certificated:

    1. Successful performance on the Family Medicine Certification Examination
    2. The Program Director verifies that the resident has successfully met all of the ACGME program requirements
    3. The candidate obtains a currently valid, full, and unrestricted license to practice medicine in the United States or Canada

    The ABFM requires residents who entered family medicine residency training on or after June 1, 2012 (including those who received advanced placement credit for prior training in another specialty, including osteopathic training), to complete the Resident Certification Entry Process. In order to become certified by the ABFM, the following requirements must be met:

    • Completion of 50 Family Medicine Certification points which includes:
      • Minimum of one (1) Knowledge Self-Assessment (KSA) activity (10 points each)
      • Minimum of one (1) Performance Improvement (PI) activity with data from a patient population (20 points each)
      • Additional approved KSA Knowledge Self-Assessment, Clinical Self-Assessment (CSA 5 points each), or Performance Improvement activities to reach a minimum of 50 points.
    • Application and full examination fee for the Family Medicine Certification Examination
    • Attainment of a full, valid, unrestricted, and permanent medical license and compliance with the Guidelines on Professionalism, Licensure, and Personal Conduct
    • Successful completion of family medicine residency training and verification by the program
    • Successful completion of the Family Medicine Certification Examination

    Knowledge Self-Assessment

    The Knowledge Self-Assessment (KSA) is an assessment of the physician's knowledge in a particular domain. Each domain consists of core competencies that the physician must master. In order to successfully complete the assessment, eighty percent (80%) of the questions in each competency must be answered correctly. If the physician is not successful initially, the activity moves to a review mode, in which a critique and references for each incorrectly answered question can be reviewed before entering new answers to the missed questions.

    In order to satisfy the minimum requirement of one Knowledge Self-Assessment (KSA) activity, residents MUST complete one of the activities listed below:

    • Asthma KSA
    • Care of the Vulnerable Elderly KSA
    • Cerebrovascular Disease KSA
    • Childhood Illness KSA
    • Coronary Artery Disease KSA
    • Depression KSA
    • Diabetes KSA
    • Health Behavior KSA
    • Heart Failure KSA
    • Hospital Medicine KSA
    • Hypertension KSA
    • Maternity Care KSA
    • Mental Health in the Community KSA
    • Pain Management KSA
    • Preventive Care KSA
    • Well Child Care KSA

    Performance Improvement

    ABFM-developed Performance Improvement (PI) activities are web-based, quality improvement modules in health areas that generally correspond to the Knowledge Self-Assessment (KSA) activities.

    Each physician will assess his or her care of patients using evidence-based quality indicators. After a physician enters data from 10 patients into the ABFM website, feedback is provided for each of the quality indicators. The performance data is used by the physician to choose an indicator for which a quality improvement plan will be designed. Using a menu of interventions available from various online sources, the physician designs a plan of improvement, submits the plan, and implements the plan in practice. After a minimum of 1 week, the physician again assesses the care provided to 10 patients in the chosen health area and enters the data into the ABFM website. The physician then is able to compare pre- and post-intervention performance, and compare their results to those of their peers. Evidence of improvement is not required to satisfy this requirement.

    In order to satisfy the minimum Performance Improvement activity requirement, residents MUST complete one Performance Improvement activity using data from a patient population. Examples of Performance Improvement activities accepted by the ABFM include:

    • Asthma PI activity
    • Comprehensive PI activity
    • Coronary Disease PI activity
    • Depression PI activity
    • Diabetes PI activity
    • Hand Hygiene PI activity
    • Heart Failure PI activity
    • Hypertension PI activity
    • Self-Directed Quality Improvement Efforts
    • AAFP Metric

    Click here to view a list of external approved alternate PI activities.

    There are no fees charged by the ABFM for completing ABFM-developed KSA, CSA, and PI activities during the Resident Certification Entry process. However, residents who complete approved alternate PI activities may be required to pay a participation fee to the external sponsor of that activity.

    Alternative Self-Assessment & Performance Improvement Activities Available

    Residents may complete of the alternative activities listed below to count toward the overall 50-point requirement. However, these activities do not count toward the minimum required KSA activity and PI activity with patient population data.

    Clinical Self-Assessment Activities

    The Clinical Self-Assessment (CSA) presents patient care scenarios corresponding to the topic chosen in the Knowledge Self-Assessment (KSA). Simulated patients evolve in response to therapeutic interventions, investigations, and the passage of time, providing an opportunity for residents to demonstrate proficiency in patient management skills.

    Alternative Self-Assessment Activities

    • Patient Centered Medical Home (10 points)
    • Health Literacy Module (10 points)

    Alternative Performance Improvement Activities

    • Hand Hygiene PI Activity (20 points)

    Methods in Medicine Modules

    • Cultural Competency MIMM (20 points)

    When applying for the certification examination, a resident may begin the application process and submit payment for the examination without having all the Knowledge Self-Assessment (KSA) and Performance Improvement (PI) activity requirements completed. In order to avoid late application filing fees, it is recommended that physicians start the application early. However, in order to be approved to take the examination and select a test center date and location, all 50 certification activity points and the minimum Knowledge Self-Assessment (KSA) and Performance Improvement (PI) Activity requirements must be complete.

    Residents will be able to complete the above requirements for the Resident Certification Entry Process during their residency training years and up to three calendar years after completion of training. If a resident does not fulfill the requirements within the three calendar years following training completion, he/she will have to go through the ABFM Entry process, which includes the above requirements plus CME and process fees to gain eligibility to sit for the certification examination. Any activities started or completed during the Resident Certification Entry process will not count toward the ABFM Entry process.

    Eligibility Requirements for Initial Certification
    All candidates for the ABFM Certification Examination for initial certification must have satisfactorily completed three years of training (a full 36 calendar months with 12 months in each of the G-1, G-2, and G-3 years) in a Family Medicine residency program accredited by the Accreditation Council for Graduate Medical Education (ACGME) subsequent to receipt of the M.D. or D.O. degree from an accredited institution and, when applicable, a Fifth Pathway Year, or receipt of a Standard Certificate from the Educational Commission for Foreign Medical Graduates (ECFMG), or compliance with other ACGME requirements for entry into graduate medical training in the United States. If a physician does not meet the eligibility requirements of the ACGME for residency training in Family Medicine, his/her training will not be recognized by the Board.

    Candidates who obtained their M.D. degree from medical schools in the United States or Canada must have attended a school accredited by the Liaison Committee on Medical Education or the Committee for Accreditation of Canadian Medical Schools. Candidates who obtained a D.O. degree must have graduated from a college of osteopathic medicine accredited by the American Osteopathic Association.

    All applicants for the Family Medicine Certification Examination are subject to the approval of the Board, and the final decision regarding any application rests solely with the ABFM. No candidate will be allowed to take the examination until all fees are paid and all requirements have been satisfactorily met.

    Satisfactory Completion of Residency
    The Board prefers all three years of postgraduate training to be in the same ACGME-accredited Family Medicine program; however, other training may be considered as equivalent (e.g., Flexible/Transitional Year, AOA Osteopathic Internship, etc.). In these cases, the ABFM requires residency programs to notify the Board of residents who are entering training with Advanced Placement credit via the Resident Training Management (RTM) System. If the Program Director fails to comply, the Board will determine the amount of transfer credit at the time of its discovery of the transfer. Consequently, the resident may receive less credit toward certification than anticipated and may be required to extend the duration of training.

    The last two years of Family Medicine residency training must be completed in the same accredited program. Transfers after the beginning of the G-2 year are approved only in extraordinary circumstances.

    All candidates' education and training experiences are subject to review and approval by the ABFM.

    Deadline for Completion of Training—Residents who are expected to complete training by June 30 are automatically provided the application link for the April examination. Residents who are expected to complete training between July 1 and October 31 may be declared eligible to apply for the April examination based on a recommendation from their residency program director. Residents who are expected to complete after October 31 and before December 31 will be permitted to apply for the November exam. Residents who are expected to complete training between November 1 and December 31 will be permitted to apply for the November exam. Residents who are expected to complete training between January 1 and April 30 may be declared eligible to apply for the November examination based on a recommendation from their residency program director.

    Final Verification—Verification of satisfactory completion of residency training is submitted through the Resident Training Management (RTM) system by the Family Medicine Residency Program Director. Program Directors may access the RTM system up to 15 days before the anticipated completion date of the resident to verify satisfactory completion of residency training. Candidates for the Certification Examination will not receive certification until the Program Director has verified this information (pending all other certification requirements have been met). The effective date of certification will be the date on which the physician has met all certification requirements.

    Certification will be awarded when all of the criteria are met:

    1. Successful performance on the Family Medicine Certification Examination
    2. The Program Director verifies that the resident has successfully met all of the ACGME program requirements
    3. The candidate obtains a currently valid, full, and unrestricted license to practice medicine in the United States or Canada

    Continuing Medical Education
    Candidates who apply for the Certification Examination within three years of completion of an ACGME-accredited Family Medicine Residency are not required to document any continuing medical education (CME). Candidates who apply after the 3-year period will be required to complete the Entry Process, which requires 150 hours of acceptable CME in the last 3 years. Additional information regarding the Entry Process is located below.

    Licensure Requirements
    To obtain and maintain certification, all candidates and Diplomates must hold a currently valid, full, and unrestricted license to practice medicine in the United States or Canada and be in continuous compliance with the ABFM Guidelines for Professionalism, Licensure, and Personal Conduct [PDF].

    The ABFM will monitor the issue/renewal and expiration dates of license information entered through the Physician Portfolio and will issue email reminders of upcoming expirations. Please note that the ABFM does not currently receive licensure data, other than Disciplinary Action Reports, directly from any other source than the Diplomate. Consequently, it is your responsibility to maintain current license information with the ABFM. Failure to maintain an active and unrestricted license and/or the failure to maintain that information in your Physician Portfolio with the ABFM will result in the loss of your certification status.

    Please note: Candidates may begin an application and sit for the examination while in the process of securing a permanent medical license; however, in order to gain certification a permanent license must be obtained and the candidate must be compliant with the ABFM Guidelines for Professionalism, Licensure, and Personal Conduct (presuming all other certification requirements have been met).

    Permanent license information must be submitted through the Physician Portfolio on the ABFM website. The effective date of certification will be the date on which the candidate meets all certification requirements.

    Institutional, temporary, and training medical licenses are not acceptable and should not be entered in the Physician Portfolio. If a candidate uses an institutional, temporary, or training medical license, or enters an inaccurate date of initial licensure or renewal, in order to complete the requirements for certification and the ABFM determines that the information does not match the records from the licensing state or if the license does not meet the ABFM Guidelines for Professionalism, Licensure, and Personal Conduct , the certification will be invalidated. The candidate will be notified subsequent to this action. Falsification of any information entered in the application and/or the Physician Portfolio is a serious violation of ABFM policies and can result in withdrawal of certification for an extended period of time.

    When updating or adding a new license record, applicants are required to attest that the license is current, valid, unrestricted, and permanent. If the medical license does not meet the ABFM Guidelines for Professionalism, Licensure, and Personal Conduct, the candidate must contact the ABFM License Coordinator.

    It is the responsibility of the physician to inform the ABFM in writing, by letter, email, or notification through the medical license page in the application or the Physician Portfolio, immediately following any action by a licensing authority. Should a physician be uncertain about whether or not they are meeting the ABFM Guidelines for Professionalism, Licensure, and Personal Conduct, a written inquiry should be made to the Board immediately.

    Any candidate sitting for an examination while under an action by a licensing authority that places him/her in violation of the ABFM Guidelines for Professionalism, Licensure, and Personal Conduct will have their examination invalidated and the examination fee will be forfeited. Eligibility for examination will not be reinstated until the physician is in full compliance with the guidelines. If any action by a licensing authority is taken after this application is filed, but prior to the examination, it is still the responsibility of the applicant to report the action to the ABFM prior to examination for review. If a candidate is appealing a decision relative to their certification status to the Credentials Committee, they are permitted to sit for the examination with the understanding that if the appeal is unsuccessful, their examination will be invalidated and the examination fee will be forfeited.

    Certification Entry Process
    Any physician who does not successfully pass the Family Medicine Certification examination within three calendar years following the year in which residency training is completed will be required to satisfy the Certification Entry Process in order to be eligible for the exam and gain certification status.

    The Certification Entry Process includes:  

    • Completion of 50 points which includes:
      • Minimum of one (1) Knowledge Self-Assessment (KSA) activity (10 points each)
      • Minimum of one (1) Performance Improvement (PI) activity (or an approved alternative; 20 points each)
      • Additional approved KSA, Clinical Self-Assessment (CSA; 5 points each), or PI activities
    • Completion of one hundred fifty (150) credits of acceptable CME (minimum 50% Division I), acquired in last three (3) years
    • Compliance with ABFM Guidelines for Professionalism, Licensure, and Personal Conduct which includes holding a currently valid, full and unrestricted license to practice medicine in the United States or Canada
    • Submission of three (3) Process Payments (i.e., one [1] payment at the start of each activity)
    • Submission of application and accompanying full examination fee for the Family Medicine Certification Examination
    • Successful completion of the Family Medicine Certification Examination
    • The Entry process must be completed no later than 3 calendar years following the year the process is started. If the process is not completed in the established timeframe, a new cycle of the Certification Entry Process will be required in order to gain certification. Any modules completed prior to starting the Certification Entry Process (and the associated fees) will not carry forward. Any incomplete modules started prior to the Certification Entry Process will be reset so they may be started anew, and unused fees will be refunded.

     

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