The Family Medicine Certification Longitudinal Assessment (FMCLA) is the alternative to the one-day examination requirement for Family Medicine Certification. Launched in December 2018 as a pilot to study the feasibility and validity of this approach, FMCLA quickly earned an overwhelmingly positive reputation as the preferred option for most Diplomates and was approved for permanent implementation in April of 2021.

A longitudinal approach like FMCLA promotes enduring learning and retention. This has been endorsed by those who participated, with the predominant feedback being that physicians are learning as they go. Participants have also reported that FMCLA has reduced their stress, eliminated travel, and minimized preparation time as compared to the one-day examination. To date, over 70% of eligible physicians have chosen the FMCLA option, which becomes available for current Diplomates to select in the year prior to when their next examination is due.

As a participating physician, you would complete 25 quarterly questions over three to four years until you complete 300 questions. Clinical references can be used during the exam and you have five minutes to complete each question. Immediate feedback is provided, and you choose the time and location that’s convenient for you. You’ll remain certified throughout your participation as long as you meet other ABFM requirements. Download our FMCLA Handout for a quick summary.

Introduction to FMCLA:

Watch our new video explaining the basics of FMCLA for a simple introduction to this exam alternative.


How It Works:

  • You will begin in the first quarter of the year when your exam requirement is due.
  • You will answer 25 timed questions each quarter for a total of 300 questions over 3 to 4 years.
  • Questions can be answered all at one time, or you may space out completing questions during the quarter.
  • Answering a minimum of 75 questions is required in year one to meet meaningful participation.
  • Immediate feedback and critiques are provided for each question answered.
  • Quarterly performance summaries will be available at the end of the first year, so you can continually assess your performance and identify focused areas for future study.
  • ABFM will provide regular updates on key deadlines to help you remain on track with completion of the questions needed for FMCLA to meet your exam requirement.
  • Final results will be provided at the end of the quarter in which you complete 300 questions.
  • Once your final results are released, you will receive up to 30 Division 1 CME and up to 10 certification points for your participation.

FMCLA 2022 Chart

How To Prepare:

FMCLA has the same content blueprint as the one-day examination. The blueprint outlines the targeted percentage of questions you will receive in each category over the 300 questions.

One way to prepare is by regularly reviewing clinical conditions and topics that are commonly seen in family medicine practice. You can do this in many ways, including reading articles such as those found in the American Family Physician and other journals which publish high-quality clinical review articles. Board review courses may also be helpful for those who would benefit from a concentrated, broader review of topics. Topic-specific CME is also helpful when there are areas of clinical medicine that need updating.

Another way to prepare is to utilize ABFM’s knowledge self-assessment activities such as KSAs or CKSA for a clinical review of the most prevalent diagnoses seen in family medicine practice. The new ABFM National Journal Club articles may also be selected by topic, to address any identified gaps in knowledge. Physicians who have participated in CKSA and FMCLA simultaneously noted that CKSA was a great practice opportunity for the longitudinal assessment.