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Longitudinal Assessment

The Family Medicine Certification Longitudinal Assessment (longitudinal assessment) is a flexible alternative to the 300 question one-day exam. Answer 25 questions each quarter over three to four years, when and where it’s convenient for you.

If you choose this exam option, you can begin your application in the fall prior to the year your exam requirement is due. For example, if your exam is due in 2025, you can apply for the longitudinal assessment in the fall of 2024 and begin answering your quarterly questions in January of 2025.


  • You will receive 25 timed questions each quarter for a total of 300 questions over three to four years.
  • Questions are multiple-choice and you will have five minutes to answer each question.
  • You can choose to answer all 25 questions at one time, or space them out during the quarter.
  • You can use references and you will receive immediate feedback and critiques for each question answered.
  • You will receive up to 30 Division I CME and up to 10 certification points when you complete the longitudinal assessment.

Eligibility & Application Information

You may be eligible to apply for the longitudinal assessment in the fall of the year prior to your 10th year of certification, and you can begin answering questions in the first quarter of the year your exam requirement is due. For example, a Diplomate whose exam is due 12/31/2024 is eligible to apply for the longitudinal assessment in the fall of 2023 and can begin answering questions in January of 2024. Requirements for eligible physicians to enroll include:

While there is no additional cost for the longitudinal assessment, your yearly certification fees will still be required.

Diplomates are encouraged to submit an application for the longitudinal assessment early in the application window to avoid late fees and ensure the maximum period of time to complete the first quarter of questions. Please see your MyABFM Portfolio for further details.

Candidate Information Booklet

To assist you with the longitudinal assessment application and results process, ABFM provides you with a Candidate Information Booklet that includes a comprehensive description of our requirements and policies. We recommend you read this thoroughly before beginning the application process.

2024 Longitudinal Assessment Candidate Information Booklet

Need the Candidate Information Booklet from a previous year? Find it here.

ADA Accommodations

ABFM provides reasonable accommodations in accordance with the Americans with Disabilities Act (ADA). More information regarding accommodations can be found in the Candidate Information Booklet. If necessary, you may request accommodations after the application process is completed by submitting a written request to [email protected].

Application Withdraw

You may withdraw your longitudinal assessment application and switch to the one-day exam on, or before, the final deadline to submit your online application. This can be done through your MyABFM Portfolio. Your fee will simply be transferred from one application to the other. If your application has been approved before you choose to withdraw, you will need to contact ABFM for assistance to switch to the one-day exam application at [email protected].


During the longitudinal assessment, you will receive 25 multiple-choice questions per quarter that cover a breadth of family medicine topics. You will have five minutes to answer each question, and they may be answered online, anywhere, at any time within your MyABFM Portfolio. The complete assessment includes answering 300 questions over a maximum of four years. When you complete 300 questions and achieve a passing score within the four-year window, you will meet your exam requirement to maintain your board certification.  Please note, questions are considered secure and should not be copied, printed, or reproduced in any other way before, during, or after the assessment.

Deferred Questions

Deferred questions are questions that were available to be answered in a given quarter, but never opened. While these questions do carry forward to be presented in the future, it is important to note that if more than 100 questions are deferred, it will not be possible to answer the full 300 question assessment in the allotted four-year window. Any questions that are not attempted will be counted as incorrect.

Only 25 questions will be presented in each quarter, so deferring questions will ultimately result in completing your assessment in year four. You cannot answer more than 25 questions in a quarter to make up for previously deferred questions.

Answering Questions

The Longitudinal Assessment platform delivers 25 questions each quarter providing you with flexibility to complete the entire process in as little as three years or a maximum of four years. The table below lists the beginning and ending date for each quarter that you will have to answer your questions.

Participation Guidelines

To maintain your eligibility for the longitudinal assessment, you are required to adhere to several guidelines.

Meaningful Participation for Longitudinal Assessment

Meaningful participation within the longitudinal assessment is defined as answering 75 of the 100 questions you receive in the first year and completing a brief survey to provide feedback, following completion of each quarter. Please note, the requirement is 75 questions answered, not 75 questions correctly answered. Once you have met the meaningful participation requirement, you may continue the longitudinal assessment . If less than 75 questions are answered in your first year, you will be withdrawn from the assessment and required to pass the one-day exam by the end of the following year.

​Minimum Answered Questions

All participants must answer a minimum of 275 total questions by the conclusion of the maximum 4 years to complete the assessment. Those who do not do this will be removed from FMCLA after the quarter in which it becomes impossible to reach 275 answered questions. The one-day examination would need to be completed by December 31 of the following calendar year in order to continue ABFM certification.

Stage Requirements

Participating in the longitudinal assessment only satisfies your exam requirement. You are still required to complete your 3-year stage requirements to maintain your certification. To view your outstanding requirements and stage deadline, visit your MyABFM Portfolio.

Optional Withdraw

If you choose, you may withdraw from the longitudinal assessment during the first year of participation with no penalty. If you withdraw at any point after the end of the sixth quarter, an exam attempt is considered used.

For complete details, please refer to the Candidate Information Booklet.

Preparing for the Longitudinal Assessment

You may choose to prepare for the longitudinal assessment by reviewing clinical conditions and topics that are commonly seen in family medicine practice. One way to do this is to participate in ABFM’s certification activities such as the Continuous Knowledge Self-Assessment (CKSA). Physicians who have participated in CKSA and the longitudinal assessment simultaneously noted that CKSA was a great practice opportunity, as the questions are constructed similarly and may assist you in familiarizing yourself with the question format. You may also review articles from ABFM’s National Journal Club by topic to address any identified gaps in knowledge.

Resources such as journals, like the Journal of the American Board of Family Medicine (JABFM) and Annals of Family Medicine, may be used to keep current with medical advances and standards. Although ABFM does not offer a board review course, physicians may explore options offered by other organizations.


The longitudinal assessment uses the same content blueprint as the one-day exam, which describes the targeted percentage of questions in each of the 16 clinical content categories.


Scoring and Performance Feedback

You will receive an immediate response indicating whether your answer is correct or incorrect, as well as the rationale and the percentage of respondents who selected each option. You will have the opportunity to select a confidence and relevance rating for each question to analyze your results.

After completing year one of the longitudinal assessment, an estimated scaled score will be provided to monitor your performance over the duration of the assessment. You can also view the percentage of questions answered correctly in each blueprint category to identify gaps in knowledge and areas for improvement.

All questions included in the longitudinal assessment will be marked as correct or incorrect. After all 300 questions are scored, your raw score will be transformed into a scaled score, which accounts for the difficulty of the questions you received. This ensures that no Diplomate is unfairly advantaged or disadvantaged by receiving a relatively easy or difficult set of questions. Your final scaled score and a detailed report will be delivered in the quarter following your completion of 300 questions or the end of the fourth year, whichever comes first. To continue your certification, you must meet the minimum passing standard, which is set at the same standard as the one-day exam.

Final Score Report

Your final score report will consist of four sections that will assist you in evaluating your performance:

  • Performance Report Overview: A full description of the contents of the report.
  • Blueprint Category Performance Summary: Performance information organized by blueprint categories.
  • Item Testing Points: A summary of the testing points associated with the questions you answered.
  • Additional Content Dimensions: Performance information organized by patient age and the urgency and duration of conditions.

To learn more about longitudinal assessment procedures and determine your eligibility, please visit your MyABFM Portfolio.

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