The purpose of ABFM’s Performance Improvement (PI) activities is to help you identify an improvement opportunity, implement a change in care delivery and measure the impact of that change. Demonstration of high-quality patient care includes your ability to identify performance gaps, design an improvement intervention to address the gap(s), and reassess to see if your intervention was effective.  

For clinically active physicians, meaningful participation in and completion of one PI activity, every three-year stage allows you to successfully meet the requirements of the Family Medicine Certification process.

If you have declared yourself clinically inactive in your Physician Portfolio, you are not required to complete a PI activity, though you may choose to do so as part of fulfilling your 50-point activity requirement in each three-year stage.  

How Do I Start My PI Activity?

To begin a new PI activity, resume an in-progress PI or to review the complete list of available PI activities, please log into your Physician Portfolio and select Performance Improvement Activities. 

PI Activity Points

To meet your requirements for Family Medicine Certification you will need to complete a total of 50 certification activity points, which includes a minimum of one PI activity.    

There are a variety of PI activities that have been developed by ABFM as well as external providers.  Completing any these activities will provide you 20 points towards your overall 50-point activity requirement; specifically designated activities are necessary to fulfill your minimum of one PI activity requirement.

Complete These Activities for 20 Activity Points & PI Credit

When you successfully complete any of following activities, you will earn 20 activity points towards your overall 50-point activity requirement and also fulfill your PI requirement.

  • ABFM-Developed PI Activity

The ABFM-developed PI activity platform presents a broad range of measures and resources for you to develop individual performance improvement interventions. Organized by Chronic Care Model categories, this activity is available in a number of topic areas to fit your practice setting and can be completed individually or in a small group of family physicians. It also provides feedback regarding performance compared with your peers. 

  • Transforming Clinical Practice Initiative (TCPI)

ABFM PRIME Support and Alignment Network in collaboration with the University of Colorado, Department of Family Medicine's e-Learning Team have developed three new Transforming Clinical Practice Initiative (TCPI) performance improvement activities that focus on key TCPI concepts: TCPI Person-and-Family-Centered Care Design, TCPI Cost and Value of Care, and TCPI Care Coordination Across the Medical Neighborhood. 

If you would like to participate in one or more of these new TCPI performance improvement activities, please register at and enter the registration code: ABFM.  You may also access these new TCPI performance improvement activities in your Physician Portfolio.

  • Precepting performance improvement program

If you are a preceptor, the Precepting Performance Improvement Program (Precepting Program) allows you to receive PI activity credit for meaningful participation in customized performance improvement projects as well as meeting the required 180 hours of 1:1 precepting.  Approved sponsors will be able to develop and oversee PI projects for teaching physicians without having to apply for each activity for ABFM review through the Precepting Program.  The Precepting Program is available at

  • ABFM Self-Directed PI Project: Clinical Pathway

The ABFM Self-Directed PI Project: Clinical Pathway activity allows you to submit customized clinical improvement projects based on the work you may already be doing in your practice or work setting.  The Self-Directed PI Project: Clinical Pathway allows you to document your project and submit it for Family Medicine Certification credit. This activity may be completed by you individually or collectively as a small group of family physicians.   As part of this clinical pathway, you will be asked to describe your role, identify the measures used, and the intervention(s) implemented during your project. ABFM does offer a non-clinical pathway for this activity; however, it only provides activity points and does not fulfill your PI activity requirement. It is intended for those who have declared themselves clinically inactive.     

  • Organizational PI Projects

You may be eligible to receive Family Medicine Certification activity credit through the Organizational PI Project pathway if you have participated in a local, regional or national performance improvement project with a team of 10 or more family physicians. Doing so provides you with 20 activity points, including PI credit.

If you would like to submit your completed project to ABFM through the Organizational PI Project pathway, your organization will need to submit an application that includes the project description.  The application process requires a non-refundable $100 fee for each application submitted to ABFM, regardless of the number of physicians participating. The application is available at:

  • Residency Performance Improvement Program (ResPIP)

If you are a resident or faculty member, the Residency Performance Improvement Program (ResPIP) allows you to receive PI activity credit for meaningful participation in customized clinical performance improvement projects with a team of 10 or fewer family medicine residents or residency faculty in your Residency Teaching Practice.  Your residency program is able to submit these activities for approval through the ResPIP process available at  

  • AAFP PI-CME Activities

The American Academy of Family Physicians creates and approves activities that provide 20 activity points, PI credit and offer CME. Learn more about these activities at

  • ABP Practice Improvement Modules (PIMs)

The American Board of Pediatrics (ABP) has developed several PI options, known as Practice Improvement Modules (PIMs).  PIMs are self-paced activities that can be completed individually or in a small group. These are available in an array of topic areas that could be applicable to your practice.

All of the ABP-developed PIMs are acceptable options to complete for activity and PI credit, with one exception, the Virtual QI Learning PIM.  By choosing to complete the Virtual QI Learning PIM you will earn 20 activity points towards your overall 50-point activity requirement, but it will not fulfill your minimum PI requirement.  

  • ABMS Reciprocal Activities

ABFM has reciprocity agreements with other ABMS member boards that provides you with a range of additional PI activity options.  Upon successful completion of one of these activities, you will receive both an external activity certificate of completion and verification documentation that states the activity is eligible for Family Medicine Certification.  This documentation must be submitted to ABFM to receive your activity and PI credit.  

All activities you submit will be reviewed by ABFM and appropriate activity credit will be awarded.  In order to avoid delayed assignment of Family Medicine Certification activity credit when participating in a reciprocal activity, be sure to submit both pieces of documentation. Once awarded by ABFM, your credit will be applied to the stage in which your activity was completed.

  • ABMS Portfolio Program

The ABMS Portfolio Program sets standards for identifying, creating opportunities for, and evaluating meaningful participation in organizational quality, safety, improvement, and continuous professional development activities. 

As a Portfolio Program Sponsor, ABMS helps to develop initiatives that align with organizational improvement priorities such as improved quality of care, enhanced communication, greater efficiency and assurance of patient safety.  Initiatives could address community health concerns, ranging from cancer screenings, cardiovascular disease prevention to improvement immunization programs and transitions of care. Portfolio Program Sponsors include leading hospitals, health systems, professional societies, and community health care organizations from across the country.

If your organization is participating in the ABMS Portfolio Program, you could be eligible to receive Family Medicine Certification activity credit. To find a list of ABMS Portfolio Program Sponsors visit this website:  

Complete These Activities for 20 activity points

Additional alternative PI activities are available that will provide you with 20 points towards your 50-point activity requirement but will not fulfill your PI requirement.  The breadth of these activities allows you to choose options that are relevant to your specific practice environment. To review a complete list of approved alternative performance improvement activities, please log into your Physician Portfolio

Meaningful Participation

Through demonstrating meaningful participation in PI you will gain the most benefit for your practice.  ABFM defines meaningful participation as the following:

  • Reviewing practice data and identifying a gap in care or clinical processes that you wish to improve
  • Engaging in planning and execution of your PI project
  • Actively participate in implementing change in your practice setting that are designed to improve your quality of care for patients
  • Review and analyze your post-intervention data to assess the impact on care delivery and outcomes
  • Actively collaborate with your peers where applicable