- The American Board of Family Medicine thanks all family physicians for their exceptional commitment to caring for their patients and their communities during the COVID-19 pandemic. We recognize that these are truly unprecedented times and want to do everything we can to allow you to focus on what is most important: your patients and your families. As the COVID-19 pandemic continues to evolve rapidly and the need for family physicians to care for patients during the outbreak increases, ABFM will continue to communicate with you regularly to make you aware of adjustments we are making with respect to certification activity requirements to accommodate these extraordinary times.
Our commitment is that no family physician will lose their ABFM certification because of the extraordinary patient care pressures associated with this pandemic. Additionally, if you are unable to participate in certification activities or Family Medicine Certification Longitudinal Assessment (FMCLA) in 2020 because of the demands of this pandemic, it will not jeopardize your certificate or your ability to continue your certification. We do not want ABFM requirements to play any role in the decisions you need to make to provide the best personal and public health response to this pandemic. Residents need not be worried about future consequences for their board certification in this regard. We will work with you.
We are working out many operational details. We will communicate these with you in coming weeks. It will take up to a month to reflect these changes in your Physician Portfolio. We also commit to ongoing review of what is happening as the pandemic evolves and will adjust as necessary going forward.
For specific questions, please look in the links to specific categories below where you can find more information. If what you need is not there, you may contact our Support Center with any questions that you may have. Although our office is working remotely, we will continue to provide seamless service and response times.
What to Expect During Your Upcoming Examination
Changes to Certification Deadlines
Certification Stage Activity Requirements
Certification and CAQ Examination Information
Residency / Fellowship Training
Family physicians across the country are learning rapidly about COVID-19, applying what they learned to their practice setting, and adapting their approach to provide better care for patients at an unprecedented rate. ABFM will recognize you for these contributions in its continuing certification program. We understand how challenging this is for those of you on the front line and are grateful for all that you are doing to serve your patients and communities.
What to Expect During Your One-Day Examination
Prometric’s current "Test Center Policies" are available on its website, which we would encourage you to read in preparation for your exam day. For your convenience, here are some of the critical points of their policy, designed to provide as safe an experience as possible for all examinees:
- Masks required. All examinees will be required to wear a mask during the entirety of their time at the test center. Prometric will not be providing masks to examinees; you must provide your own. Please note that you will not be allowed to test without a mask. Gloves (such as latex or nitrile) may be worn without the need for pre-approval if you would like, but they are not required.
- Arrive early. Given the additional procedures that must now take place, please be sure to arrive 30 minutes before your scheduled appointment start time. Some centers will have a limit on the number of people that can be allowed into the lobby at once, so know that you may not be allowed in to check in right away if the lobby is at capacity.
- COVID-19 exposure. Prometric will ask examinees the following questions upon arrival. You must not fall into any of the following categories to enter the test center.
- Have been diagnosed with COVID-19 in the past 14-days;
- Have been exposed to someone diagnosed with COVID-19 in the past 14-days;
- Medical and healthcare professionals who have been practicing preventive measures using personal protective equipment with their patients are an exception.
- Are experiencing flu or cold-like symptoms; OR
- Have returned from travel to a highly infected area in the past 14-days.
- "Highly infected areas" are defined at the local level and may vary. Please consult local resources regarding travel restrictions/quarantine requirements if you have concerns.
If you fall into one of the above categories, ABFM will be happy to work with you in determining rescheduling options.
- Check-in procedures. Prometric will be implementing a "no-touch" experience during this time, so some of the procedures for check-in will be different. Appropriate distancing will be observed while doing the regular checks of pockets, arms & ankles. Bring water! Public/community water fountains will not be available. Given the length of ABFM exams, we encourage you to bring water in a resealable bottle. You will be permitted to store this in your locker.
- Breaks. When you take a scheduled or unscheduled break during testing, you will need to raise your hand so that the test center administrator may clear a path for you to exit and maintain control of the traffic in/out of the testing room.
- Cleaning. All workstations will be thoroughly cleaned before and after each delivered examination with an approved disinfecting cleaner. Common areas such as the test center administrator desks, waiting areas, and restrooms will be cleaned throughout the day. You will be issued a clean pen that only you will use to sign in and out throughout the day and then return at the end of your appointment.
Changes to Certification Deadlines
At this time, ABFM has made the following accommodations to the deadlines for your continuous certification participation:
All Diplomates with a three-year stage ending in 2020 will have a one-year extension on completing all stage requirements.
All FMCLA participants will have the option of an additional three months beyond each original quarterly deadline in 2020 to complete quarterly question sets. For participants who began in 2020 and are in their first year of FMCLA, the meaningful participation requirement was reduced to 50 answered questions by the deadline to complete the 2020 quarterly questions.
Any Diplomate in Year 10 of their certification cycle who opted for the one-day examination will have an additional year to meet their examination requirement.
Any board-eligible family physician with an eligibility end date in 2020, or anyone participating in the Re-Entry process with an end date in 2020, will have an additional year to obtain their certification.
Any Diplomate who also holds a Certificate of Added Qualification with an examination deadline in 2020 will have the option for an additional year to complete the examination requirement.
Those facing financial hardship as a result of the pandemic have the ability to delay 2020 payments. Additional information can be found in the Physician Portfolio.
Certification Stage Activity Requirements
We are continuing our efforts to improve our current Knowledge Self-Assessments (KSA) and will begin to support learning on COVID-19 as evidence becomes more available.
COVID-19 Self-Directed Clinical Pilot:
The new COVID-19 Self-Directed Clinical Pilot allows Diplomates to direct a custom rapid cycle quality improvement effort, regardless of whether they provide continuing care. This activity provides a mechanism for meeting the Performance Improvement (PI) requirement by telling us about the unprecedented and rapid changes that you had to make in the ways that you deliver care, regardless of practice type or scope. This PI can address many different dimensions of care—not just clinical quality measures but process effectiveness and efficiency, patient satisfaction, safety and the other characteristics that the practice has identified. Log into your Physician Portfolio to get started.
An extension has been granted to the first quarter deadline for anyone who is utilizing Continuous Knowledge Self-Assessment (CKSA) as part of their certification activities. The deadline to complete your current quarter 25-question set has been extended from March 31 to June 30, 2020. As the experience of the pandemic evolves, further extensions may be needed.
Any Diplomate who had planned to participate in a Group KSA that has been canceled or postponed can still do the activity online in their ABFM Physician Portfolio. The same certification points and CME credit will be applied as if it was done in a group setting.
Given the increased demands on time and resources during this crisis, all FMCLA participants will have the option of an additional three months beyond each original quarterly deadline in 2020 to complete quarterly question sets. The original quarterly timeline will remain in place, but if needed optional deadline extensions will be available as follows:
For those physicians in their first year of FMCLA participation, we have relaxed the meaningful participation requirement that would have required completion of 80 questions by the end of 2020. To meet meaningful participation requirements for 2020 and continue to move forward with FMCLA, we ask that you complete 50 questions out of the 100 that will be delivered in 2020 by no later than March 31, 2021.
We have received questions about CME requirements for LIVE CME, especially given that so many upcoming conferences have had to be canceled. ABFM does not require live hours to meet CME requirements. Online and other virtual CME opportunities will suffice to satisfy requirements. Those physicians reporting CME through the AAFP, can continue to do so. Those completed hours will be reported to ABFM once the minimum number has been reached. Otherwise, CME can be reported directly through the ABFM Physician Portfolio. CME requirements for ABFM Certification can be found by clicking here. ABFM plans to follow any modifications to CME requirements as determined by the AAFP; these will apply to all Diplomates regardless of AAFP membership status
ABFM is aware that many family physicians are beginning to utilize telemedicine as a method of screening and providing care that can be offered more safely out of the office. We have had questions about whether a telemedicine-specific medical license would be in compliance with ABFM Guidelines for Professionalism, Licensure, and Personal Conduct. Any board-certified family physician practicing telemedicine will continue to be in compliance with certification requirements as long as they meet the requirements of holding a full and unlimited license in their own, or another, jurisdiction. As such, using telemedicine to provide care in your own practice state, or in another state as needed, will pose no problems with your certification status, even if the limited telemedicine license is only granted for this period of critical need, as long as you maintain your current, full medical license.
Residency / Fellowship Training
Residency Training Requirements and the Coronavirus Pandemic:
Statement of the American Board of Family Medicine
March 20, 2020
As the COVID-19 pandemic continues to evolve rapidly, the U.S is facing unprecedented changes in health care demands and the ways in which care is delivered, including widespread virtualization of care, “scrubbing” visit schedules of nonurgent visits, and redeployment of faculty, residents, fellows and staff to different settings, such as screening tents and temporary care facilities. Compounding these dramatic clinical pressures is the social distancing of our communities, schools and civic structures. Collectively, these have a major impact on the lives of residents and faculty as they try to balance their personal and family needs, while at the same time stepping up to serve their patients and communities.
On March 18, 2020, the Accreditation Council of Graduate Medical Education (ACGME) published a response to COVID-19 and residency training (ACGME COVID-19 Response). In this communication, the American Board of Family Medicine (ABFM) wishes to respond to questions from the community about the impact of the pandemic on Family Medicine Board Certification.
The ABFM and the ACGME Family Medicine Review Committee are jointly responsible for family medicine residency training in the U.S., with ABFM certifying individual physicians and ACGME accrediting residency programs. We have worked closely with the leadership of the Family Medicine RC to develop this response. We understand that the ACGME will be developing a website that will provide guidance about the accreditation of residencies. ABFM Board Eligibility and Certification In order for a resident to be eligible for ABFM certification, program directors must attest that the resident has met minimum training requirements as defined by the ACGME. For residents graduating in 2020, some necessary adjustments will need to be made. ABFM will allow inclusion of precepted televisits and visits in other novel settings (e.g., tent clinics, COVID-19 diagnostic center) toward the 1650 visit minimum. We ask that you document these visits in the ways you have routinely done for in-person continuity visits.
Similarly, we understand that the situation may not allow the traditional rotation curriculum and we will approve residents for board eligibility with changes in residency rotations forced by the COVID-19 pandemic, such as subspecialty rotations, nursing home experience, or electives. We intend to trust program directors to balance the complex needs of the current time. We also expect program directors, in collaboration with the residency Clinical Competency Committee, to make the final decisions about readiness for autonomous practice. Finally, ABFM will keep the burden of reporting to a minimum—following an attestation form and process similar to what residency directors are currently using. We will communicate any changes as necessary.
As previously communicated, any COVID-19 mandated quarantine or personal illness will count towards clinical time and will not violate the ABFM One Month Away from Continuity Care rule nor require extension of training. Additionally, we have had questions about the impact of cancelation of the April 2020 initial certification exam on the ability of residents to obtain jobs and become credentialed after training. Residents are board eligible upon graduation as long as the program director has attested to the fact that they have met all ACGME requirements. Employers will accept board eligible or board certified status for physicians just out of residency. To move from board eligible to board certified, residents must secure an active, valid, unrestricted medical license and pass their initial certification examination. Family Medicine is the only specialty in which the certifying board offers the initial examination prior to graduation.
Prior to 2012 this examination was offered in July of each year with scores being provided 8 weeks or longer after completion. It did not impact credentialing or jobs then, and we do not expect it to do so this year, especially considering the unique circumstances of a global pandemic. While it was our desire to offer this examination before graduation, that simply is not possible this year. The test centers have closed for the next 30 days beginning March 17, 2020 and may well need to extend. We have explored alternative ways to deliver the examination, and for a variety of reasons that is not possible this year. We are focusing our energy on trying to get exam seats for thousands of family physicians in July or August, if possible, so we can still offer two exam delivery periods in 2020.
We are very sensitive to what you will be facing in the coming days. We prefer that certification is not what is top of mind at this time. ABFM is committed to focusing on the needs of all faculty and residents and will continually be evaluating for any further decisions that might be needed about certification requirements or extensions for the 2020 graduating residents. We also understand that, depending on the course of the pandemic, the experience of current first- and second-year residents may be altered. We will review the situation as it evolves and make changes over time that we think are necessary. Over the longer term, the American Board of Family Medicine anticipates that the pandemic will bring significant changes in many aspects of clinical care and residency training. It has exposed many structural challenges in the organization of care in the U.S. We also believe that the upcoming major revision of our family medicine residency requirements provides an excellent opportunity to develop a new vision for what America needs from family physicians, which will impact the training they receive. When this first phase of the COVID-19 pandemic subsides, we look forward to working with you on this important goal.
COVID-19 Updates for Graduating Family Medicine Residents
March 20, 2020
These are extraordinary times in our nation and world and the COVID-19 pandemic has touched all aspects of our life and work. There is much concern, fear, and uncertainty in the midst of this and ABFM is working hard to assess our processes, requirements, and accommodations needed related to your initial board certification and to communicate them to you as quickly as we can. Please find a summary of these, to date:
What happens to my initial certification examination?
We had every intention, and desire, to offer your initial certification examination before graduation. With the progression of the pandemic, it was simply not possible this year. Prometric test centers initially closed for 30 days beginning March 17, 2020 and extended the closure through early June. There were a variety of reasons that the examination could not be offered outside of the secure test center—as you do with your ITE. These include the unique ways that the exam is delivered (random question delivery, delivery of different forms, etc.), the timing of sections, the security of items, the number of responses needed for scoring, the fact that many other non-resident family physicians take the exam in April. Unfortunately, there was no capacity in any sector to stand up a new delivery platform that could have been used this spring in the midst of everything else that was happening. In light of this, we secured thousands of exam seats in July/August and were able to offer an alternative exam window after the April administration was cancelled.
What about my ability to get a job? Become credentialed?
Any resident who completes an ACGME accredited residency program is considered board-eligible once they have obtained a program director sign-off that they have met all ACGME requirements and have obtained a medical license that meets ABFM Guidelines for Professionalism, Licensure, and Personal Conduct.
Board certification is awarded once you have a) obtained an active, valid and unrestricted medical license and b) passed your certification examination. Until that time, employers and credentialers typically will accept board eligible status out of residency. In fact, ABFM is the only specialty board that offers the initial certifying exam prior to graduation. Historically, the ABFM examination was administered in July each year, with certification being award approximately 8 weeks later after scoring was completed. This, coupled with the experience of residents who are off-cycle, or who simply choose to take the exam in November or later, leads us to believe you should be able to gain support for employment or credentialing. If needed, ABFM will work with you to provide documentation in the event that you encounter a problem with this.
My daily work is already changing, what if I am not able to meet ABFM requirements for eligibility to take my examination?
Any mandated quarantine or personal illness time out of training that is COVID-19 related will count towards clinical time and will not violate the ABFM one month away from continuity care per year rule. With respect to requirements for continuity patient visits, we expect that most of you will already have met the 1,650 minimum visit requirement prior to the pandemic. Yet, for those who have not, we recognize that most in person visits are being converted to virtual visits. We also appreciate that you are being called to staff drive through clinics, hospital-based outpatient and inpatient service needs, and other innovative ways of delivering care. Reporting to the ABFM about your successful completion of ACGME patient visit and training requirements has always been done through Program Director attestation for each graduating resident. Specifically, for residents graduating in 2020, ABFM will allow inclusion of virtual and other care delivery innovations toward the 1650 visit minimum. We also intend to waive requirements for nursing home visits, subspecialty electives, and elective experiences as allowed by ACGME, in situations where this becomes necessary based on the conditions of the pandemic.
We want you to know that ABFM is committed to focusing on the needs of all family physicians, including residents, through the challenges ahead. We will continually be evaluating and making decisions about certification extensions or adjustments, if needed, through this pandemic. We have a COVID-19 link on the front page of our website which is updated regularly. If you cannot find your answer there, you can contact our Support Center at 877-223-7437 or [email protected] and let us know what additional questions or needs that you have. We are immensely proud of the role that you, along with your faculty members and staff, are playing in the care of your patients and communities. Your professionalism, broad-based knowledge and skills, and on-the-fly flexibility represents the best of what family medicine has to offer. We support you and wish you safety, good health, and resilience in the weeks ahead. Please let us know if you have any questions by contacting Ms. Kathy Botner.
The American Board of Family Medicine is actively monitoring the spread of coronavirus (COVID-19) and will post ongoing updates here on our site. We recommend reviewing the United States Centers for Disease Control and Prevention (CDC) website for the latest updates along with additional information regarding COVID-19.
There is still much uncertainty about the coronavirus outbreak and what we know is changing daily. Given that family physicians are on the front lines of care delivery, both in the outpatient setting where upper respiratory symptoms are common, and in inpatient and long-term care settings where they might be exposed to yet-undiagnosed patients with more acute COVID-19 disease, we are committed to communicating to you regularly about any impact of this pandemic on certification activities.