Exam Item Writers: A Long History of Family Physicians Committed to Helping Us Improve

The longest active groups of American Board of Family Medicine (ABFM) volunteers are a group of family physicians who serve as item writers and reviewers for ABFM examinations. On average, 40 family physicians serve as item writers, and an additional 20 serve on the committee that reviews the certification exam draft. Additionally, ABFM benefits from the volunteer efforts of 10 current or recent program directors who review its annual In-Training exam draft.

These item writers and committee members come from a variety of practice settings, including private or employed practice and academic faculty, with sizes ranging from small to large, located in rural, suburban, and urban settings. These groups of volunteers currently represent 30 different states and are fairly evenly split between academic medicine and private practice.

The first group of item writers was assembled around 1980 to create items for the first In-Training Examination, which was provided as a service to residency programs. Before that time, the questions for the exams were written and reviewed by the ABFM Board of Directors. Having a separate group of item writers proved to be so successful that additional item writers have been recruited over time to build a robust item pool for the Family Medicine Certification (FMC) examinations. We also began adding committees of family physicians that were separate from the Board of Directors to review the drafts of the examinations during the 1980s.

New item writers were recruited and trained each year throughout the 1980s and early 1990s and then as needed after that point. The item writing group provides the content for not only the traditional exams, but also for Family Medicine Certification Longitudinal Assessment (FMCLA) and Continuous Knowledge Self-Assessment (CKSA). To keep them updated on best practices in item writing and provide individual feedback, ABFM hosts a yearly conference where we are able to meet with them in person.. Many of our item writers have also served on exam committees and helped to create Knowledge Self-Assessments (KSAs), and some have been elected to serve on ABFM’s Board of Directors.

We are grateful to these physicians who volunteer their time to this service as a result of their commitment to the mission of ABFM and to enhance the specialty.