Defining the content of board certification examinations

A system of medical classification based on the fundamental dimensions of body system, etiology, and stage of disease was evaluated by classifying the content of one specialty board’s examinations. Ten physicians encoded 2,310 test items that constituted three previously administered certification-recertification examinations of the American Board of Family Practice. Analysis of the data for the major content of one of these certification examinations suggests that a profile based on this classification system might provide a specialty board, the residency programs, and candidates for certification with important information not produced by discipline labels or disease names. This classification system may allow a board to define more effectively the content of its examinations, monitor other requirements for certification, and communicate its standards to the medical profession and society.