Developing the New Family Medicine Certification Scale Blueprint

Purpose: The American Board of Family Medicine (ABFM) approved the use of a new blueprint for the Family Medicine Certification Examination, the In-Training Examination, Family Medicine Certification Longitudinal Assessment, and the Continuous Knowledge Self-Assessment. It will go into effect in January 2025. The blueprint defines the content domains for the questions on the examination and the percentage of questions in each domain. This article describes the process used to establish the clinical activities that comprise family medicine and group them into content domains. Methods: A list of family medicine clinical activities was generated from a list of family medicine entrustable professional activities, diagnostic codes from National Ambulatory Medical Care Survey data, PRIME registry data, a publication on skills and knowledge needed at the completion of residency, content topics from the National Board of Medical Examiners, previous ABFM item classification categories, and an in depth analysis from the International Classification of Primary Care diagnosis. The distilled list of clinical activities were grouped into content domains. Finally, the activities were reviewed by stake-holders to establish if the activities and their grouping were representative of the practice of family medicine. Results: A 5-category content domain structure was adopted: Acute Care and Diagnosis, Chronic Care Management, Emergent and Urgent Care, Preventive Care, and Foundations of Care. Conclusions: The clinical activities and their grouping into content domains were accepted as being representative of the practice of family medicine. Meeting this criteria made these activities and grouping an appropriate basis for a practice analysis survey.