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Monday Mar 04, 2019

Curious About the ABFM Pilot? Here's My Experience So Far

Like many family physicians certified by the American Board of Family Medicine (ABFM), in mid-2018, I started to plan which board review course I would take to prepare for my 2019 board examination. My usual routine would be to map out how many months until my exam (in either April or November) and divide the subject matter accordingly with times allocated each week to review written material and practice exam questions. I would try to meet with colleagues to review pearls, and I would avail myself of either a live or recorded board review course.

[let's try something new concept]

And like many other board-certified family physicians, I was ecstatic when I found out in late 2018 that I could be part of the pilot group that would take the alternative Family Medicine Certification Longitudinal Assessment (FMCLA),(www.theabfm.org) which offered 25 questions every quarter -- open book and answered at my own pace and location with immediate feedback.

I was already familiar with the 25-question format, having previously completed the ABFM's Continuous Knowledge Self-Assessment activity. So the opportunity to do this instead of taking the high-stakes, one-day exam was a true gift.

For those not familiar with this new option, the AAFP has a webpage dedicated to the pilot where you can find answers to many of your questions about the process. That page, in turn, links to the ABFM site, where you'll find even more details.

So at the end of 2018, I waited to receive the usual email from the ABFM notifying me that it was time to sign up for the exam. This email, however, allowed me to choose which format I would utilize for my continuing board certification in 2019 -- the usual one-day exam or the new three- to four-year option with 25 questions each quarter until I had completed a total of 300 questions. At first, I was concerned -- why up to four years? Reading the details, it turns out that the extra year (essentially four extra quarters) is given to accommodate "life" -- illness, family obligations, vacation, etc.

Reassured, I chose the latter.

I then had to figure out how to prepare for this new method of being tested all year long for three to four years. The questions were still randomly assigned, and I would not know which topic was coming up next. The first question could be cardiology, the next pediatrics and the next population health. Totally random, which meant I needed to study broadly every week.

There is a longitudinal assessment content guideline that gives a breakdown of the percentage (and total number) of questions that will be given during the period. Cardiovascular, musculoskeletal and respiratory topics are the top three, but you can check the document yourself to determine your areas of strength and areas for improvement.

Because of my hectic schedule, I decided to allocate time once a week to answer a few questions. Some of my peers decided to answer all of them at one sitting. The choice is up to the individual. For me, it required trying to be innovative in doing a little review daily -- be it by text, AAFP videos, the American Family Physician podcast, online questions, journal articles, the ABFM app or even Alexa reading the questions to me.

And I had to learn how to efficiently utilize the open-book resources. We use these resources every day in real practice, but this would be timed; the FMCLA allows just five minutes per question.

I am trying to stay on schedule because those of us in the pilot must have meaningful participation in this first year (i.e., answer at least 80 percent of the questions). If you don't make this benchmark, or if you should fail at the end of the three- to four-year period, you automatically revert to the one-day exam.

In fact, anyone can decide during this process to revert to the one-day exam. At that point, you would have one year to prepare and register for the exam (with payment) while still maintaining certification status.

I must say, so far (I started in January and this quarter ends March 31), the biggest pro for utilizing this format is that it is forcing me to learn something new each week. If I get something wrong, I know immediately and get the critique, which informs my ability to utilize the information in real life. The other pro is not having to schedule time off to take the exam. And I love the flexibility of choosing when and where to answer questions.

You should know, too, that the AAFP is developing new CME resources to assist members like me with this new option for continuing certification, so watch for announcements regarding those products soon.

Lessons learned to date:

  • Answer the questions in a quiet environment away from distractions.
  • Take advantage of the open-book format to confirm knowledge via trusted online or text resources.
  • Breathe.

As I finish up the first quarter, I am quite optimistic for those who prefer this format.

I'll keep you posted once I've completed my first four quarters. And if you see a "Do not disturb" sign on my door, I might be in the middle of my longitudinal assessment!

Tochi Iroku-Malize, M.D., M.P.H., M.B.A., is a member of the AAFP Board of Directors.

Posted at 12:04PM Mar 04, 2019 by Tochi Iroku-Malize, M.D., M.P.H., M.B.A.

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