Guest Editorial

ABFM Certification Pilot Proves Worthy Alternative

July 24, 2019 09:25 am Clif Knight, M.D.

After I graduated from residency in 1990, I traveled from Flora, Ind., to Chicago to take the American Board of Family Medicine certification exam. The trip required an investment in travel, a hotel stay, meals and time away from my new role as a family physician.

[headshot of Clif Knight, M.D.]

Clif Knight, M.D.

I repeated that process when I recertified in 1996 and 2002, again taking time away from my job (and my family). Fortunately, by the time I took the test again in 2009, the ABFM had instituted online testing, so I was able to take the exam without leaving my community. I did, however, have to spend a day in a testing center rather than with my patients.

Fast forward to 2019, and it's time for me to take the exam again. However, this year, the ABFM is offering a pilot to gauge the value and feasibility of a longitudinal assessment alternative to the one-day, 10-year certification examination. The new option is similar in format to the ABFM self-assessment activity known as the Continuous Knowledge Self-Assessment in that it offers participants 25 online questions each quarter that can be answered from the convenience of your home, office, etc. I have been participating in the CKSA since its debut in January 2017 and have developed a high level of comfort with the format.

I'm enthusiastically participating in the pilot, and after two quarters, my assessment is so far, so good. In addition to my role as the AAFP's senior vice president for education, I also have oversight of the Academy's Physician Health First initiative, and the feedback we have received from members is that the ABFM pilot is less stressful and less burdensome than the traditional one-day exam.

It's not hard to understand why. The pilot consists of 300 questions broken into 25-question segments per quarter. The questions can be answered at your own pace in an open-book format. Each question must be answered within five minutes. (Yes, you can use resources you might find in a family medicine practice. No, you can't phone a friend.)

In addition to eliminating travel costs and time away from practice, the online exam tells me immediately whether or not I have answered a question correctly and provides references to back up the ABFM's evidence regarding the correct diagnosis and treatment. That's in contrast to the one-day exam, which offers preliminary test results to most participants within a few weeks and no feedback regarding incorrect answers.

The pilot also allows participants to identify weaknesses in certain topic areas, and because the test is taken over time, you have an opportunity to study and improve your score in those areas rather than continuing to struggle with them.

Now if this sounds like a good alternative for you but you aren't recertifying this year, here's some good news: The ABFM announced this month(www.theabfm.org) it is expanding its Family Medicine Certification Longitudinal Assessment pilot to 2020. Eligible diplomates -- those who will be in their 10th year and due to take the exam in 2020 -- will be able to sign up for the pilot beginning Dec. 6. The last day to begin a new application for the FMCLA is March 2, 2020.

We know from years of member surveys that you look to the AAFP to support your board certification preparation. In addition to our traditional board review course and resources, you also should know that the AAFP has created resources specifically for members interested in the pilot. The AAFP's Longitudinal Assessment Self-Study Package offers access to

  • the AAFP Family Medicine Board Review Self-Study Online Package,
  • FP Comprehensive 2019,
  • a customizable exam study plan,
  • additional readings and more to help you prepare, and
  • access to an online community to discuss clinical topics with colleagues and expert faculty.

Of the AAFP members who were eligible to participate in the pilot this year, 71% chose to participate in FMCLA, while the remainder have taken, or plan to take, the one-day exam if they are continuing their certification. Physicians in both groups have indicated they made their choices based on perceived convenience. Some FPs value the benefits of the pilot; others would rather be done with the process in one day. Fortunately, we now have options. Pick the one that's right for you.

Clif Knight, M.D., is the AAFP's senior vice president for education.