ABFM to pilot alternative to board exam

Tags: ABFM, alternative to board exam, Continuous Knowledge Self-Assessment, congress of delegates new orleans

By Jonathan Nelson

At this year’s AAFP Congress of Delegates in New Orleans, the American Board of Family Medicine announced plans to pilot a longitudinal assessment alternative to the 10-year secure examination family physicians must take to maintain board certification. This option will be available to physicians who are current with continuous certification and are due to take the exam in 2019.

Based on ABFM’s popular Continuous Knowledge Self-Assessment platform, the new assessment option will deliver 25 questions online each quarter to diplomates who choose to participate.

"This approach is more aligned with the ongoing changes in medicine and draws upon adult learning principles, combined with modern technology, to promote learning, retention and transfer of information," Jerry Kruse, MD, Chair of the ABFM Board of Directors, said in an Oct. 9 ABFM release. "Over time, we will be able to assess the core clinical knowledge of board-certified family physicians and recognize the vast majority who work to keep up to date to take care of their patients."

The announcement marks a milestone in the evolution of the specialty’s maintenance of certification program. In July of 2017, AAFP established a task force to evaluate alternative methods of achieving ongoing board certification. The group delivered its recommendations to the AAFP Board in July of this year.

TAFP President-elect Rebecca Hart, MD, served on the task force and is excited about the new alternative. "Most family physicians were unhappy with the expensive, time-consuming, and anxiety-producing high-stakes exam required for continuing board certification,” she says. “The new longitudinal assessment, being consistent with adult learning theory, provides a much better approach. Physicians find more value in keeping up with current literature by being tested longitudinally on new knowledge as it occurs. Having the opportunity to answer questions conveniently on your own time, with your own device, wherever you want simplifies the process, and eliminates the expense of travel to testing centers.”

Diplomates who participate in the longitudinal assessment will also be able to consult clinical references while answering the questions each quarter, so physicians can access information just like they do in practice.

“It’s what we’ve been asking for, and it evens the playing field by aligning with the reasonable requirements of other specialty boards,” Hart says.

The pilot program was approved by the ABFM Board of Directors in September and it is expected to be approved by the American Board of Medical Specialties' Committee on Continuing Certification in November.

"We believe that longitudinal assessment can meet many of the needs and desires we have heard voiced by family physicians," said Warren Newton, M.D., incoming ABFM president and CEO, in the release. "It will provide questions on a regular, longitudinal basis, in a format that is much more convenient — a few questions at a time, in the place and time of your choice."


  • John Manning, MD said

    Totally excited about this new common sense and effective Maintenance of Certification Plan! So happy to hear!

  • Ike Nweke M.D, M.B.A said

    I have no problem with this approach whatsoever.

  • Melissa Urrea, MD said

    This is wonderful news and very timely. The one question I have regards the timing of guidelines. For example, the 2017 examination might reference guidelines from 2012 even though new guidelines from 2016 might have been recently released.

    For the longitudinal examination process, how will the diplomats in the 2018 pilot know which guidelines upon which the questions are based?

  • Ronald W Bradshaw said

    I have taken the exam four times and my next one is due in 2024. I will be 65 at that point and had pretty much decided I would probably just plan to retire and avoid taking the exam again. This longitudinal option, however, sounds like it could be a workable solution.

    I wonder how other physicians feel about this? It would be a shame at a time when we have a shortage of family doctors in the US to see physicians give up practicing just because they are weary of the exam.

    Anyone have similar thoughts?

  • Anuj Sharma said

    I am due to take the exam in 2019.
    How do I become a part of the pilot?
    If I take that track, how long will the certification be valid?

  • Maxwell Axler said

    They're a little late. I stopped the very expensive recertification process after having passed the exam many times - it's too bad they are not offering an option for people like me who have now not maintained continuous certification. It took the ABFM a long time to see the light.

  • Beth Bebout said

    I think it is a step in the right direction.

  • Todd Cowan, M.D. said

    I'm all for it! If delivered as described in the article it makes perfect sense. Even though slow to change, thanks ABFM for listening to us, the members.

    Todd Cowan, M.D.

  • Linda Porter-Tucci, MD said

    This is a much better alternative to the current board exam. Thank you for listening to us.

  • Robin Eickhoff said

    As a clinical educator and practicing physician, I am very excited to see this change come about. It makes more sense and is a much more evidence-based, palatable way to assess and demonstrate core knowledge. It's about time!

  • Rolf Naley said

    Finally! After taking the exam in 1977, 1984. 1991, 1998, 2005, and 2012 and not currently in active practice, this seems like a workable solution. I would like to see an emeritus status for those of us no longer in practice.

  • Ralph De La Rosa said

    Great idea and I am interested. Medicine is always evolving and focus on current information is a great way to keep current.

  • Stephen H. Barth MD said

    I just passed the exam again at 67 years old. (2018) Am I eligible for this process?

  • Francisco Barrera MD said

    As Dr Axler mentions a little to late for "busy practicing" physicians that have decided not to retake board exam after passing it several times before, maintaining CME every year as required. Recertification exams should test on actual medical practice...Family Medicine is the only specialty that requires recertification. Once certified ==Always Certified

  • Dallal Abdelsayed said

    Wonderful idea I stopped taking the exam due to the expenses and time taken away from my Practice Now I will start back applying

  • Cheri Mann, DO said

    This is wonderful news! I was dreading the exam I planned to take in Dec 2019 and am happy for this alternative. Thank you!
    We need an update with answers to some of the questions posted please. For example, is this to be a continuous, quarterly, assessment to remain board-certified?

  • Suzanne Gnaegy said

    Thank you, GOD! this is way overdue, but I am grateful and look forward to enrolling in this option.

  • Andrea V Brown MD said

    Great news. I too was planning to retire before I took the exam again - too stressful!! This sounds like a good alternative. It may keep me in the game a little longer....Thanks

  • Steve Randall said

    While this may seem like a good idea, its not. It is another trick of ABFM to continue to collect outrageous fees. There is zero justification of why we should be in any MOC program as physicians who have passed board certification. Yes to CME of course, but any of you who okays these tactics is contributing to the problem. Keep in mind as well, there are many FPs who actually specialize as an internist does and personally, I have practiced interventional pain medicine for over 10 years. Board-certified in an ABMS program and I'm forced to learn about medicine I haven't practiced in many, many years and never will again. What sense does this make? I've already heard many complaints about the pilot program. Very little time allowed to answer questions and not knowing the results until it's to late.

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