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Amice Golden
It's the only specialty where a physician is trained to care for patients from birth to end of life, and the practices options are nearly endless. In collaboration with HOSA, the AAFP has collected videos and articles that cover the basics of medicine's most limitless specialty.
HOSA's 50-item multiple choice written exam (plus a tie-breaker essay question!) will test your knowledge in a variety of areas. For a complete overview of test rules, visit HOSA's guidelines for this test. To study for your test, review the material included in this study guide and be prepared to:
The AAFP has compiled videos, articles, and tables for HOSA secondary and postsecondary/collegiate members studying to take the AAFP Family Medicine Career Test. These materials were used by HOSA to develop the exam, and they will help you learn about the role of family medicine in the health care system, how to become a family physician, and more!
The specialty of family medicine grew out of the general practitioner movement in the late 1960s in response to the growing level of specialization in medicine that was seen as increasingly threatening to the primacy of the doctor-patient relationship and continuity of care. Conceptually, family medicine is built around a social unit (the family) as opposed to either a specific patient population (i.e. adults, children, or women), organ system (i.e., otolaryngology or urology), or nature of an intervention (i.e., surgery). Consequently, family physicians are trained with the intent to be able to deal with the entire spectrum of medical issues that might be encountered by the members of a family unit.
Much of the confusion likely arises because the majority of patients seen by family physicians are adults, thus overlapping with the patient population focused on by internal medicine physicians. A general estimate is that a typical family medicine practice might see 10% to 15% children, meaning that 85% to 90% of patients will be adults, the same population seen by internal medicine physicians. Additionally, an increasing number of family physicians do not include obstetrics, neonatology, or significant surgery as part of their practices, which makes the care provided to adults appear similar to that provided by internal medicine physicians. These factors make it is easy to see that the differences between general internal medicine and family medicine may not be easily understood.
Family medicine training is typically based in dedicated outpatient training centers in which residents work throughout the course of their training. Trainees are required to provide acute, chronic, and wellness care for a panel of continuity patients, with a minimum number of encounters being with children and older adults. Family medicine trainees are also required to have at least 6 months of inpatient hospital experience and 1 month of adult critical care, and up to 2 months of care for children in the hospital or emergency settings. Additional requirements include 2 months of obstetrics, a minimum number of newborn encounters, 1 month of gynecology, 1 month of surgery, 1 month of geriatric care, and 2 months of training in musculoskeletal medicine. Family medicine trainees must also have experiences in behavioral health issues, common skin diseases, population health, and health system management, and there is a particular emphasis on wellness and disease prevention.
These differences between internal medicine and family medicine training result in unique skill sets for each discipline and different strengths in caring for patients. Because internal medicine education focuses only on adults and includes experience in both general medicine and the internal medicine subspecialties, training in adult medical issues is comprehensive and deep. The general and subspecialty nature of training equips internal medicine physicians to develop expertise in diagnosing the wide variety of diseases that commonly affect adults and in managing complex medical situations where multiple conditions may affect a single individual. internal medicine physicians are well prepared to provide primary care to adults through their outpatient continuity experience during training, particularly for medically complicated patients. Their training also enables them to effectively interact with their internal medicine subspecialty colleagues in co-managing complex patients (such as those with transplants, cancer, or autoimmune disease) and easily managing the transitions from outpatient to inpatient settings (and vice versa) for their patients who require hospitalization. Additionally, the extensive hospital experience during training uniquely prepares internal medicine physicians who choose to focus their clinical work in inpatient settings (learn more about hospital medicine).
Family medicine education is broader in nature than internal medicine since it involves training in the care of children and procedures and services often provided by other specialties. This breadth of education equips family physicians to deal with a wide range of medical issues, and this broad skill set may be particularly valuable in communities or geographical areas where certain specialists and subspecialists may not be available. Because of their broad skill set, family physicians typically adapt the nature of their practices to meet the specific medical needs of their community. Although the depth of training in adult medical issues may be less than in internal medicine, the emphasis on outpatient medicine, continuity of care, health maintenance, and disease prevention allows family physicians to function as primary care physicians for adults as part of a family unit depending on individual medical need. And family physicians are trained to coordinate care among different specialists and subspecialists when these services are needed by their patients.
Thus, it can be seen that there are important differences between internal medicine and family medicine. Both have unique skill sets and important roles in the care of adult patients and providing primary care depending on the practice setting and the specific needs of the patient.
You may be eligible to apply for the longitudinal assessment in the fall of the year prior to your 10th year of certification, and you can begin answering questions in the first quarter of the year your exam requirement is due. For example, a Diplomate whose exam is due 12/31/2024 is eligible to apply for the longitudinal assessment in the fall of 2023 and can begin answering questions in January of 2024. Requirements for eligible physicians to enroll include:
Diplomates are encouraged to submit an application for the longitudinal assessment early in the application window to avoid late fees and ensure the maximum period of time to complete the first quarter of questions. Please see your MyABFM Portfolio for further details.
To assist you with the longitudinal assessment application and results process, ABFM provides you with a Candidate Information Booklet that includes a comprehensive description of our requirements and policies. We recommend you read this thoroughly before beginning the application process.
ABFM provides reasonable accommodations in accordance with the Americans with Disabilities Act (ADA). More information regarding accommodations can be found in the Candidate Information Booklet. If necessary, you may request accommodations after the application process is completed by submitting a written request to [email protected].
You may withdraw your longitudinal assessment application and switch to the one-day exam on, or before, the final deadline to submit your online application. This can be done through your MyABFM Portfolio. Your fee will simply be transferred from one application to the other. If your application has been approved before you choose to withdraw, you will need to contact ABFM for assistance to switch to the one-day exam application at [email protected].
During the longitudinal assessment, you will receive 25 multiple-choice questions per quarter that cover a breadth of family medicine topics. You will have five minutes to answer each question, and they may be answered online, anywhere, at any time within your MyABFM Portfolio. The complete assessment includes answering 300 questions over a maximum of four years. When you complete 300 questions and achieve a passing score within the four-year window, you will meet your exam requirement to maintain your board certification. Please note, questions are considered secure and should not be copied, printed, or reproduced in any other way before, during, or after the assessment.
Deferred questions are questions that were available to be answered in a given quarter, but never opened. While these questions do carry forward to be presented in the future, it is important to note that if more than 100 questions are deferred, it will not be possible to answer the full 300 question assessment in the allotted four-year window. Any questions that are not attempted will be counted as incorrect.
Only 25 questions will be presented in each quarter, so deferring questions will ultimately result in completing your assessment in year four. You cannot answer more than 25 questions in a quarter to make up for previously deferred questions.
The longitudinal assessment platform delivers 25 questions each quarter providing you with flexibility to complete the entire process in as little as three years or a maximum of four years. The table below lists the beginning and ending date for each quarter that you will have to answer your questions.
All participants must answer a minimum of 275 total questions by the conclusion of the maximum 4 years to complete the assessment. Those who do not do this will be removed from FMCLA after the quarter in which it becomes impossible to reach 275 answered questions. The one-day examination would need to be completed by December 31 of the following calendar year in order to continue ABFM certification.
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