Choosing Your Self-Selected ABFM Modules for Recertification

In addition to the general part of the exam covered by the ABFM blueprint, the ABFM certification/recertification exam contains eight modules, or areas of focus, from the family medicine field. When you take the certification or recertification exam, you will be expected to choose two ABFM elective modules to complete, as well as the standard sections of the exam that are covered by the blueprint.

You can select which two of these modules to take, but how to choose?

The obvious answer is to choose ABFM modules based on your expertise and experience. However, we’d like to go a little deeper into your selection process, so that you can understand how your daily experiences in your practice of medicine can help you successfully prepare for them.

Choose Modules Based on Your Practice

Family medicine physicians can be found in many diverse roles, and your choice of module should be aligned with your role. You will find that the ABFM modules line up well with typical family medicine physician career paths. Think of it this way: You’ll be better prepared to answer questions in the ABFM module you choose if you’re seeing examples of the material covered in it every day. For example:

According to Mark Nadeau, MD, MBA, FAAFP, Senior Reviewer for NEJM Knowledge+ Family Medicine Board Review, even a family medicine physician running a typical office-based practice will find that his or her practice eventually develops its own customized culture owing to the local population and physician and patient preferences. “Over time, your practice will tailor itself based on your personal interests and expertise, as well as the patients who walk in your door,” explains Dr. Nadeau, “so even a ‘garden-variety’ family medical practice has enough specificity to let you know which ABFM module to choose.”

Self-Selected Modules on the ABFM Exam: Descriptions

It’s important to note that all of the ABFM modules have about the same level of difficulty, and that they are scored the same way that the regular sections are. Thus, selecting a module will very much depend on your own bank of knowledge, your breadth of experience, and your confidence in each focus area. First, here’s a brief rundown of the modules of the exam; for a full description, please see the ABFM website.

Ambulatory Family Medicine

Patient age range: all ages

This module covers: office-based care

Conditions/topics may include:

• acute and chronic disease
• common emergencies (such as anaphylaxis, chest pain)
• minor trauma
• psychosocial and behavioral issues
• preventive care

This module may include:

• management of patients with multiple health issues
• family dynamics
• clinician-patient communication
• collaboration with other members of the health care team

Child and Adolescent Care

Patient age range: newborn to 21 years old

This module covers:

• acute and chronic diseases
• developmental issues
• preventive care
• screening and immunization

Conditions/topics may include:

• infectious diseases
• normal and abnormal growth and development
• congenital problems
• psychological and psychosocial issues
• dehydration
• obesity
• chronic diseases such as diabetes and cystic fibrosis

This module may include:

• Problems of infants, such as
  • failure to thrive
  • hyperbilirubinemia
  • feeding problems

Geriatrics

Patient age range: over 65 years of age

This module covers: problems and diseases in the population over age 65, including issues that may affect other age ranges (however, even with such issues, you may need to shift tactics for cases involving elderly patients)

Conditions/topics may include:

• infectious diseases commonly seen in the elderly (e.g., pneumonia)
• chronic problems (e.g., osteoporosis and Parkinson’s disease)
• typical aging
• nursing-home care
• psychiatric issues (e.g., dementia )
• preventive care
• screening
• patient education about nutrition, exercise, and fall prevention

This module will include:

• functional assessment
• pain management
• end-of-life issues

Women’s Health

This module covers: problems and conditions specific to women, aside from pregnancy

Conditions/topics may include:

• menstrual disorders
• contraception
• sexually transmitted diseases (STDs)
• reproductive and breast cancers
• conditions most commonly seen in women (e.g., osteoporosis and eating disorders)

This module may include:

• preventive care
• screening and patient education
• behavioral issues (e.g., domestic abuse)

Maternity Care

This module covers:

• prenatal care
• antepartum care
• management of labor and delivery
• postpartum care

Note: This module does not include the management of high-risk pregnancy.

Conditions/topics may include:

• screening
• nutrition
• complications of pregnancy
• acute and chronic disease in pregnant women
• key concepts of advanced life support in obstetrics

This module may include:

• selected neonatal problems (e.g., ABO incompatibility and neonatal resuscitation)

Emergent/Urgent Care

Patient age range: all ages

This module covers: major and minor conditions in patients that require immediate attention (i.e., issues seen in urgent or emergency care settings).

Conditions/topics may include:

• assessment, triage, stabilization, and disposition of acute medical and surgical problems
• musculoskeletal trauma
• lacerations
• cardiac and respiratory distress
• acute exacerbations of chronic disease (e.g., asthma attacks or diabetic ketoacidosis)
• cardiac problems
• conditions with environmental etiologies (i.e., heat, cold, or toxins)

Hospital Medicine

Patient age range: all ages

This module covers: inpatient care of conditions requiring hospitalization

Conditions/topics may include:

• infectious diseases (e.g., sepsis)
• preoperative and postsurgical care
• myocardial infarction, acute coronary syndromes, and unstable angina
• stroke
• fluid management
• management of patients with multiple comorbidities

This module may include:

• coordination of care with other members of the health care team
• discharge management

Note: Advanced intensive care unit (ICU)(e.g., ventilator and catheter management) will not be covered.

Sports Medicine

Patient age range: school-age and older

This module covers: issues related to participation in sports and exercise, by both competitive and recreational athletes

Note: This module does not include care of elite athletes such as Olympic athletes, professional athletes, or members of NCAA Division I sports teams.

Conditions/topics may include:

• trauma caused by acute injury or overuse
• preparticipation evaluation of both recreational and competitive athletes
• preparticipation evaluation of individuals engaging in exercise for health reasons
• nutrition and exercise
• physiology and biomechanics
• prevention and management of disease

Strategic Study: Finding Ways to Prep in Your Practice

As you study for the general exam, focus your attention on case studies found in your strongest module areas: in this way, you can maximize your time preparing for the exam as a whole. Knowing clinical practice cases that apply to the ABFM elective modules where you are strongest will help you maintain the knowledge you need for the elective modules and the general exam. The ABFM module questions will have more depth than the general sections. The outpatient modules (e.g., ambulatory and child) also have a significant number of questions on preventive care.

Because the ABFM exam emphasizes the importance of current knowledge in family medicine, ABFM recommends you use the most recent evidence to support your answers as you work on the exam questions. That’s why it’s even more critical for you to rely on your daily practice of medicine to prepare for these exams.

How NEJM Knowledge+ Helps with ABFM Module Selection

NEJM Knowledge+ Family Medicine Board Review is designed to help you concentrate your study of the general and elective ABFM modules. As you work through the question bank, you can track the areas where you need more focus. A quick glance at the dashboard will also reveal the sections where you’re strongest, so you can be confident in your selection of ABFM modules when exam day comes.

You may already know the modules you want to choose for your exam. If so, NEJM Knowledge+ will save you time by allowing focused study. Perhaps though, you are inclined to brush up on the full range of family medicine topics. In that case, you can complete all the modules on your own time.

Certifying vs. Recertifying

In another of our blog posts, we’ve included some tips for residents to use their residency training as a way of studying for the certification exams. Many residents gravitate toward specific modules due to their own experiences in the field: for example, the structured setup and preventive care focus of pediatrics lends itself well to the questions in the Child and Adolescent Care module.

Practicing physicians will not only begin to see similar types of patients on a regular basis, but will also be more likely to seek out information about those types of patients and their situations: “When I certified, I’d done a fair amount of urgent care, working in an emergency medicine setting, so I chose emergent/urgent care and ambulatory care for my self-selected modules,” says Dr. Nadeau, “now, my daily practice of medicine has changed, but it still informs my choices. When I sit down to read something, that’s what I read about — what I’m doing on a daily basis.”

In summary, the best advice we can provide for the self-selected ABFM modules is to maximize your time by choosing modules that reflect daily experiences in your practice. You’ll do best on ABFM modules in areas where you’re competent and confident; choose ABFM modules where you not only have experience, but also continually build on your knowledge.

To register for the ABFM certification exam, go to the ABFM website.