Once you have met the application requirements, you must take the ABFM exam to become certified or recertified by the American Board of Family Medicine. The ABFM exam is designed to test your medical knowledge and problem-solving ability in the field of family medicine.

As you prepare for the ABFM exam, you will likely use several tools to build knowledge and review topics. One of the most important resources you should use is the certification/recertification exam blueprint provided by ABFM. Although no one can be sure exactly what questions will appear on the ABFM exam, the blueprint will give you an idea of what to expect in broad strokes.

We have included the most recent (as of this writing) ABFM exam blueprint below. As you can see, the blueprint lists topics and organ systems that will appear on the exam. Next to each item, you will see the percentage of the exam that is focused on that topic. Use the blueprint as a tool to help develop an effective exam preparation strategy that will maximize your time.

ABFM Certification/Recertification Exam Content: Blueprint

Medical-Content CategoryRelative Percentage
Reproductive — Female3%
Reproductive — Male1%
Special Sensory2%
Population-Based Care3%
Patient-Based Systems3%
Module 113%
Module 213%

Modules 1 and 2, the “Elective Modules,” are self-selected on the day of the exam. Physicians can choose from the following family medicine topics:

Ambulatory Family MedicineChild and Adolescent Care
GeriatricsWomen’s Health
Maternity CareEmergent/Urgent Care
Hospital MedicineSports Medicine

*This includes topics such as biostatistics and epidemiology, evidence-based medicine, prevention, health policy and legal issues, bioterror, quality improvement, and geographic/urban/rural issues.
**This includes topics such as clinical decision-making, communication and doctor-patient interaction, family and cultural issues, ethics, palliative care, and end-of-life care.

Read more about the eight elective modules here.

The Structure of the ABFM Exam

The ABFM exam is a daylong exam and is only available by computer through Prometric. The exam is comprised of five sections, including 20 field test items that will not be scored, and three scheduled optional breaks. It’s important to remember that you cannot return to any section once it has timed out. You can find more information about what to expect on the day of the exam on this website.

ABFM Exam Review Strategy

With the blueprint as your guide, you will be able to prepare for the ABFM exam efficiently and effectively. Dr. Mark Nadeau, Senior Reviewer for NEJM Knowledge+ Family Medicine Board Review, recommends, “First, review the areas where you have a good knowledge base. Depth of knowledge is important. Next, you should address areas where you are not as strong. Then, look at the categories on the blueprint which have a high percentage of questions on the board exam. Lastly, study the categories that account for the smaller percentages on the blueprint.”

Here’s where NEJM Knowledge+ Family Medicine Board Review can help. Our question bank is guided by the ABFM exam blueprint categories and meets nearly 2000 learning objectives through more than 1500 case based questions and roughly 4000 total questions, providing you with a comprehensive survey of family medicine. Like the board exam itself, NEJM Knowledge+ focuses on the clinical scenarios most relevant to primary care.

Because it adapts to you, NEJM Knowledge+ will help you focus on the areas where you need the most review, providing efficient, effective preparation for the ABFM exam.

Using our dashboard, you can see the following information:

  • The progress you have made in each module
  • Modules where you are strong
  • Modules where you are weak

You can even activate a customized review program based on your progress and proficiency through our Recharge function. This feature helps ensure that you retain all that you learn through the product. With the blueprint as your guide and ours, you will be able to maximize your ABFM exam review.

NEJM Knowledge+ also provides a robust reporting mechanism that allows you to see exactly how you performed on different aspects of the modules. The “practice dimensions” report shows a full performance breakdown that measures everything from how you performed on questions with patients in different age ranges (e.g., 1 to 5 years, 65 to 80 years) and genders to how you performed on competencies (e.g., interpersonal and communication skills, patient care, professionalism and ethics). Although individual modules for patient disease acuity are not on the dashboard, learning objectives on chronic, subacute, acute, and emergency situations are covered in our question bank — and you can see how you performed on these types of patient scenarios in the practice dimensions report.

ABFM Exam Scoring

As you take the exam, it’s helpful to know how your score will be tabulated. There is no penalty for incorrect answers, so it is in your best interest to answer every question — just make your best educated guess if you don’t know. Don’t leave any blank questions if you can help it. Read each question carefully, so you can be sure you understand it and can answer accurately.

Passing scores are set using the Angoff method. This method relies on a group of peers to estimate the percentage of family physicians who would answer each question correctly. The exam questions are assessed by this group of experts to produce ratings for a passing score.

Elective Modules

The elective modules offer an opportunity to select exam sections based on your own proficiency, experience, and daily practice of medicine. Assuming you will choose modules that reflect your personal expertise, you can also use your choice of module to increase the number of questions you will be presented with in the areas where your knowledge base is strongest.

You should decide on your module choices well before the exam to help you optimally prepare. Your choice of module can also help direct your exam preparation, and you should choose carefully. You will make your final choice of module at the time of the exam and once you select your module, you will not be able to go back and change it.

For example: If you are a resident taking the ABFM initial certification exam and your residency sees a lot of pediatric patients, you should consider choosing Child and Adolescent Care as one of your two elective modules.

Similarly, if you practice in an assisted living facility, you would probably be comfortable selecting the Geriatrics module, relying on your daily practice experience.

The ABFM Exam: A Measure of Cognitive Performance

The ABFM certification/recertification exam is just one part of the Maintenance of Certification for Family Physicians (MC-FP) process. The following components form the foundation of the MC-FP process:

  1. Professionalism, which denotes professional standing and requires that physicians hold a full and unrestricted medical license.
  2. Self-Assessment and Lifelong Learning, which requires that physicians continually build skills and knowledge through educational programs like Self-Assessment Modules (SAM) and Continuing Medical Education (CME).
  3. Cognitive Expertise, which requires physicians to pass the ABFM exam.
  4. Performance in Practice, which requires that physicians continuously improve aspects of their daily practice of medicine like systematic measurement and patient care.

The exam blueprint for family medicine isn’t just a list of categories you have fight your way through. It is a blueprint for the enormously varied experiences family physicians see every day. It is what makes the field so challenging and rewarding.

In this way, preparing for your boards can be an opportunity to build and reinforce knowledge that will enrich your daily practice of medicine — and isn’t that why you got into family medicine in the first place?

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