The most direct route to success in a high-stakes exam like the certification and recertification exams from the American Board of Family Medicine is to align your studying as closely as possible with what the test will ask. That sounds obvious enough. But it is not always easy given long clinical days and uncertainty of just what to study.
NEJM Knowledge+ Family Medicine Board Review strives to provide you with family medicine board review questions that are in sync with the MC-FP exam itself, material that will have the strongest potential impact for both excellent patient care and lifelong learning.
Our layered editorial process includes extensive planning, curating, writing, and editing of the 1,500 board review questions in NEJM Knowledge+ Family Medicine Board Review. Our goal is to make your study time as efficient and productive as possible.
Here are six things to know about the questions in NEJM Knowledge+ Family Medicine Board Review:
1. The ABFM Certification/Recertification Blueprint Is Our Guide
The 1,500 questions that make up NEJM Knowledge+ Family Medicine Board Review reflect the blueprint for the exam content that is defined by ABFM. In our “general modules,” we cover the organ systems and topics that you would expect to see on the exam: cardiovascular, respiratory, gastrointestinal, musculoskeletal, and so forth. The blueprint is the same for first-time certification and for recertification.
NEJM Knowledge+ Family Medicine Board Review also includes a representative number of questions in eight elective modules: ambulatory family medicine, adolescent and child care, geriatrics, women’s health, maternity care, emergency/urgent care, hospital medicine, and sports medicine. Experience working with these modules should help you decide which two modules to choose on exam day.
To create NEJM Knowledge+ Family Medicine Board Review, our editors ranked the questions developed for our first board review product in internal medicine for their relevance to family medicine practice. The highest-scoring questions then were reviewed and curated by a panel of family medicine physicians. Only the most suitable questions were retained. We subsequently developed 600 additional questions, carefully focused to reflect the patient scenarios most likely encountered in a family medicine practice.
2. Key Learning Objectives in Family Medicine Board Review Questions
A crucial, early step in creating NEJM Knowledge+ was to define key learning objectives for each content area. Graham McMahon, MD, MMSc, our executive editor, along with the program directors at institutions around the country created a series of scenarios and learning objectives that form the framework for our case-based questions:
- Decision focus: prevention, evaluation, diagnosis, and treatment
- Clinical setting: ambulatory, hospital, and nursing home
- Medical condition severity: chronic, subacute, acute, or emergency
- Patient characteristics: age, gender, and ethnicity if relevant
Each scenario was mapped to a specific learning objective. For example, the question writer might be asked to address diagnosis and initial treatment of diabetes in a middle-aged woman with a history of high blood pressure. This multidimensional approach ensures that NEJM Knowledge+ content addresses the topics likely to arise on board exams, as well as in daily practice.
3. Each Question Is Built with Layers of Quality
When it comes to creating the questions, we use a multilayered writing and editing process. This mirrors the editorial standards in all NEJM Group publications. Our aim is to ensure that every hour you invest in learning pays dividends in high-quality, evidence-based content:
- Questions are written by subspecialty faculty, fellows, and residents chosen from centers of excellence. These physicians are tasked with writing case-based questions that address a specific learning objective. Working in groups, these initial writers often review one another’s questions before they are passed on for further refinement and review by the NEJM Knowledge+ executive editor and editorial staff.
- Section editors with expertise in key topics provided a completely independent review of each question, carefully examining questions for veracity, clarity, and relevance.
- Next, our panel of reviewers — all practicing physicians with academic appointments in family medicine — evaluated each question for clinical relevance. They verified that all feedback that we offer to support the answer is accurate.
- As a final review, staff editors and proofreaders worked with the lead physician editors to make sure every detail is concise and accurate.
In all, we drew upon the expertise of nearly 300 clinicians to create and review the Family Medicine Board Review questions.
Even so, as every practicing physician knows, there is no substitute for the individual and collective wisdom of clinicians who see thousands of patients yearly. That is why we built in yet one more mechanism for reviewing and revising questions. The “challenge us” feature seeks your input, via a simple process, for us to improve questions on the basis of your knowledge and experience. We take your input seriously, frequently making changes to our content — usually subtle, occasionally substantial — that improve the learning of all.
4. Family Medicine Board Review Questions Reflect Complexity of Exam — and Real Life
The multiple-choice case-based questions in NEJM Knowledge+ match the complexity of decision making in board exams. As in the MC-FP exam, they all test your knowledge and problem-solving ability. In NEJM Knowledge+, each case-based question has three parts: a patient vignette, the “lead-in” that is the question itself, and answer options.
Most board questions — MC-FP included — require physicians to think through multiple steps, ultimately asking for “the next best step” or “the most likely diagnosis.” To reach the correct answer, you might need to draw upon both knowledge and then higher-order decision making to rule in and out various options.
To learn how to zero in on essential cues within the questions and other helpful ways for addressing complex, two-step questions, see Strategies for Working Through ABIM Board Questions, which apply equally to MC-FP exams.
This is not to say that all questions on your exam will be equally challenging. Similarly, some NEJM Knowledge+ Family Medicine Board Review questions will seem easier than others. The adaptive learning platform starts you off with clinical scenarios that you are most likely to see in a family medicine practice. Increasingly, questions may become more complex and focus on conditions seen with less frequency. As you begin to work through the cardiovascular section, for example, you first would encounter questions about hypertension before one about a rare cardiac defect.
Our case-based questions engage your skills in reasoning and decision making — a type of active learning in medical education that helps you get the most out of each moment of studying.
5. Variety of Question Types — and Feedback — Reinforce Your Knowledge
NEJM Knowledge+ Family Medicine Board Review includes three styles of questions: multiple-choice long questions, multiple-choice short questions, and fill-in-the-blank questions. They share the same underlying content and learning objective. This variety creates multiple opportunities for you to learn, review, and reinforce your knowledge.
In this way, family medicine board review questions build upon each other, creating a scaffold for your knowledge. For example, if you answer a long version incorrectly, the adaptive learning platform may send you a short version later. This helps to consolidate the new knowledge and for the adaptive learning system — and you — to know whether you have achieved mastery of that learning point.
A third style of question is fill-in-the-blank, a way to test your recall of essential knowledge built around the learning objectives you’ve encountered in the long and short multiple-choice questions. Fill-in-the-blanks are only served up in the Recharge feature, which helps you retain what you’ve learned and to combat memory decay. Because you must answer these questions without the aid of a multiple-choice listing, they strengthen the neural pathways you have built through study and review.
Detailed feedback available in each question further enhances learning. After you submit an answer, you are presented with the key learning point and detailed feedback — an explanation of why the correct answer is right and why the other choices are wrong in this case. Source material backs up each answer, and with a click you can find more in-depth information, including links to relevant content on PubMed and, for free, from the New England Journal of Medicine.
6. Editorial Independence
One final fact that you probably already knew: As with all content created by NEJM Group, NEJM Knowledge+ Family Medicine Board Review is editorially independent. This is just one more reason to feel confident when you turn to our family medicine board review questions for exam preparation and lifelong learning.
What is your biggest challenge — or success — in studying for your family medicine boards? Share your thoughts here.