ABFM Exam Overview

The American Board of Family Medicine (ABFM) is the second largest medical specialty board in the United States. The ABFM was founded in order to:

  • Improve the quality of medical care available to the public
  • Establish and maintain standards of excellence in the specialty of Family Medicine
  • Improve the standards of medical education for training in Family Medicine
  • Determine the fitness of specialists in Family Medicine who apply for certification

Test Length and Format

Four Components for Board Certification by the American Board of Family Medicine (for candidates that began residency in 2012 or later):

  • Part I (Professionalism): Valid, current, full and unrestricted license to practice medicine
  • Part II (Self-Assessment and Lifelong Learning): Completion of at least one Self-Assessment Module (SAM); 150+ CME Credits
  • Part III (Cognitive Expertise): Multiple choice question (MCQ) computer based board exam
  • Part IV (Performance in Practice): Completion of at least one Performance in Practice Module (PPM)

Overview for Part III (Cognitive Expertise) – Computer based standardized examination

  • Timed, computer-based multiple choice question examination
  • Scheduled twice a year (April & November) at Prometric centers nationwide
  • 5 sections - 3 general curriculum modules and 2 elective modules chosen on exam day
  • 370 Multiple Choice Questions (MCQ) total
  • 20 of the 370 are pilot questions that will not be used for assessment

Sections breakdown:

Section 1 120 MCQ General Module (120 minutes)
Section 2 45 MCQ Elective Module (45 minutes)
Section 3 45 MCQ Elective Module (45 minutes)
Section 4 80 MCQ General Module (95 minutes)
Section 5 80 MCQ General Module (95 minutes)

Examination Content

The majority of the examination content is focused on outpatient and chronic disease management, but the exam also covers acute inpatient management of emergent conditions in lesser detail. Due to the amount of time spent for development and proofing of writing new questions, any recently published research or guidelines from the previous nine months till test date will not appear as a tested item on the individual exam.

General Module - Topic Distribution 74%
Cardiovascular 9%
Endocrine 6%
Gastrointestinal 5%
Hematologic/Immune 2%
Integumentary 5%
Musculoskeletal 9%
Nephrologic 2%
Neurologic 2%
Nonspecific 7%
Psychogenic 5%
Reproductive — Female 3%
Reproductive — Male 1%
Respiratory 10%
Special Sensory 2%
Population-Based Care (epidemiology, biostatistics, and public health) 3%
Patient-Based Systems (communication, ethics and legal) 3%
Elective Modules (2 of 8) 26%
  Emergent/Urgent Care
  Hospital Medicine
  Child and Adolescent Care
  Ambulatory Family Medicine
  Sports Medicine
  Women’s Health
  Ambulatory Family Medicine
Ambulatory Family Medicine

Acute and chronic conditions commonly encountered in general outpatient practice, including minor emergencies and trauma. Additional topics outside of general medicine focus on preventative care, psychosocial considerations, family dynamics, professionalism and teamwork.

Child and Adolescent Care

This module encompasses the entire range of pediatric conditions, from the neonatal intensive care unit to screening for sexually transmitted disease. Developmental disorders, medical conditions both congenital and acquired, sports medicine, nutrition, and psychosocial considerations are all fair game.


This module is specific to additional considerations given to medical care in an aging population. Preventative medicine is emphasized, as well as commonly encountered medical conditions both acute and chronic. Particular emphasis is placed on neurodegenerative disorders, medicolegal issues, nutrition, capacity, palliative and the end-of-life aspects of care.

Women’s Health

This module is an overview of medical conditions and considerations given to women’s health not covered in the maternity care module. This includes medical conditions and psychosocial aspects of caring for a predominantly female patient population, including preventative care.

Maternity Care

This module covers the entire peripartum aspect of obstetrical care including neonatal considerations and the postpartum period. The exam does not test the management of obstetrical conditions that would require the care of a subspecialist, only management of acute and chronic disease manifesting in pregnant women. Preventative medicine, labor and delivery, complications in pregnancy, and recognition of emergent conditions are emphasized.

Emergent/Urgent Care

The module will test the appropriate assessment, triage, stabilization, and disposition of patients of all ages with emergent conditions, both minor and major. Any presentation commonly encountered in a busy emergency department is considered fair game.

Hospital Medicine

This module focuses exclusively on inpatient management of medical conditions. High yield areas include sepsis, perioperative management, cardiology, coordination of care, and management of multiple comorbidities. Advanced procedural care in the intensive care unit will not be tested.

Sports Medicine

This module covers commonly encountered topics in semiprofessional sports and recreational exercise. The exam does not test subspecialty topics (e.g. surgical conditions with exclusively orthopedic or podiatric management). Particular care is given to management of overuse injuries, clearance for participation in sports at all ages, nutrition, physiology, and preventative medicine.

Eligibility Criteria

Examinees must have three years of uninterrupted GME training in a three year family medicine residency program in the United States of America.

Reciprocity for licensure is also granted to practicing physicians with equivalent training and board certification in Canada, the United Kingdom, New Zealand, and Australia

Exam Difficulty

Minimum Passing Score of 380 is determined by a preset cut-off (the exam is not curved)

2014 ABFM pass rates

92.4% for initial certification
87.4% for recertification
60.4% for repeat testers
80% for FMG/IMG

2013 ABFM pass rates

86.3% for initial certification
85.7% for recertification
40.6% for repeat testers
72.2% for FMG/IMG

2012 ABFM pass rates

87% for initial certification
75.9% for recertification
44.1% for repeat testers
77.2% for FMG/IMG

Importance of Certification and Maintaining Certification

Maintenance of Certification (MC-FP) Exams were established in order for the AFM to establish a minimum standard of care.

The Maintenance of Certification for Family Physicians (MC-FP) process provided by the American Board of Family Medicine (ABFM) is the means by which the ABFM continually assesses Diplomates.

The American Board of Medical Specialties (ABMS), sensing growing and repeated threats from outside the medical field, determined that ABMS specialists within every discipline should be required to meet the highest standards of accountability. In response, the ABMS designed a process called Maintenance of Certification, and each specialty board agreed to adhere to a set structure in developing their individual programs.

This structure consists of four components, each designed to assess important physician characteristics: professionalism (Part I), self-assessment and lifelong learning (Part II), cognitive expertise (Part III), and performance in practice (Part IV).

Although these elements are similar to and consistent with the ABFM's long-standing recertification program, the ABFM Maintenance of Certification process stresses the importance of ongoing participation in activities that evaluate each of these components between recertification examinations. ABFM MC-FP is a requirement that the ABFM believes encourages clinical excellence and benefits both physicians and their patients.