ABFM Family Medicine Certification

The Family Medicine Certification process, provided by the American Board of Family Medicine (ABFM), is the means by which the ABFM continually assesses its Diplomates.

The certification structure consists of four components, each designed to assess important physician characteristics that stress the importance of ongoing participation in activities that evaluate each of the following components between recertification examinations:
  • Professionalism
  • Self-Assessment and Lifelong Learning
  • Cognitive Expertise
  • Performance Improvement.

On November 12, 2020, Ohio Academy of FAmily Physicians (OAFP) Quality Improvement Champion Ryan Kauffman, MD, FAAFP; ABFM Executive Vice President Elizabeth Baxley, MD; ABFM Certification Program Manager Erin Myhre; and ABFM Strategic Projects Manager Kevin Graves held a webinar about all of the updates and changes happening to the certification process and gave an exclusive look at the new and improved Physician Portfolio and virtual Certification Planner, set to launch in 2021! To watch the webinar archive and for more information, visit the OAFP meeting web page.

The OAFP  offers the following programming towards your ABFM certification requirements:

Knowledge Self-Assessments (KSA)

The AAFP and the OAFP continue to represent the needs of our family physician members as we work alongside the ABFM to improve processes and communication. In the fall of 2018, we were pleased to share that after diligently collecting and listening to member feedback, accepting the AAFP’s rigorous report recommending needed improvements for continuing certification, the ABFM is making changes. Read “ABFM Announces New Leadership, Programs, and Solutions to Help Alleviate Administrative Burdens” from the winter 2018 issue of The Ohio Family Physician to learn more and read on for additional information on new ABFM initiatives.

Alternatives for Performance Improvement Activity Credit (formerly Part IV)  

Continued improvement in clinical practice is a critical hallmark of the commitment family physicians make to ensure they are providing the highest quality care to patients.

In the fall 2019, the ABFM launched its Performance Improvement (PI) Locator tool that allows diplomates to enter and save personal preferences like the type of practice, areas of practice interest, and awards. The PI Locator will then select the most relevant activities to the preferences you set making it easier to choose an activity the is right for you and your practice. Log into your Physician Portfolio to check out the PI Locator today!

Self-Directed Performance Improvement Pathway

Did you know that physicians can claim PI credit for quality improvement (QI) activities that they are already doing in their daily work? It’s called the Self-Directed Performance Improvement Pathway and it’s a terrific way for physician practices of all types and sizes, even the most non-traditional, to capture credit for meaningful change that’s already occurring in practice.

The Self-Directed Performance Improvement Project pathway is now available through your ABFM Physician Portfolio and it allows practices with 1-10 physicians to report customized improvement projects specific to their practice environment, regardless of the scope of care they deliver.

This pathway does not require a physician to be in a practice that has a consistent patient population or a broad scope of care. In fact, the benefit of this pathway is that it can be custom tailored to fit any practice type. The activity just needs to be focused on improving some aspect of your practice.

Project ideas include, but are not limited to:
  • Access to care
  • Asthma
  • Cancer
  • Cardiovascular
  • Child and adolescent health
  • Communication
  • Community health
  • Decision support
  • Diabetes
  • Documentation
  • Efficiency
  • Emergency medicine
  • Geriatric medicine
  • Health literacy
  • Hypertension
  • Immunizations/vaccinations
  • Laboratory testing/imaging studies
  • Maternity care
  • Mental health
  • Obesity
  • Patient adherence
  • Patient education
  • Patient engagement
  • Patient safety
  • Prescriptions
  • Preventive care
  • Sports medicine
  • Satisfaction
  • Teamwork


Before beginning your project, please note the following key information about this pathway and review the sample application you will need to submit for credit after your project is completed.
  • You may report a project you conducted alone or participated in within a single practice group, an Accountable Care Organization, or other larger group practices.
  • You can use this pathway whether you see patients in a continuity setting, or if you are providing non-continuity episodic care (e.g., hospitalist, telemedicine, locums, urgent care, emergency department, etc.).
  • If you have already done a project, or are currently doing a PI activity in your practice, the process requires simply completing a short, online form available in your ABFM Physician Portfolio describing the activity. Estimated completion time of the form is 15 minutes if you have all the information at hand.
  • If you have not yet started, but are planning, a PI activity, please reference the sample application. This will tell you exactly what steps you will need to take to help ensure your project is eligible for approval by the ABFM before beginning.
  • The individual pathway is for reporting of activities for 1-10 physicians. The ABFM will walk you through the steps to report credit for multiple physicians using a group code. The initial application is estimated to take 15 minutes to complete. Those subsequent physicians claiming credit using the group code should take approximately 5 minutes to complete.
  • Your annual certification fee covers the cost of this activity.
  • ABFM review and approval takes approximately 1 week.

For more information, view the step-by-step instructions, visit the ABFM website or view the Fall 2018 issue of The Phoenix.

Organizational Performance Improvement Pathway

Similar to the Self-Directed Performance Improvement Pathway, the ABFM has also created the Organizational Performance Improvement Pathway to allow groups of more than 10 physicians a way to track, report, and claim credit together for their customized, ongoing QI initiatives, regardless of the scope of care they deliver.

Key things to know about this pathway:
  • Organizations, or groups of more than 10 family physicians, may apply for approval for organizational PI activities that will provide certification credit for anyone who is meaningfully participating in the effort.
  • These projects may be ongoing, and project teams may participate at different times.
  • A designated contact for the organization is responsible for tracking and reporting participation to the ABFM. The person reporting the data can be a non-physician team member or practice designee.
  • The organizational pathway only costs $100 per approved PI project, regardless of the number of physicians receiving credit.
Ready to get started?
  • For the self-directed pathway for 1-10 physicians, log in to your ABFM Physician Portfolio, select “Access Performance Improvement Activities” from the main screen, and choose “Self-Directed Performance Improvement Project: Clinical Systems.”
  • For the Organizational option, visit the ABFM website for more information on how to submit group projects.

Self-Directed Clinical Activity Instructional Videos
Health Disparities/Equity Self-Directed Clinical Activity
This activity provides a mechanism for meeting your PI requirement by showing how you have assessed and improved the way that your practice addresses social determinants of health; health equity (broadly defined); and/or systemic ways in which you assure that patient access, experience, and care are equitable.To help walk you through this application process, the OAFP and Quality Improvement Champion and American Academy of Family Physicians Alternate Delegate Ryan Kauffman, MD, FAAFP, made an instructional video taking you step-by-step through the online application.For additional information, please view the Resources for Consideration for Health Equity PI Activity and the ABFM Health Disparities/Equity Self Directed PI Sample Application.

COVID-19 Self-Directed Clinical Pilot
This pilot allows Diplomates to direct a custom rapid cycle QI effort, regardless of whether they provide continuing care. This activity provides a mechanism for meeting the PI requirement by describing the unprecedented and rapid changes that you had to make in the ways that you deliver care, regardless of practice type or scope. This PI can address many different dimensions of care—not just clinical quality measures but process effectiveness and efficiency, patient satisfaction, safety, and the other characteristics that the practice has identified.To help walk you through this application process, the OAFP and Ryan Kauffman, MD, FAAFP, AAFP Alternate Delegate and Quality Improvement Champion, made an instructional video taking you step-by-step through the online application.

Both of these activities have each been approved for 20 continuing medical education (CME) credits! The CME credit for the COVID-19 Self-Directed Clinical Pilot is retroactive to April 4, 2020, and the Health Disparities/Equity Self-Directed Clinical activity is retroactive to January 1, 2020.

Continuous Knowledge Self-Assessment (CKSA)

ABFM’s continuous Knowledge Self-Assessment (CKSA) can help you continuously identify your personal strengths and weaknesses in medical knowledge and clinical decision-making within the framework of broad-spectrum family medicine. This is accomplished by completing 25 questions per quarter, delivered through your ABFM Physician Portfolio. Completing these can be done throughout the quarter in a manner that best suits your needs and schedule, whenever and wherever it is convenient for you.

There is no passing or failing for this activity. After each question you will be given the correct answer, a critique that explains why other options were incorrect, a set of references and the option to comment on the question. This information allows you to focus subsequent CME in those areas.

CKSA questions are similar in format to those seen on the certification examination. Once you have completed 100 questions over four quarters, you will receive a performance report that will estimate your probability of passing the certification examination, along with your likely score.

After successful completion of each quarter, you will earn 2.5 certification points and 2.5 CME credits. If you participate in four quarters of CKSA you will earn 10 certification points, satisfying your minimum KSA requirement for that stage.

For more information, visit the ABFM website.

Family Medicine Certification Longitudinal Assessment (FMCLA)

In December 2018, ABFM launched a pilot to study the feasibility and validity of an alternative to the one-day family medicine certification examination, called Family Medicine Certification Longitudinal Assessment (FMCLA). This approach to assessment of cognitive expertise is more aligned with adult learning principles, promoting more enduring learning, retention, and transfer of knowledge than infrequent, episodic examinations.

The FMCLA pilot evaluation will be conducted over several years in order to collect enough feedback and data to evaluate the quality, effectiveness, and acceptability to the program. Participant feedback is sought and reviewed at multiple steps along the way. This information will be used in continuous improvement of the process.

Thanks to the early success of the pilot, Diplomates whose 10-year examination requirement is due in 2021 will have the option to select participation in the FMCLA or continue taking their examination in a test center. The start of FMCLA participation will be January 2021.

In order for FMCLA to count for your examination requirement, you will need to answer 300 questions over a four-year time period. Since the platform delivers 25 questions each quarter, FMCLA provides you with flexibility to complete the entire process in three years or extend to a maximum of four years, with breaks along the way if needed. The FMCLA pilot program is designed to maintain the same high standards as the examination. The cut score for the Longitudinal Assessment will be just as rigorous as the one-day examination.

For more information please visit the ABFM website.

Additional Information