ABFM Family Medicine Certification

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

Being board certified by the ABFM demonstrates your commitment to an ongoing process of keeping up-to-date and striving to deliver the best care possible to your patients and your community.

This voluntary process emphasizes the importance of ongoing participation in activities that assess the following physician characteristics:
  • Professionalism
  • Self-Assessment and Lifelong Learning
  • Cognitive Expertise
  • Performance Improvement.

To maintain your certification, you will need to complete all requirements of the Continuous Certification Process. This process is divided into continuous three-year stages, with an examination every 10 years. Within each stage, there are minimum requirements for Knowledge Self-Assessment and Performance Improvement activities, as well as total points and continuing medical education (CME) credits. Every 10 years, you may choose to either take the one-day examination or participate in the alternative Family Medicine Certification Longitudinal Assessment (FMCLA) method for demonstrating cognitive expertise. Additionally, you must always remain in compliance with the ABFM’s Guidelines for Professionalism, Licensure, and Personal Conduct. The ABFM recommends that you participate in at least one certification activity per year to say current with your certification; however, because that’s not always possible, there is flexibility built into the process and the required activities may be completed at any time during each three-year stage.

Your certification means a lot! However, sometimes navigating through the FMC process can get a tad confusing, especially if you are doing it on your own for the first time. We understand and the Ohio Academy of Family Physicians (OAFP) is here for you!

The OAFP  offers the following programming and resources to assist member-diplomates in meeting their ABFM certification requirements:

The purpose of this component is to help you assess and enhance your clinical knowledge and skills to provide high quality patient care. These activities allow you to self-assess your knowledge in a topic area relevant to your practice.

The three main activities that will fulfill your self-assessment requirement are the Knowledge Self-Assessment (KSA), the Continuous Knowledge Self-Assessment (CKSA), and the National Journal Club (NJC)

Knowledge Self-Assessment (KSA)

The KSA is focused on evaluating and enhancing your knowledge base in a particular topic area common to family medicine. All KSAs have been updated to single best answer and include updated questions, critiques, and references. You will need to get 80% correct overall instead of 80% correct in certain categories to pass the assessment.

To assist in completing this activity, the OAFP offers the following group KSA programming during the year:

For more information about the OAFP’s KSA programming, please contact Kaitlin McGuffie.

Continuous Knowledge Self-Assessment (CKSA)

The 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 MyABFM 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 the 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.

The 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 the CKSA you will earn 10 certification points, satisfying your minimum KSA requirement for that stage.

National Journal Club (NJC)

This new service offers a convenient solution to access peer-reviewed articles to help you stay current with advances in medical literature, support shared decisions making with patients and families, and advocate for their patients with subspecialists, health systems, and payers.

Participation in this service offers the opportunity to earn one (1) certification point for successfully completing the article assessment; 10 completed article assessments will fulfill the ABFM KSA requirement for each stage.

To begin participating in the NJC, select an article from the reading list in your MyABFM Portfolio and you will be provided free access to the full text article. When you have finished reading and reviewing the article, you will participate in a short article assessment.

The purpose of the ABFM’s Performance Improvement (PI) Activities is to help you identify an improvement opportunity, implement a change in care delivery, and measure the impact of that change. Demonstration of high-quality patient care includes your ability to identify performance gaps, design an improvement intervention to address the gap(s), and reassess to see if your intervention was effective.

For clinically active physicians, meaningful participation in and completion of one PI Activity every three-year stage allows you to successfully meet the requirements of the FMC process.

If you have declared yourself clinically inactive in your MyABFM Portfolio, you are not required to complete a PI Activity, though you may choose to do so as part of fulfilling your 50-point activity requirement in each three-year stage.

Helpful PI Tool

If you are having trouble deciding what type of PI Activity to complete, the ABFM has created a helpful questionnaire within your MyABFM Portfolio, located under “My Activities” and “Activity Preferences.”

Once in the “Activity Preferences,” you can click on “View and Edit My Preferences” to fill in details regarding your personal preferences like the type of practice, areas of practice interest, and activity type. After these preferences are saved, the system will provide you with a list of possible activities to complete making it easier to choose an activity that is right for you and your practice.

Types of PI Activities

A full list of PI Activity types can be found on the ABFM website. Below are helpful resources created by the OAFP to assist you in completing some of these options. 

Self-Directed PI Project: Clinical 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 Project: Clinical 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 available through your MyABFM 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.

For a step-by-step guide to completing this pathway application, please watch the video to your right.

If you need assistance in selecting a topic to focus on, the OAFP has created EasyPI, a peer-reviewed online compilation of all the resources you’ll need to complete a self-directed clinical PI Activity on one of the topics currently available. However, many of the materials included on each track page can be incorporated in any topic you choose. Learn more on the EasyPI webpage.

You can also, review a sample application before beginning your project. Projects need to be completed before submitting your application for credit.

Topic-Specific Self-Directed Projects
  • 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.
  • COVID-19 Self-Directed Clinical: This option allows Diplomates to direct a custom QI effort, regardless of whether they provide continuing care. This activity provides a mechanism for meeting the PI requirement by reporting the clinical practice improvement that you made 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. This application will be submitted once your project is completed and you have both baseline and follow-up data.

We’ve created a list of COVID-19 project ideas for reference!

All self-directed activities provide 20 ABFM points, fulfill a certification requirement, and have been approved for 20 American Academy of Family Physicians (AAFP) Prescribed CME credits.

Workflow Process Mapping

Workflow & process mapping creates a visual map of the steps your practice currently uses for a specific patient care or administrative task. Benefits of process mapping include allowing everyone to visualize and appreciate what role/contribution they and their colleagues play in the care of patients; gives an overview of the current processes that allows the team to plan for change; identifies unintended variations in care, inefficient procedures, and opportunities to involve other team members in care; improves communication between team members; gives team members increased ownership in patient care; and can increase employee job satisfaction.

Linked below is an outline of the mapping process as well as two instructional videos on the process with different example project ideas to help you visualize the exercise:
Additional Performance Improvement Resources

If you have any questions regarding your PI Activity requirement for the ABFM FMC, please contact Ann Williamson at the ABFM.

The Family Medicine Certification Longitudinal Assessment (FMCLA) is the alternative to the one-day examination requirement for the FMC. Launched in December 2018 as a pilot to study the feasibility and validity of this approach, the FMCLA quickly earned an overwhelmingly positive reputation as the preferred option for most Diplomates and was approved for permanent implementation in April 2021.

A longitudinal approach like the FMCLA promotes enduring learning and retention. This has been endorsed by those who participated, with the predominant feedback being that physicians are learning as they go. Participants have also reported that the FMCLA has reduced their stress, eliminated travel, and minimized preparation time as compared to the one-day examination. To date, over 80% of eligible physicians have chosen the FMCLA option, which becomes available for current Diplomates to select in the year prior to when their next examination is due.

As a participating physician, they would complete 25 quarterly questions over three to four years until they complete 300 questions. Clinical references can be used during the exam, and they have five minutes to complete each question. Immediate feedback is provided, and they choose the time and location that’s convenient for them. They will remain certified throughout their participation as long as they meet other ABFM requirements.

To find out more about the FMCLA process, watch the following video or view the informational handout.

Archived Webinars


  • Certification Planning Tool – The OAFP drafted and piloted a paper certification planner tool that helped guide diplomates through their FMC requirements and allowed the opportunity to think ahead and plan out what activities they’d hope to complete and when within their three-year cycle. After success of this pilot, the ABFM integrated this tool into the new MyABFM portfolio. Available directly on the dashboard of your MyABFM portfolio is access to the new certification planner. Use this to create a personalized plan to complete stage requirements based on your interest and schedule. It is a flexible plan and can be adjusted as you go but it will provide a great way to plan ahead and avoid the end of year rush.  
  • The Phoenix (ABFM’s newsletter)


As a family physician who is participating in continuous certification, benefits you will realize include:
  • Recognition of your ongoing efforts to keep up to date in your medical knowledge and to improve the care you provide to patients and your community. Patients place faith in Board certification and expect that it reflects ongoing education and practice improvement activities. They understand that keeping current requires constant work and practical application.
  • Independent assessment of your medical knowledge, which will help with your ongoing learning. Studies have demonstrated that physicians often don’t recognize what they don’t know; Board certification helps with this.
  • Ongoing participation in a series of certification activities that you and your peers engage in collectively ensures that all Board-certified family physicians meet high standards of knowledge and trustworthiness. Numerous studies have demonstrated that certification is associated with greater expertise in family medicine, improvement in the quality of care delivered, and fewer adverse medical license actions.
  • Recognition by patients, other physicians, hospitals, insurers, employers, and the public that you have met high standards of physician quality. They believe that Board-certified physicians are better physicians.


Please contact Deputy Executive Vice President Kaitlin McGuffie or call 800.742.7327.

Disclaimer: Page content and images shared with permission directly from the ABFM website.