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Preparing for the Certification Examination in Family Medicine

Candidate guide

Canadidate Guide to the Certification Examination in Family Medicine download

Canadidate Guide to the Certification Examination in Family Medicine

The pandemic has provided us an opportunity to modernize and deliver our examinations virtually.  We are creating and updating our examination resources to support this transition.

Self-study

Because the certification examination is clinically oriented and reflective of the day-to-day practice of family medicine, the most effective way to prepare for it is to participate actively in clinics, family medicine offices, and learning opportunities such as case discussions, rounds, and journal clubs.

That said, it should be easy to study for the examination at home. Candidates should create an individual program of continuing medical education to fit their schedule.

There are many convenient ways of keeping up-to-date with developments in primary care and family medicine. A few of the most popular options are listed here. 

  • Review programs

    Self LearningTM Program

    The Self Learning Program is a voluntary, Internet-based, College of Family Physicians of Canada (CFPC) educational program that allows physicians to evaluate how well they keep up with current issues in medical literature. Written by a group of family physicians from across Canada, the program is self-contained with all the information required to understand new research results and therapeutic techniques. Residents in family medicine may register for free online access to the Self Learning Program.

    Request more information about the Self Learning Program

    Home study and Knowledge Self-Assessment—American Academy of Family Physicians

    Audio, monograph, and combined subscriptions are available on topics of current interest. For more information, please visit the American Academy of Family Physicians (AAFP) website or contact the AAFP by phone at (913) 906-6000, ext. 5298, fax (913) 906-6285, or by email.

  • Other programs

    Many other continuing professional development (CPD) formats, including interactive online CPD, are also available. For more information, please refer to the lists of CPD programs eligible for Mainpro+® credits.

  • Books and journals

    Many physicians preparing for the exam found it useful to quickly review the current edition of their favourite textbook in each of the major clinical disciplines contributing to family medicine: obstetrics, pediatrics, medicine, surgery and psychiatry.

    Journals also offer opportunity for review. Canadian Family Physician, the official publication of the College of Family Physicians of Canada (CFPC), publishes useful clinically-oriented articles pertinent to the practice of family medicine in Canada. Journals of other national colleges and academic associations of family medicine include American Family Physician, Journal of the American Board of Family Practice, and the BJGP: British Journal of General Practice. Journals, such as Journal Watch and the ACP Journal Club, provide critical summaries of the original research literature, and are intended to help apply relevant, high-quality research to the practice of medicine.

    The following three-part article may also be helpful: 

    Weston Wayne W., Brown Judith Belle, Stewart Moira A. Patient-Centred Interviewing Part I: Understanding Patients’ Experiences. Can Fam Physician. 1989;35:147-51.

    Brown Judith Belle, Weston Wayne W., Stewart Moira A. Patient-Centred Interviewing Part II: Finding Common Ground. Can Fam Physician. 1989;35:153-7.

    Stewart Moira A., Brown Judith Belle, Weston Wayne W. Patient-Centred Interviewing Part III: Five Provocative Questions. Can Fam Physician. 1989;35:159-6.

  • The Canadian Library of Family Medicine

    The College of Family Physicians of Canada’s (CFPC’s) library service is always ready to help with any information needs. CFPC members can request free literature searches and full text articles.

    Contact the library for more information or to request help with preparing for certification:

    Library Services

    [email protected]

Simulated office orals (SOOs)

The Certification Examination in Family Medicine is comprised of two components: a written examination and an oral examination.

The oral examination is comprised of five simulated office orals (SOOs) where a candidate and an examiner interact virtually. The person being examined (the candidate) spends 15 minutes interviewing the mock patient (the examiner), played by a certified family physician, who then marks the encounter. Each of the five SOO stations are structured with the same three parts: a reading section where basic patient information is presented in print form to the candidate, the candidate/examiner encounter, and the examiner marking time where the candidate waits.

Even though the mock-patient/candidate encounter occurs virtually, the candidate should act as if they are in the same room as the patient. This examination is not a test of how well an individual provides virtual care, but a test of how well care is provided in the setting of a patient consulting a physician. No physical examination is needed or expected in any of the scenarios. Family physicians chosen as examiners are trained to role-play patients with specific complaints and background life stories. The family physician playing the role of the patient assesses how each candidate manages both the case and the patient/physician interaction. The examiners score each candidate according to predefined criteria.

This examination assesses how a candidate comes to understand and manage the patient’s health problem(s). The scoring system focuses on the candidate’s approach to interacting with patients—including how they come to understand the patient’s unique experience, - establish a positive doctor-patient relationship, and negotiate a medically appropriate plan with follow-up acceptable to the patient.

The College of Family Physicians of Canada (CFPC) believes that physicians who use a patient-centered approach best meet their patients’ needs. The patient-centered clinical method is explained in detail in the book, Patient-Centered Medicine: Transforming the Clinical Method.*  The SOO marking scheme is based on the patient-centered care framework presented in this book.

*Stewart M, Brown JB, Weston W, McWhinney I, McWilliam C, Freeman T, eds. Patient-Centered Medicine: Transforming the Clinical Method. 3rd ed. London: Radcliffe Publishing; 2014.

  • FAQ about virtual simulated office oral examinations

  • Virtual simulated office oral candidate training resources

  • SOO video library

    The CFPC’s SOO video library serves as a resource with videos that, other than portraying in-person SOO examples, are representative of the virtual SOO examination. The College advises exam candidates to read the preparatory material (e.g., instructions to candidates and examiners, marking schemes, and critiques if available) as well as the Introduction, and Guidelines on the Optimum Viewing and Scoring of SOO Video below to become familiar with the process and the case presented before viewing the demonstration videos.

    Introduction

    Guidelines on the Optimum Viewing and Scoring of SOO Video

    SOO video library

    Video

    Summary

    Instructions to Candidate: Candidates are given basic information on the patient they are about to see, such as their name and age. the only written material the candidate will see, provided five minutes before the interview

    Instructions to the Examiner: an abbreviated version of the script that examiners study to familiarize themselves with the casean abbreviated version of the script that examiners study to familiarize themselves with the case

    Marking Scheme for the SOO Video: a detailed outline of the unique scoring criteria developed for this sample casea detailed outline of the unique scoring criteria developed for this sample case

    Demonstration Video

    Dr. Cohen interviews a 55-year-old patient, Margaret O’Brien, a retired teacher with osteoarthritis in her left knee and high blood pressure.

    Dr. Jenny Clement

    Case Description

    Marking Scheme

    Critique

    Dr. Jenny Clement conducts the interview with a 42-year-old male patient, Bill Snook, presenting with symptoms of gastroesophageal reflux disease (GERD) and a gambling addiction.

  • SOO scripts library

    SOO Character Topics

    Sample 1

    Ann Brown

    1. A flare-up of rheumatoid arthritis
    2. Hypertension

    Sample 2

    Aurora Enderby-Smith

    1. Symptoms of polycystic ovarian syndrome (PCOS) and fertility questions
    2. Acute recurrent sinusitis

    Sample 3

    Bill Evans

    1. A need for post-myocardial infarction medical management
    2. Depression following a cardiac event

    Sample 4

    Bill Snook

    1. Gastroesophageal reflux disease
    2. A gambling addiction

    Sample 5

    Bruce Crothers

    1. A desire to bank sperm because of an abnormal prostate-specific antigen test result
    2. Parents have dementia and deteriorating health

    Sample 6

    Charles Potvin

    1. Thyroiditis
    2. Post-concussion syndrome

    Sample 7

    Danica Williams

    1. Body dysmorphic disorder
    2. Hyperhidrosis

    Sample 8

    Florence Bruneau

    1. Anogenital warts (condylomata acuminate)
    2. Victim of sexual assault

    Sample 9

    Gary Mcnicholl

    1. Hypertension
    2. Plantar fasciitis

    Sample 10

    Helen Pereira

    1. Caregiver burnout
    2. Headaches

    Sample 11

    Henry Brooks

    1. Cluster headaches
    2. Undiagnosed paranoid schizophrenia

    Sample 12

     Irene Bouchard

    1. Chronic obstructive pulmonary disease (COPD)
    2. Financially abused by daughter

    Sample 13

    Jane Webber

    1. Grief secondary to husband’s death
    2. Diabetes

    Sample 14

     Jeffrey Dalmazian

    1. A new diagnosis of hepatitis infection
    2. An anal fissure

    Sample 15

     Jeffrey Hope

    1. Chronic disease as it presents in diabetes
    2. Culturally sensitive post-traumatic stress disorder (PTSD)

    Sample 16

    Lilliane Lawrence

    1. Assistance with smoking cessation
    2. Memory loss

    Sample 17

     Maria Fournier

    1. Postpartum depression
    2. A breast mass

    Sample 18

     Mark Leeves

    1. Hypertension secondary to a stressful work environment
    2. Symptoms of chronic prostatitis

    Sample 19

    Michael Sears

    1. Concern about son’s headaches
    2. Concern about possible post-traumatic stress disorder

    Sample 20

     Mona Raymondo

    1. Musculoskeletal pain
    2. Use of methylphenidate (Ritalin) for undiagnosed adult attention deficit disorder

    Sample 22

     Paul Lambert

    1. Malaria
    2. Concerns about a sexually transmitted infection

    Sample 23

     Richard Grandon

    1. Ulcerative colitis
    2. Anxiety attacks

    Sample 24

     Robert Martin

    1. A child with atypical behaviours
    2. Polyarthritis secondary to ulcerative colitis

    Sample 25

     Sheena Murdoch

    1. Rectal bleeding of unknown etiology
    2. Headaches following a concussion

    Sample 26

     Sunrise Barrister

    1. A feeling of responsibility for a dying father
    2. Pregnancy nausea

    Sample 27

    Victor Mcallister

    1. A thyroid mass
    2. A conflict with wife because of parenting issues

    Sample 28

     Wendy Frontenac

    1. Pregnant
    2. Post-traumatic stress disorder
  • SOO documents and links library

    Distinguishing a “Certificant” from a “Superior Certificant”: Exploration of the Illness Experience
    This document features evaluation tools to assess a candidate’s performance with an emphasis on communication skills.

    Guidelines on the Optimum Viewing and Scoring of a SOO Video
    This document outlines the CFPC-recommended protocol to create the optimum SOO video viewing and scoring environment.

Short-answer management problems (SAMPs)

The written examination is comprised of short-answer management problems (SAMPs) designed to test a recall of factual knowledge and clinical reasoning abilities related to identifying and managing health problems, and critical thinking.

This portion of the examination is delivered using a computer-based platform administered by Prometric Canada. The video demonstration provides orientation to the functionality and features of the Prometric testing interface.

The SAMP portion of the examination is four-and-a-half hours in length and takes place on a weekday. The SAMP examination is designed to last four hours. The additional 30 minutes are composed of a 15-minute mandatory orientation tutorial at the beginning of the exam and a 15-minute break. This break is optional and, if wished, can be taken at any time during the examination. The examination clock does not stop during the break.

For each SAMP case, information regarding the patient is provided (I.e., the case stem) and is followed by a variable number of questions, usually three to five. Each question requires anywhere from one to five answers.

When answering questions in this examination, read the question carefully and provide only the information that is requested. For the most part, each question will require a single word, short phrase or short list as a response.

To help candidates prepare for the family medicine examination, the Committee on Examinations has authorized the release of some SAMPs used on previous examinations. The purpose is to give candidates some sense of the format and content they can expect during the exam, and to demonstrate the correct way to answer questions. The content of these SAMPs are not intended to be study aids.

 

SAMPs Instructions to the Candidate

Frequently Asked Questions

What to expect

Video Demonstration

SAMP Software Tutorial

Sample SAMPs

Assessment Objectives for Certification in Family Medicine

Assessment Objectives for Certification in Family Medicine (previously titled Defining competence for the purposes of certification by the College of Family Physicians of Canada: The evaluation objectives in family medicine) describe the essential skills and observable competencies that are expected from residents at the end of their training. As such, the document serves as a major guide to both in-training assessment and the content of the Certification Examination.

Competencies are described in terms of their most salient key features and observable behaviours. Each competency is specific to the situation’s context and to the phases of the clinical encounter; furthermore, each competency is linked back to the appropriate skill dimension, reinforcing this essential relationship.

Assessment Objectives for Certification in Family Medicine

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