Preparing for the Certification Examination in Family Medicine
- Find out everything you need to know about the family medicine and emergency medicine examinations, virtual and remote delivery, and news and updates by visiting www.cfpc.ca/exams
- Frequently asked questions and candidate training resources for the family medicine virtual simulated office oral exam are also now available
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.
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.
SOO video library
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 caseDemonstration 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 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
- A flare-up of rheumatoid arthritis
- Symptoms of polycystic ovarian syndrome (PCOS) and fertility questions
- Acute recurrent sinusitis
- A need for post-myocardial infarction medical management
- Depression following a cardiac event
- Gastroesophageal reflux disease
- A gambling addiction
- A desire to bank sperm because of an abnormal prostate-specific antigen test result
- Parents have dementia and deteriorating health
- Post-concussion syndrome
- Body dysmorphic disorder
- Anogenital warts (condylomata acuminate)
- Victim of sexual assault
- Plantar fasciitis
- Caregiver burnout
- Cluster headaches
- Undiagnosed paranoid schizophrenia
- Chronic obstructive pulmonary disease (COPD)
- Financially abused by daughter
- Grief secondary to husband’s death
- A new diagnosis of hepatitis infection
- An anal fissure
- Chronic disease as it presents in diabetes
- Culturally sensitive post-traumatic stress disorder (PTSD)
- Assistance with smoking cessation
- Memory loss
- Postpartum depression
- A breast mass
- Hypertension secondary to a stressful work environment
- Symptoms of chronic prostatitis
- Concern about son’s headaches
- Concern about possible post-traumatic stress disorder
- Musculoskeletal pain
- Use of methylphenidate (Ritalin) for undiagnosed adult attention deficit disorder
- Concerns about a sexually transmitted infection
- Ulcerative colitis
- Anxiety attacks
- A child with atypical behaviours
- Polyarthritis secondary to ulcerative colitis
- Rectal bleeding of unknown etiology
- Headaches following a concussion
- A feeling of responsibility for a dying father
- Pregnancy nausea
- A thyroid mass
- A conflict with wife because of parenting issues
- 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.
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.