The fee for the 2024 Certification Examination in Family Medicine is $4,201 per candidate.

When determining the amount, the CFPC Board approved a strategy and mathematical formula to calculate the cost of the exam annually. This is to make sure we deliver a high-quality exam that is as affordable as possible for candidates while ensuring the method used to determine the fee is transparent. This fee now includes all costs, including the centralized and shared services needed to support the design, development, and delivery of the exam.

The table below outlines all costs related to the exam, including the subsidy:

View the detailed mathematical formula.

Note: Candidates who withdraw from the examination more than 60 days prior to the date of the examination will be refunded their examination fee less $500. Candidates who cancel 60 days or less before the exam will be charged a fee based on when their application was withdrawn. See our cancellation policy for more information.

• Customer service for candidates before, during, and after the exam. We are always here to help.
• Transparent and specific subsidization of the exam fee by CFPC members through their annual fees to financially support all residents sitting the exam
  • The CFPC Certification Examination in Family Medicine continues to be one of the lowest costing exams in comparison with other medical exams
• High-quality, cutting-edge technology to improve the user experience, minimizing unnecessary stress on exam day
• Upgrades to privacy and security systems to continue keeping candidates’  information safe
• High levels of quality assurance, making sure exam content and assessment strategies reflect the complex needs of patients in all our communities
• Design and development of new exam content

An in-person model versus a virtual delivery format requires different resources, which come with different expenses. The digital platforms used exceeds the costs of securing facilities for in-person exams but result in minimizing travel expenses for examiners and candidates.

The CFPC understands the importance of keeping fees down, annually considering all costs associated with exam delivery, while making every effort to keep the exam as affordable as possible for members.

This fee increase will help the CFPC sustain its commitment to supporting candidates and administering a high-quality, reliable exam. The strategy and mathematical formula will be reviewed annually by staff to ensure it is meeting its goals and every three years by the Finance and Audit Committee and the Board of Directors, which may result in a change to the fee. At a minimum the exam fee will be adjusted for inflation forecasts annually.

The College’s Board, volunteers, and staff remain devoted to supporting members to become the best doctors they can be throughout their medical careers. The CFPC is and will always be in members’ corner and this is the rationale for subsidizing the family medicine exam fee. The CFPC Certification Examination in Family Medicine continues to be one of the lowest costing exams in comparison with other medical exams.

• Improved customer service for candidates before, during, and after the exam. We are always here to help.
• High-quality, cutting-edge technology to improve the user experience, minimizing unnecessary stress on exam day
• Upgrades to privacy and security systems to continue keeping candidates’ information safe
• High levels of quality assurance, making sure exam content responds to and reflects the changing and more complex needs of patients in all our communities

Further, in recognition of the financial challenges of entering practice after successfully attaining certification, the CFPC reduces the practising member fee (i.e., membership in the CFPC) for the first year of practice by 50 per cent.

This fee now includes all costs—including the centralized and shared services provided by the  CFPC—needed to support the design, development, and delivery of the exam.

Based on analysis, the Board of Directors approved a strategic and mathematical formula to determine the revised fee structure (and subsequent fee increase).

View the detailed mathematical formula.

The strategy and mathematical formula will be reviewed annually by staff to ensure it is meeting its goals and every three years by the Finance and Audit Committee and the Board of Directors, which may result in a change to the fee. At a minimum the exam fee will be adjusted for inflation forecasts annually.

This fee will be posted approximately one year in advance of the Spring exam. Should anticipated costs decline the fee will be adjusted downward, up to April 1st of the exam year. Once posted, the fee will not be changed.

If you have any additional questions about how the CFPC determines exam fees, please contact us at [email protected]. We are here to help!
 

The number of candidates impacts the number of examiners, SOO Leads, and markers required to support exam delivery activities. The CFPC staff support candidates, examiners, SOO Leads and markers, other subject matter experts (SMEs), the Board of Examinations and Certification, other CFPC committees, and vendors.

There is a direct correlation between the number of candidates sitting the exam and the number of examiners plus SOO Leads plus markers needed to support the candidates’ exam experience.

There is both a direct and an indirect correlation between the number of candidates and the number of staff needed to effectively design, develop, and deliver the Exam. We have seen the number of candidates increase gradually over the past several years but note that there may be a spike in the future. The Board is reminded there are at least two more medical schools being planned in Canada and most family medicine residency programs are increasing their intake number of trainees. Furthermore, many provinces, territories, and the federal government seem interested in increasing the number of internationally trained physicians hired, many of whom will want to be assessed for certification in family medicine.

We will set the number of permanent staff full-time-equivalents (FTEs) and examiners/SOO Leads/markers required based on the number of candidates. As the number of candidates rises so will the number of FTEs and examiners/SOO Leads/markers but the ratio should stay the same or become slightly more positive due to efficiencies. This is unique to FTEs providing direct member (in this case candidate) support for any College activity. We have noted an increase in support requested due to expectations of candidates and the examiners/SOO Leads/markers.

There is a growing number of applicants via both the residency-eligible and the practice-eligible routes, all of whom need to be reviewed to determine if they meet the stated requirements.

At this time there is no separate equation for the CFPC cost related to determining if an applicant qualifies to sit the exam. Further work will be done to adjust future exam fees once these cost determinations are completed.

• Communicating with candidates is crucial. It is often their first major interaction with the CFPC. We need [1] general information such as web pages, social media, and instructions in various formats to be continually refreshed and presented in easy to find formats, [2] responses to specific concerns from individuals and key stakeholders, and [3] information to flow in both predicted and responsive situations (e.g., emails with login details as one example). The communication needs to be more than information sharing but a form of relationship building and becoming connected to the CFPC.
• Attending to communication and relationship building when working with members as they act in various roles, especially as SOO examiners. It requires ongoing work to manage recruitment, and train, show appreciation, and nurture a community of members with similar interests in being connected to the CFPC through examining.
• Addressing legal actions: These are rare and unique, but when they occur they require significant time commitment and input from staff.

• Shared by all candidates
• Attract a specific fee (e.g., appeals, remarking)

At this time there is no separate equation related to the needs described above.

Further work will be done to adjust the individual fees and/or exam fees at a future date.

1. Review of marks
2. Reconsideration of awarded standing
3. Appeal a Board of Examinations and Certification (BEC) reconsideration decision

The current exam is made up of two components: short answer management problems (SAMPs) and simulated office orals (SOOs).

• Costs related to the maintenance (and initial top up) of content banks for both SAMPs and SOOs
• Costs related to the number of SOOs included in the examination

In addition, as the number of candidates increase, so too are the number of ‘test forms’ (i.e., comparable versions of the exam given during the same administration window) needed each year for the SAMPs. The greater the number of candidates, the greater the number of testing days needed and with this, a greater number of different test forms (for exam security reasons), which means more content exposed per administration, thereby requiring more content development.

We anticipate that to reach an adequate number of items in our exam content banks, we need to invest in funding derived from the certification and assessment reserves. Staff will develop a plan to identify the optimum number of questions in the SAMP and SOO banks, along with the estimated time and honorarium needed to secure the required number of SMEs to produce this content.

Annual amortization and maintenance costs for the question bank are a fixed cost, which is included as a per anticipated candidate cost.

A future ‘investment cost’ will be added to the exam fee at a later date, once we can better determine the impact of current activities on the reserves and an appropriate replenishment rate to ensure funds are available to carry out all development activities related to the exam.

1. New Examination Administration Tool (NEAT)
2. Re-Envisioning the Future of Assessment, Certification and Examinations (ReFACE)

Both of these projects have been included in our priorities for the 2023/24 fiscal year and the assessment/operating costs have been budgeted to be funded through reserves. The capital costs for the NEAT project will be approximately $1.8M and will be amortized over a three-year period starting with the 2024/25 fiscal year. This would be equivalent to approximately $300 per candidate on an annual basis.

This is not the end of continuous improvements, but if we use these as a baseline and we assume that this level of expenditure would occur in some manner every three to five years, it makes sense to set up an average amount to be included in the exam costs as a contribution to the Certification and Assessment Reserve for future projects. This will make certain that projects can continue to be funded through this reserve without seeing sharp increases/decreases in the fee. This cost will be developed once we have examined plans and can provide reasonable replenishment costs. Using current improvement initiatives, an average amount of approximately $300 per candidate is likely and would be included as a step adjustment. The amount in 2024 will be $100 with further assessment needed for the 2025 component.

Both components of the exam are now being administered electronically, the SOO component as a result of pandemic proofing exam delivery. This continues to have benefits to both the exam candidate and the CFPC. The candidate is no longer required to travel to an exam site for a two-day exam. The exam will no longer fall victim to physical risks such as one or more exam sites experiencing an interruption of service or weather-related travel cancellations. In addition, this new delivery method significantly reduces the carbon footprint that resulted from many candidates, over 400 examiners, and a large contingent of CFPC staff travelling to in-person exam sites. Plus, our paper and printing consumption has fallen dramatically—two areas of planetary health that the CFPC is supporting.

We now rely heavily on technological processes to enable remote delivery and we must consider investments in those technological processes that can impact our overall cost. These will be seen as per candidate direct costs and will be estimated to remain steady with the exception of increases resulting from inflation and other business factors that could impact our suppliers.

• Administrative coordinators
• Centre expenses
• Certificates/Plaques/mailing tubes
• Consulting fees
• Editing
• Exam - simulated candidate test
• Mailing and courier
• Miscellaneous
• Exam administrative tool maintenance
• Printing
• Translations
• Actors
• Staff travel
• Video tape duplication
• General insurance - Errors and Omission
• Board of Examination and Certification (BEC) and committee costs
• Amortization
• Office expenses

These costs, with the exception of the impacts of inflation, remain relatively stable and will be introduced as a flat fee using past cost trends.

• Membership Services
• Marketing and Communications
• Executive Leadership
• Governance
• Strategic Planning
• Finance
• Facilities
• Human Resources
• Meetings Support
• Information Technology Services

All of the costs above combined represent the total direct cost per candidate for the exam. Such costs are allocated based on a ratio of the exam direct expenses against the total direct expenses for all CFPC programs.

Exam fees are set one year in advance of the exam taking place. We will be using historical forecasts for the prior year when setting all of the per candidate costs. A general inflation amount will be added to set the fee using the Consumer Price Index (CPI). Six months prior to the exam date the CPI will be reviewed and, if a lower percentage exists than the estimate used initially, the exam fee will be lowered accordingly. If the CPI is higher than the estimate, the exam fee will remain unchanged and in-year budget adjustments will be made if required.

We have experienced a high level of inflation in this past year, but typically, have seen inflation representing cost increases of two to four per cent. The impact of forecasted inflation needs to be considered in setting a fee and applies to both staffing and vendors.

To date we have not set a subsidy or a specific subsidization strategy for the exam. We have historically subsidized the full cost of the fee and amounts between 20 per cent and 40 per cent, with the majority of years being close to 25 per cent. The amount of subsidy will impact the percentage of full costs covered by each candidate in the fee that they are assessed.

We have debated in the past if the full cost of the exam should be covered by the fee that the candidate pays, the norm in assessment organization environments. The Medical Council of Canada (MCC)’s exam fees cover the full costs to run the organization given that exam fees are their only source of revenue. The Royal College of Physicians and Surgeons of Canada (Royal College)’s exam fees have been determined using full cost accounting. It has been a long-held belief at the CFPC that the discipline of family medicine must continue to be supported by family medicine members and, as such, has resulted in the subsidization of the exam fees. Of course, within this belief is the understanding that since very few other offerings of the College have an income stream, the level of subsidization incurs opportunity costs on the CFPC.