As family medicine residents, we are used to adapting to a wide range of situations during rotations. Med School 2.0, as I like to call it. Our specialty is, well, all specialties, which is rewarding but extremely challenging in practice, and most annoyingly, during standardized testing.
Sure, we have an advantage during Step 3 because we never got away from “general medicine” and still do pediatrics, obstetrics, and even surgical specialties. But when it comes to board exams, the test is its own beast.
If you are studying for the ABFM family medicine board exam, you realize that there are a lot of different ways you might approach medicine. That is the unfortunate truth of medicine today: we aren't always able to practice perfect evidence-based medicine, and we have to deal with real world expectations of patients.
But it’s important, for the board exam, that you stay up-to-date with guidelines and recommendations and get into the “vibe” of the family medicine board exam.
Family Medicine Board Study Resources
ITE & ABFM Question Banks: The Most Important ABFM Prep Resources
If you could only choose one resource to study from for your ABFM exam, it should be the ABFM questions which you can find in 2 places: from old ITEs (In-Training Examinations) and from the ABFM question banks.
1. In-Training Examinations
If you don’t already know what the ITE is, it is a yearly exam that you take while in residency to gauge your progress compared to your peers in your preparedness for the board examination.
You have access to the three most recent ITE examinations through your portfolio on theabfm.org. You will need to log in to access these exams. Ask residents ahead of you if they will share exams from previous years with you.
The Value of In-Training Exams:
In-Training Exams are by far the most important study resource because these are the only questions written by the same people who write the test. There are a lot of repeat questions year to year which is okay, because the test itself is very similar year to year!
You will actually see some word-for-word questions on the real exam. My recommendation: Before your test, do as many ITE exams as you can and review them. Do them twice if you are able to!
2. ABFM KSA Questions
These are the same questions (with some new and some old) as those that are in the ITE examinations. You can access these most easily through the ABFM CKSA App available on the app store. You can also get these questions through the CKSA (continuous knowledge self-assessment) section on theabfm.org.
The KSAs are detailed questions that test your knowledge in one topic of family medicine. Though the website is not user-friendly, the questions are fairly detailed and come straight from the source.
The Value of ABFM Questions:
Again, these questions are the most important resource to prepare you for this exam, and with this app, you can do questions on the go without having to sit down with a whole examination in PDF format.
additional high-yield ABFM Study Resources
The American Academy of Family Physicians offers many great articles and algorithms for bread and butter family medicine, but the real gem for ABFM exam prep is AAFP’s board review questions. There are over 1,000 multiple choice questions with explanations all for free!
The questions aim to mirror those multiple-choice questions you’d expect from the ABFM boards but aren't as detailed. This is a great source to start out with; do a few sets of questions weekly to brush up on your family medicine knowledge, study for your in-service training examinations, or prep for boards with these.
All it requires is an AAFP membership and login (also free). Take advantage of this resource.
2. UWorld ABFM Questions
I have a love-hate relationship with UWorld. I love how consistently useful it is for every exam that I’ve taken in med school. The interface is simple and the questions are appropriately difficult with detailed explanations. UWorld is a great tool for improving your weaknesses. Have a knowledge gap in endocrinology? Select that section and dive straight into endo questions. Easy!
Another benefit of UWorld's ABFM question bank is that you are familiar with the format, you know the information is solid, and there are plenty of questions.
The hate is for how long it takes to complete the entire Qbank, as Uworld has over 1,100 questions for family medicine. The best thing to do is make a study plan and stick to it. You can purchase the entire Qbank for different amounts of time. Three to six months is what I’d recommend for ABFM exam prep.
This resource can be overwhelming if you are close to your test date. If you had to choose between doing the ITE questions or UWorld Qbanks, I would definitely recommend the ITE questions.
One way to incorporate these questions into your studying if you have limited time is to use them to help you with topics that you are still struggling with.
Overlooked Gems for Family Medicine Board Review: USPSTF and the Choosing Wisely Campaign
Family medicine residents know that these tests are very guideline-heavy with an emphasis on conservative management. The best places to peruse the most up-to-date recommendations are USPSTF and the Choosing Wisely Campaign.
1. USPSTF Recommendations
The US Preventive Services Task Force is the quintessential source for all of the most recent recommendations for screening and prevention.
Take some time to visit the website and read all of the A/B recommendations and sort by important topics.
Review USPSTF recommendations throughout your studying and the night before your test!
2. Choosing Wisely Campaign
The Choosing Wisely Campaign is an initiative by the American Board of Internal Medicine to limit unnecessary testing/imaging/interventions to prevent unintended consequences and to control the cost of healthcare.
This is a huge principle on the family medicine boards, so taking a look at the published “choosing wisely” recommendations in some key areas is a good reminder of when the next step should be “watch and wait” versus some type of diagnostic or intervention.
Additional Family Medicine Board Review Resources
Swanson’s Family Medicine Review
There are tons of companies offering questions for these exams, but unless you are way ahead of the game, stick to ITE and UWorld.
But if you do have time/want something a little more topic focused, I recommend Swanson’s Family Medicine Review.
Swanson's Family Medicine Review is available in digital and hard copy format. Each chapter is focused on a different topic and it will do back-to-back questions about one topic, making it really easy to drive home some topics (for example, pediatric fever).
The Value of Swanson's Family Medicine Review:
Swanson's questions differ from UWorld questions in that they are shorter stems, shorter explanations, and some very high-yield points are made after a string of approximately ten questions about one particular topic. I would say don’t plan to finish this resource, but use as needed to solidify topics. This is also a great resource for rotations to drive home important points in question format!
Utilize Old Resources for Family Medicine Board Review
If you are struggling with specific topics that you remember learning well from a medical school resource, by all means dust it off (First Aid for Step 2, Step Up to Medicine, etc). Just remember to make sure your information is up to date and “on brand” for the ABFM exam.
First Aid is a particularly helpful "old" study tool. The First Aid Family Medicine Boards review is great to reinforce topics when you need more than just a Qbank. The book is also great if you’re tired of staring at a computer screen and want some actual paper to read and take notes on.
Start early, be consistent, and stay calm. The pass rate is extremely high for the family medicine boards, because remember: you are testing with people from all walks of life (including doctors who have been in practice for over 30 years). Remember that your training should be preparing you to do well on this exam, and if all else fails on test day: think back to your training!