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No More ABFM Board Certification Exam

Not sure how this news escaped me. Today I interviewed for a utilization management job and their medical director who is Family Medicine physician told me about this new option. Apparently the ABFM Board Certification exam is being replaced.

For Family Medicine doctors who are Board Certified through ABFM and don’t have their Board Certification exam until 2019, they can opt into the Longitudinal Assessment Pathway. Referred to as the FMCLA by the ABFM.

Instead of taking the Board Exam every 7-10 years, the physician can answer 25 open-book questions every quarter. This will replace their need to take the board exam supposedly. Which is a huge MOC satisfier.

The shocking and ridiculous irony here is that you don’t get CME credits for this activity. Really, ABFM?

75% of Family Medicine physicians have already opted into this option. So it has been as popular as expected.

ABFM Board Certification Exam

My ABFM board certification lapsed 12/2018. I had to take the Board Exam in 2018 in order to be eligible for this option.

I had many reasons for not wanting to take the exam again.

  • I didn’t see myself staying in medicine.
  • I didn’t want to study for 3 months.
  • I didn’t think this would make me a better clinician.
  • The ABFM suspended my board certification for 30-days because of my medical board investigation.
  • I didn’t want to pay the money for the exam or the study course.
  • I didn’t want to travel back to the US from Spain to take the test.

In reality, the exam isn’t all too bad if you have the time and headspace to study for it.

My colleagues who are good test takers only studied for it for 2-3 weeks. Others generally spent 3 months studying test questions.

Alternative to Taking the Board Exam

This Longitudinal Assessment Pathway is considered a pilot program, still. But it will most likely stick around.

It came about because of all of the pressures of MOC (maintenance of certification). And I have to say that it was rather smart on the ABMS (parent to ABFM) to approve this pathway.

Please remember that it was exactly because of the NBPAS that the ABMS changed their tune. Otherwise the ABFM doesn’t give a shit about you or I. They are a for-profit entity, despite their corporation status.

NBPAS Alternative

I still prefer the NBPAS alternative because you’ll still have to shell out a lot of money to the ABFM in order to remain board certified.

And I don’t see any reason why the ABMS/ABFM should be allowed to trademark the term “Family Medicine Physician”. I trained in FM, I practice FM, and I have had no poor clinical outcomes.

You can certainly be dually certified – both ABFM and NBPAS. That’s the smart thing to do in order to support the NBPAS which has a strong legislative arm to fight the MOC and ABMS.

Without an ABMS certification you are certainly going to have a harder time finding jobs. But it’s not impossible. I’m working at an FQHC now and working in telemedicine as well.

For those who want to stick it to the ABMS/ABFM, here is a list of hospitals which will readily accept your NBPAS certification.

3 Year Lapse of ABFM

For anyone who is deciding to be a rebel like me, note that you can only let your ABFM lapse for 3 years.

After 3 years, the reentry process into ABFM Board Certification will be a quite a bit more laborious.

But now that the Longitudinal Assessment Pathway option is available, I don’t see a reason for anyone to worry about the Board Exam.

Still, I encourage everyone to support the NBPAS by being at least dual certified. The signup takes <15 minutes and it costs <$200 for 2 years. Well worth the money and you’ll be supporting a potentially good cause.

I am quite happy with my NBPAS certification and renewal process so far.

Justifying Examinations

The NBPAS doesn’t require you to take any exams. They trust that physicians will do their part to remain educated.

Perhaps self-policing isn’t right for everyone. But I stay active on Figure1 and Reddit forums to discuss medicine. I run cases by my colleagues and look shit up on

The best thing the ABFM could do is offer a free subscription to Uptodate to physicians. But they don’t. Policing and profits are higher on their agenda.

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