Maintenance of Certification for Family Physicians Exam

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The Maintenance of Certification for Family Physicians (MC-FP) was first implemented by the American Board of Family Medicine (ABFM) in 2003.[1] The program was developed in response to a 2000 decision by the American Board of Medical Specialties (ABMS) to mandate that its member boards formulate Maintenance of Certification (MOC) processes for all certified professionals. By 2010, all of the 80,000 diplomates of the ABFM had completed one round of the MC-FP certification maintenance process.[1]

Function of the Test

MC-FP Study Guide

The MC-FP exam is part of the Maintenance of Certification process for family physicians certified by the ABFM. It is taken by new family physicians as well as their recertifying colleagues. Until recent rule changes, it was taken by family physicians on a schedule of seven years or ten years, depending on whether the physician completed educational modules on the schedule set by the ABFM. Physicians who adhered to the schedule would take the test every ten years, while those who did not had to take the test every seven years.[2] As of 2011, physicians certifying or re-certifying in the MC-FP program are all placed on a ten-year recertification cycle.[3]

A study in 2014 reported that of the 11,260 physicians who entered the MC-FP program in 2003, 8,622 (76.6%) had successfully maintained certification ten years later. Of the 2,638 who did not, a majority were of (or near) retirement age. Of the 9,351 physicians in the cohort who took the MC-FP exam to maintain certification, 8,622 (92.2%) passed and 729 (7.8%) failed. Of the 729 who failed, 575 (78.9%) applied to retake the examination.[1]

Test Administration

MC-FP Flashcards

The MC-FP examination is a computer-based test which is offered each year at approximately 330 Prometric testing centers around the world during a single testing window in April.[4] The fee to take the examination is $1,300 if candidates apply before the normal application deadline in January. Higher application fees and additional late filing fees apply for candidates who register for the exam after the normal application deadline, up to a maximum of $1,700.[4] In addition, candidates who wish to take the examination outside of the United States must pay an additional $200 international testing fee.[4]

The MC-FP takes up to nine hours to complete, including time spent reviewing rules and instructions, taking an unscored survey, and taking optional breaks for lunch and for rest. Time specifically spent answering exam questions totals a maximum of six hours and forty minutes. Because the exam is administered individually by computer, candidates have the option of waiving or shortening any or all rest breaks to shorten the total examination time.[4]

Candidates receive examination results approximately six to eight weeks following the exam date. Results are posted in candidates' Physician Portfolio.[4] Qualified candidates who fail the examination and wish to retake it may do so without any restrictions. However, such candidates must pay the full application fee again, and because the examination is only offered in one testing window per year, there is a de facto waiting period of 12 months between exam attempts.[4]

Candidates who require special testing accommodations for a disability should indicate the need for accommodation when completing the online application to take the MC-FP. Proper documentation of the disability must be received by the ABFM by the application closing date, typically a few months in advance of the exam window.[5]

Test Format

Test Environment

Testing for the MC-FP takes place at Prometric Testing Centers. There, candidates are expected to arrive 30 minutes early to their scheduled test. For admission, an E-Ticket and one form of government-issued identification that contains a photo and signature are required. All personal items must be stored in a locker provided by the testing center. Electronics, bags, notes, watches, and other items may invalidate the test if brought into the testing room. Jackets and sweaters must be worn if brought into the testing room. The test takes place on a computer.[6]

Test Structure

The test is broken up into five sections that deal with four major topics: Professionalism; Self-Assessment and Lifelong Learning; Cognitive Expertise; and Performance in Practice. Combined, there are a total of 370 multiple choice questions. There will be 20 subtest questions that will not be scored. The exam is projected to take most of the day, and allows for breaks between each section, with a lunch break in the afternoon.[7]


The MC-FP is composed entirely of multiple-choice questions. The content on the MC-FP is distributed as follows:

Distribution of questions on the MC-FP exam[4]
Section # of Items Time limit
1 120 120
2: 1st Module 45 45
3: 2nd Module 45 45
4 80 95
5 80 95
Total 370 6 hours
40 minutes

Sections 1, 4, and 5 comprise questions drawn from 16 content areas.[8] For sections 2 and 3, candidates choose two module topics from a list of eight. Possible modules include ambulatory family medicine, child and adolescent care, geriatrics, women's health, maternity care, emergent/urgent care, hospital medicine, and sports medicine.[4]

Candidates' results for the full examination are reported on a scaled score from 200 to 800.[9] The MC-FP examination is criterion-referenced. Each individual test item is analyzed by a panel of experts to determine the percentage of qualified family physicians who would answer the test item correctly. When pooled together, these ratings enable the ABFM to establish a passing score which represents the score a minimally-qualified candidate would receive.[9][4]

In 2014, the passing score was 380. Of candidates for initial certification, 92.4% passed, whereas of candidates for recertification, 87.4% passed.[10]


  1. ^ a b c JABFM - Certification Status of Family Physicians in the Initial Cohort Entering Maintenance of Certification January 26 2015
  2. ^ ABFM - FAQ for physicians Certifying or Recertifying in 2010 January 26 2015
  3. ^ American Board of Family Medicine - FAQ for physicians Certifying or Recertifying in 2011 and Beyond January 26 2015
  4. ^ a b c d e f g h i American Board of Family Medicine - Candidate Information Booklet, Maintenance of Certification for Family Physicians (MC-FP) Examination January 26 2015
  5. ^ American Board of Family Medicine - Policy Statement for Americans with Disabilities Act (ADA) Compliance – ABFM Examinations January 26 2015
  6. ^ Candidate Handbook 2 March 2015
  7. ^ Exam Content 2 March 2015
  8. ^ ABFM - ABFM Certification/Recertification Examination Content January 26 2015
  9. ^ a b Annals of Family Medicine - Criterion-Referenced Examinations: Implications for the Reporting and Interpretation of Examination Results January 26 2015
  10. ^ ABFM - 2014 Examination Results January 26 2015