NEW ORLEANS -- A new, more flexible alternative to the current 10-year "high stakes" exam for maintenance of certification will soon be available to family physicians, the American Board of Family Medicine (ABFM) announced here on Tuesday.
Jerry Kruse, MD, chair of the ABFM, announced the new pilot program at the American Academy of Family Physicians (AAFP) Congress of Delegates meeting. He anticipates the program, which will use a longitudinal assessment, will be available to test-takers in January 2019.
Kruse, who is the dean and provost of the Southern Illinois University School of Medicine, described the new model as an "efficient and effective way" to support learning and improve practice.
He noted that the traditional 10-year exam will remain an option for those who choose it.
In crafting this new testing model, the ABFM surveyed a random sample of 6,000 family physicians after they had taken the 10-year exam in 2016 and 2017 and discovered their preferences for an alternative to the current exam.
Under the new pilot, participants will receive approximately 25 questions every 3 months, that can be answered "anywhere, any time" Kruse said, over a period of 3 to 4 years. For those who participate, once the exam is completed, the participants will not need to take another test until 2029, he stressed.
The test will be open-book, clinical references may be used, and participants will be given 5 minutes to respond to each question.
Also, no additional payment, beyond the current standard fee will be required, Kruse said.
Another benefit of the pilot is that participants will be able to learn immediately whether a question is correct or not, along with references on the topic.
Throughout the process the ABFM will solicit feedback about how to improve the assessment.
Kruse noted that the ABFM is also committed to a new approach for engaging with physicians focused on "two-way" and "just-in-time" communication.
AAFP members seemed open to the alternative testing strategy.
Robyn Liu, MD, MPH, president of the Oregon chapter of the AAFP, said the current high-stakes exam is "stressful and disruptive" to a physician's life and practice.
Some of her colleagues often take a week off from work just to study. "This would eliminate that [problem] as far as we know," Liu continued, but noted that she hadn't yet seen the details "in writing."
Alex McDonald, MD, a board member of the California chapter of the AAFP, was also enthusiastic.
"Right now cramming for a big test, for me personally, doesn't really add value to my knowledge," McDonald said, in comparison to learning in smaller chunks of continuous "digestible" information.
Another family physician, Ravi Grivois-Shah, MD, of Tucson, said he was "one hundred percent" interested in the new option.
"There's absolutely no evidence that our current high-stakes exam actually improves our understanding or knowledge, or outcomes for our patients," Grivois-Shah told ľֱ.
He likes the idea of a testing process that is open-book and more "representative" of daily practice.
"If I have a question, I don't just guess, I look it up with the patient in the room with me," said Grivois-Shah. "I tell him, 'Hey, give me a second ... because we need to get more detail.'"
"That's how we practice medicine and to take a test that doesn't reflect that doesn't make sense," Grivois-Shah added.
Daniel Derksen, MD, an alternate delegate of the AAFP, told ľֱ in an email that he's due to renew his license in 2019 and will likely choose to participate in the pilot. "It sounds like an innovative approach to lifelong learning," he said.