Skip to main content

Main menu

  • Home
  • Current Issue
  • Content
    • Current Issue
    • Early Access
    • Multimedia
    • Podcast
    • Collections
    • Past Issues
    • Articles by Subject
    • Articles by Type
    • Supplements
    • Plain Language Summaries
    • Calls for Papers
  • Info for
    • Authors
    • Reviewers
    • Job Seekers
    • Media
  • About
    • Annals of Family Medicine
    • Editorial Staff & Boards
    • Sponsoring Organizations
    • Copyrights & Permissions
    • Announcements
  • Engage
    • Engage
    • e-Letters (Comments)
    • Subscribe
    • Podcast
    • E-mail Alerts
    • Journal Club
    • RSS
    • Annals Forum (Archive)
  • Contact
    • Contact Us
  • Careers

User menu

  • My alerts

Search

  • Advanced search
Annals of Family Medicine
  • My alerts
Annals of Family Medicine

Advanced Search

  • Home
  • Current Issue
  • Content
    • Current Issue
    • Early Access
    • Multimedia
    • Podcast
    • Collections
    • Past Issues
    • Articles by Subject
    • Articles by Type
    • Supplements
    • Plain Language Summaries
    • Calls for Papers
  • Info for
    • Authors
    • Reviewers
    • Job Seekers
    • Media
  • About
    • Annals of Family Medicine
    • Editorial Staff & Boards
    • Sponsoring Organizations
    • Copyrights & Permissions
    • Announcements
  • Engage
    • Engage
    • e-Letters (Comments)
    • Subscribe
    • Podcast
    • E-mail Alerts
    • Journal Club
    • RSS
    • Annals Forum (Archive)
  • Contact
    • Contact Us
  • Careers
  • Follow annalsfm on Twitter
  • Visit annalsfm on Facebook
Research ArticleFamily Medicine UpdatesF

BUILDING PRIORITIES IN HEALTH & HEALTH CARE INTO ABFM’S KNOWLEDGE ASSESSMENTS

Warren P. Newton, Lara Handler and Michael Magill
The Annals of Family Medicine May 2022, 20 (3) 287-289; DOI: https://doi.org/10.1370/afm.2840
Warren P. Newton
American Board of Family Medicine, Department of Family Medicine, University of North Carolina;
MD, MPH
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Lara Handler
American Board of Family Medicine;
MSLS
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Michael Magill
American Board of Family Medicine, University of Utah, Department of Family & Preventive Medicine
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • eLetters
  • Info & Metrics
  • PDF
Loading

In January 2021, the Board of Directors of the American Board of Family Medicine (ABFM) decided that emerging priorities in health and health care should become an explicit component of knowledge assessment in the future. ABFM examinations and self-assessment activities are comprised of a balance of items representing the competencies within family medicine. The composition of these self-assessments and the examinations is guided by a “blueprint” that reflects current knowledge expected of every family physician regarding diagnosis and treatment in daily practice. These items are written and reviewed by volunteer family physicians who practice in a wide variety of settings across the country; the topics come from their clinical practice along with recent evidence and practice guidelines.

The Board is now adding a new explicit and proactive process to ensure that broad trends impacting the clinical practices of family physicians are reflected in the certification examination. It is not enough for family physicians to have knowledge to practice today. As the largest and most widely distributed group of primary care physicians, and as leaders in responding to emerging health problems, family physicians must address future challenges in practice. Mastery of the specific clinical knowledge will be an important foundation of that work. In this editorial, we describe the process, review the topics chosen, and describe the implications for Diplomates.

Identifying the most important emerging trends is difficult in a generalist specialty like Family Medicine. The list of possible topics is inevitably long, and prioritization is important. Our goal was to identify the most important trends in health and health care for the next 3 to 5 years which will influence clinical decisions in the office, at the bedside, or wherever family physicians practice, and which are appropriate for assessment by multiple choice questions.

We used an iterative evidence-informed process. ABFM senior staff identified possible trends in health and health care, and the ABFM Board of Directors and a national blueprint advisory panel added additional topics to identify a total of 15 options, listed alphabetically in Table 1. Staff then developed brief evidence summaries supporting each one, based on current trends and burden of suffering—prevalence, incidence, morbidity, mortality, and cost. Then, over 2 meetings, the ABFM Board narrowed the list to 7 topics, taking the input and prioritizations of the national blueprint panel and ABFM executive staff into account. There was good concordance across the groups, and the final list was approved by the ABFM Board of Directors in January 2022.

View this table:
  • View inline
  • View popup
Table 1.

Possible Priorities in Health and Health Care

All the proposed topics in Table 1 are important: the final priorities represent a clinical judgement, balancing what is known about burden of suffering and near-term trends in health care with constraints inherent in the process of writing multiple choice questions for the examination. Table 2 lists the final ABFM priorities, in order of the voting, with definitions and a brief rationale for their selection: Health Equity,1-4 Social Determinants of Health,3 and Structural Racism4; Value Based Care5 and Population Health6; Behavioral Health including Adolescent Suicide7,8; Multimorbidity9-11; Opioid Abuse and Addiction12,13; Embracing Technology (Point of Care Ultrasound,14 Genomics in Primary Care,15 and Artificial Intelligence/Machine Learning); and Obesity and Activity.16,17

View this table:
  • View inline
  • View popup
Table 2.

ABFM Priorities in Health and Health Care, 2022

What are the next steps for ABFM and for Diplomates? The initial task will be to review our existing multiple-choice questions and explore how well these topics are currently addressed; we will likely need to create new questions for some of these topics. Of note, it will be difficult to write questions for some of these topics, such as social determinants of health: it is easy to write questions, hard to write good questions! These topics will then be distributed throughout the knowledge assessments in the ABFM certification portfolio—longitudinal assessment, the one-day certification exam, the In-Training-Exam for residents, Continuous Knowledge Self-Assessment and potential future Knowledge Self-Assessment modules. Of course, it is important to keep in mind that cognitive expertise is only one of the major requirements for Board Certification: commitment to professionalism, lifelong learning and performance improvement are also critical.

Beyond our examination, we hope that setting these-priorities will support the clinical evolution of our specialty as it recovers from the pandemic. The proposed ACGME residency standards18 represent a bold vision of community engagement and emphasize that the practice is the curriculum, including integrated behavioral health and POCUS. The ABFM priorities align well with the draft residency standards.

ABFM will revisit the priorities in 3 years: given the dramatic changes in health and health care that are taking place, the priorities will likely evolve over time. We encourage suggestions for the future.

  • © 2022 Annals of Family Medicine, Inc.

References

  1. 1.↵
    1. US Department of Health and Human Services
    . Disparities. Published 2022. Accessed Apr 18, 2022. https://www.healthypeople.gov/2020/about/foundation-health-measures/Disparities
  2. 2.
    Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. National Academies Press; 2003.
  3. 3.↵
    1. US Department of Health and Human Services
    . Social determinants of health. Published 2022. Accessed Apr 18, 2022. https://health.gov/healthypeople/objectives-and-data/social-determinants-health
  4. 4.↵
    1. Yearby R,
    2. Clark B,
    3. Figueroa JF.
    Structural racism in historical and modern US health care policy. Health Aff (Millwood). 2022; 41(2): 187-194. doi:10.1377/hlthaff.2021.01466
    OpenUrlCrossRef
  5. 5.↵
    What Is value-based healthcare? NEJM Catal. 2017; 3(1). https://catalyst.nejm.org/doi/full/10.1056/CAT.17.0558
  6. 6.↵
    1. Teisberg E,
    2. Wallace S,
    3. O’Hara S.
    Defining and implementing value-based health care: a strategic framework. Acad Med. 2020; 95(5): 682-685. doi:10.1097/ACM.0000000000003122
    OpenUrlCrossRef
  7. 7.↵
    1. deGruy FV,
    2. McDaniel SH.
    Proposed requirements for behavioral health in family medicine residencies. Fam Med. 2021; 53(7): 516-520. doi:10.22454/FamMed.2021.380617
    OpenUrlCrossRef
  8. 8.↵
    1. Yard E,
    2. Radhakrishnan L,
    3. Ballesteros MF, et al.
    Emergency department visits for suspected suicide attempts among persons aged 12-25 years before and during the COVID-19 pandemic - United States, January 2019-May 2021. MMWR Morb Mortal Wkly Rep. 2021; 70(24): 888-894. doi:10.15585/mmwr.mm7024e1
    OpenUrlCrossRefPubMed
  9. 9.↵
    1. Navickas R,
    2. Petric VK,
    3. Feigl AB,
    4. Seychell M.
    Multimorbidity: what do we know? What should we do? J Comorb. 2016; 6(1): 4-11. doi:10.15256/joc.2016.6.72
    OpenUrlCrossRef
  10. 10.
    1. McPhail SM.
    Multimorbidity in chronic disease: impact on health care resources and costs. Risk Manag Healthc Policy. 2016; 9: 143-156. doi:10.2147/RMHP.S97248
    OpenUrlCrossRefPubMed
  11. 11.↵
    1. Boersma P,
    2. Black LI,
    3. Ward BW.
    Prevalence of multiple chronic conditions among US adults, 2018. Prev Chronic Dis. 2020; 17(E106): E106. doi:10.5888/pcd17.200130
    OpenUrlCrossRefPubMed
  12. 12.↵
    1. US Department of Health and Human Services
    . Opioid crisis statistics. Published 2022. Accessed April 18, 2022. https://www.hhs.gov/opioids/about-the-epidemic/opioid-crisis-statistics/index.html
  13. 13.↵
    1. Centers for Disease Control and Prevention
    . Provisional drug overdose death counts. Published 2022. Accessed Apr 18, 2022. https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm
  14. 14.↵
    1. American Academy of Family Physicians
    . Recommended curriculum guidelines for family medicine residents: point-of-care ultrasound. Published 2021. Accessed Apr 18, 2022. https://www.aafp.org/dam/AAFP/documents/medical_education_residency/program_directors/Reprint290D_POCUS.pdf
  15. 15.↵
    1. National Institutes of Health
    . Genomics and medicine. Published 2020. Accessed Apr 18, 2022. https://www.genome.gov/health/Genomics-and-Medicine.
  16. 16.↵
    1. Centers for Disease Control and Prevention
    . Adult obesity facts. Published 2021. Accessed Apr 18, 2022. https://www.cdc.gov/obesity/data/adult.html
  17. 17.↵
    1. Curry SJ,
    2. Krist AH,
    3. Owens DK, et al; US Preventive Services Task Force
    . Behavioral weight loss interventions to prevent obesity-related morbidity and mortality in adults: US Preventive Services Task Force recommendation statement. JAMA. 2018; 320(11): 1163-1171. doi:10.1001/jama.2018.13022
    OpenUrlCrossRef
  18. 18.↵
    1. Accreditation Council for Graduate Medical Education
    . DRAFT ACGME program requirements for graduate medical education in family medicine 2021. Accessed Feb 5, 2022. https://www.acgme.org/globalassets/pfassets/reviewandcomment/rc/120_familymedicine-_2021-12_rc.pdf
PreviousNext
Back to top

In this issue

The Annals of Family Medicine: 20 (3)
The Annals of Family Medicine: 20 (3)
Vol. 20, Issue 3
1 May 2022
  • Table of Contents
  • Index by author
  • Plain Language Article Summaries
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on Annals of Family Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
BUILDING PRIORITIES IN HEALTH & HEALTH CARE INTO ABFM’S KNOWLEDGE ASSESSMENTS
(Your Name) has sent you a message from Annals of Family Medicine
(Your Name) thought you would like to see the Annals of Family Medicine web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
3 + 1 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Citation Tools
BUILDING PRIORITIES IN HEALTH & HEALTH CARE INTO ABFM’S KNOWLEDGE ASSESSMENTS
Warren P. Newton, Lara Handler, Michael Magill
The Annals of Family Medicine May 2022, 20 (3) 287-289; DOI: 10.1370/afm.2840

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Get Permissions
Share
BUILDING PRIORITIES IN HEALTH & HEALTH CARE INTO ABFM’S KNOWLEDGE ASSESSMENTS
Warren P. Newton, Lara Handler, Michael Magill
The Annals of Family Medicine May 2022, 20 (3) 287-289; DOI: 10.1370/afm.2840
Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • References
  • Figures & Data
  • eLetters
  • Info & Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Support for the WHO Resolution on Social Participation
  • Resident Leadership Roles and Selection
  • New Advocacy Ambassadors Program Helps AAFP Members Engage With Their Legislators
Show more Family Medicine Updates

Similar Articles

Content

  • Current Issue
  • Past Issues
  • Early Access
  • Plain-Language Summaries
  • Multimedia
  • Podcast
  • Articles by Type
  • Articles by Subject
  • Supplements
  • Calls for Papers

Info for

  • Authors
  • Reviewers
  • Job Seekers
  • Media

Engage

  • E-mail Alerts
  • e-Letters (Comments)
  • RSS
  • Journal Club
  • Submit a Manuscript
  • Subscribe
  • Family Medicine Careers

About

  • About Us
  • Editorial Board & Staff
  • Sponsoring Organizations
  • Copyrights & Permissions
  • Contact Us
  • eLetter/Comments Policy

© 2025 Annals of Family Medicine