A Closer Look at Recertification Candidate Pass Rates

Certification Extension Policy Change

In January 2006, the American Board of Family Medicine announced an enhancement to the MC-FP process that went into effect in January 2007. The most important enhancement to the process was the opportunity to extend one's certification by 3 years, resulting in a 10-year certification period. Many physicians who would previously have taken the examination during their seventh year successfully met the new MC-FP requirements and did not sit for the MC-FP examination as a result of earning the 3-year extension of their certificate. This option resulted in a much smaller volume of MC-FP (recertification) candidates testing during the 3-year window from 2010 to 2012.

Recent Pass/Fail Statistics for Initial Certifiers and Recertifiers

Examination pass rate statistics are available on the American Board of Family Medicine website.¹ We would like to draw attention to the summer statistics for the years 2008 through 2012. In 2008 and 2009, pass rates for initial certifiers were 82.9% and 86.7% and for recertification candidates were 86.8% and 85.7%, respectively. Readers will notice that, in 2010, 2011, and 2012, initial certification pass rates remain quite comparable: 84.0%, 84.2%, and 83.2%, respectively. However, it is with the recertification candidates that the pass rate statistics become misleading. In 2010, recertification candidates passed at a rate of 67.0%, with pass rates of 66.3% and 73.9% in 2011 and 2012, respectively. These values are considerably below recent historical trends. However, when one notes the volume of candidates sitting for the examination during these years, the rest of the story begins to unfold.

The volume of candidates for initial certification has remained quite stable since 2008, with as few as 2236 and as many as 2804 examinees. The volume of recertification candidates, on the other hand, experienced a steep decline. In 2008 and 2009, the volume of recertification candidates ranged between 8356 and 8453. In 2010, this volume dipped to only 1397 examinees, thus resulting in 6959 fewer recertifiers than the previous year. The trend continued in 2011 and 2012: only 1209 and 1395 recertification candidates, respectively, sat for the examination. The certification extension reduced the volume of candidates testing during the transition period. Many candidates who did test during this period were repeating the examination because of a previous failure. A larger proportion of previously unsuccessful candidates combined with an overall smaller number of candidates testing created a dramatically lower passing rate percentage statistic.

Table 1 provides a breakdown of pass rates and mean scaled scores for both initial certifiers and recertifiers based on whether it was examinees' first attempt or a repeat attempt at the MC-FP examination. Results indicate that candidates who successfully pass their first attempt tend to continue to perform well. Candidates repeating the examination because of a previous failure tend to perform less well on subsequent examinations. Significantly fewer recertification candidates sat for the examination during the transition period in which most diplomates earned 3-year extensions on their certificates. A significant proportion of these candidates were attempting because of previous failures. Therefore, pass rate percentage statistics reported during this transition period are not truly comparable to previously reported statistics. In particular, recertification candidates testing during the 3-year extension period are not representative of recertification candidates in normal, high-volume years.