Validating the Test Plan Specifications for the American Board of Family Medicine's Certification Examination

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Figure 1.
Stability of content category proportions (from least to most) across weighting schemas.
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Figure 2.
Comparison of the FMCE content proportions with the proportions suggested by other weighting schemas. FMCE, Family Medicine Certification Examination.

Table 1.

2006 to 2019 Family Medicine Certification Examinations Content Proportions

A. Organ systems	90%
1. Respiratory	13%
2. Cardiovascular	12%
3. Musculoskeletal	12%
4. Gastrointestinal	7%
5. Special sensory (visual, hearing, etc.)	2%
6. Endocrine	8%
7. Skin	6%
8. Nervous system (brain, spinal cord, peripheral nervous system)	3%
9. Psychogenic (psychological, behavioral, mental health)	7%
10. Reproductive (male)	1%
11. Reproductive (female)	4%
12. Renal/urinary tract	3%
13. Blood/immune system	3%
14. Nonspecific	9%
B. Population-based care and health systems	5%
1. Health policy
2. Bioterrorism
3. Legal
4. Epidemiology
5. Biostatistics
6. Evidence-based medicine
7. Quality improvement
8. Informatics
C. Patient-based care and systems	5%
1. Physician-patient interactions
2. Communication
3. End of life care
4. Palliative care
5. Family issues
6. Cultural issues
7. Clinical decision making
8. Evidence-based medicine
9. Ethics

Table 2.

Content Specifications by Category and Associated Weights

Body System	Current Core	Frequency Only	3F + C	2F + C	F + C	F + 2C	F + 3C	Criticality Only	Mean	SD	Min	Max
Cardiovascular	12	17.6	15.3	14.6	13.0	11.5	10.8	8.5	13.0	1.93	8.5	17.6
Endocrine	8	6.9	6.2	6.0	5.5	5.1	4.9	4.2	5.5	0.56	4.2	6.9
Gastrointestinal	7	5.9	6.8	7.1	7.7	8.3	8.6	9.4	7.7	0.76	5.9	9.4
Hematologic/Immune	3	1.3	1.9	2.1	2.5	2.9	3.1	3.7	2.5	0.51	1.3	3.7
Integumentary	6	5.2	6.2	6.5	7.1	7.8	8.1	9.0	7.1	0.81	5.2	9.0
Musculoskeletal	12	14.6	14.9	14.9	15.1	15.3	15.4	15.6	15.1	0.23	14.6	15.6
Nephrologic	3	2.7	3.3	3.5	3.9	4.2	4.4	5.0	3.9	0.46	2.7	5.0
Neurologic	3	4.5	5.6	6.0	6.7	7.4	7.8	8.9	6.7	0.92	4.5	8.9
Nonspecific	9	7.2	6.9	6.8	6.6	6.4	6.3	6.0	6.6	0.25	6.0	7.2
Psychogenic	7	8.3	7.9	7.8	7.6	7.4	7.3	6.9	7.6	0.25	6.9	8.3
Reproductive-Female	4	3.2	4.1	4.3	4.9	5.4	5.7	6.5	4.9	0.69	3.2	6.5
Reproductive-Male	1	1.1	1.4	1.4	1.6	1.7	1.8	2.1	1.6	0.18	1.1	2.1
Respiratory	13	12.5	11.0	10.5	9.6	8.6	8.1	6.7	9.6	1.23	6.7	12.5
Special Sensory	2	4.1	4.6	4.8	5.2	5.6	5.8	6.4	5.2	0.51	4.1	6.4
Patient-based Systems	5	4.1	3.2	2.9	2.3	1.6	1.3	0.4	2.3	0.81	0.4	4.1
Population-based Care	5	0.7	0.7	0.7	0.7	0.7	0.7	0.7	0.7	0.00	0.7	0.7
TOTAL	100	99.9	100	99.9	100	99.9	100.1	100	–	–	–	–

Table 3.

Correlation of the Family Medicine Certification Examination Content Category Proportions with Proportions Suggested Using Other Weighting Schemas

Note: The correlation between the frequency condition and the criticality condition is 0.65, suggesting that they are somewhat similar but not identical.