Certification Examination in Family Medicine (CCFP)

Introduction Overview of the College of Family Physicians of Canada (CFPC) certification examination in family medicine Overview of the College of Family Physicians of Canada (CFPC) certification examination in family medicine Exam compositionExam composition PreparationPreparation Tips for written componentTips for written component Organization of oral componentOrganization of oral component

Certification Examination in Family Medicine Eligible to sit the exam in the last six months of your residency Eligible to sit the exam in the last six months of your residency 2 day examination 2 day examination Written and oral components Written and oral components Many sites across the country Many sites across the country Spring & Fall sittings Spring & Fall sittings Successful completion of the examination earns a Certification in Family Practice in Canada (CCFP) Successful completion of the examination earns a Certification in Family Practice in Canada (CCFP) This is a Family Medicine exam!!! This is a Family Medicine exam!!!

Written Component (SAMPs) 40 – 45 Short Answer Management Problems (SAMPs) 40 – 45 Short Answer Management Problems (SAMPs) Conducted on the first day Conducted on the first day Approximately six hours divided between morning and afternoon Approximately six hours divided between morning and afternoon

SAMPs “…intended to measure a candidate’s problem solving skills and knowledge in the context of a clinical situation.” “…intended to measure a candidate’s problem solving skills and knowledge in the context of a clinical situation.” Guide to the Certification Examination in Family Medicine

Preparation Tips! Study common family medicine topics Study common family medicine topics Circulating old exam questions are great for topics but don’t rely on these for exact content Circulating old exam questions are great for topics but don’t rely on these for exact content Don’t focus on any guidelines published after December since exam is prepared before January Don’t focus on any guidelines published after December since exam is prepared before January Review topics in relevant journals from Aug to Aug of the year prior to the one in which you are writing Review topics in relevant journals from Aug to Aug of the year prior to the one in which you are writing

Tips cont… Write legibly!!!! You will be scored only on what can be read. Write legibly!!!! You will be scored only on what can be read. Exams are scored by physicians Exams are scored by physicians Answers are pre-defined on an answer key. Answers are pre-defined on an answer key. No opportunities for interpretation No opportunities for interpretation

Tips cont… For each case, the setting in which you are practicing is described. Base answers on this. For each case, the setting in which you are practicing is described. Base answers on this. Most questions can be answered in 10 words or fewer. Most questions can be answered in 10 words or fewer. You are scored only on the number of answers required. You are scored only on the number of answers required. If they ask for three and you put down five, only the first three will be considered. If they ask for three and you put down five, only the first three will be considered.

Tips cont… One answer per line One answer per line Answers must be listed vertically Answers must be listed vertically If put list on one line, only first answer will be considered If put list on one line, only first answer will be considered

Tips cont… Usually the question asks for the best available so don’t answer based on what’s available in your area but on GOLD standards. Usually the question asks for the best available so don’t answer based on what’s available in your area but on GOLD standards. Watch if the question asks for drug class or name of the drug. Watch if the question asks for drug class or name of the drug. Generic names are preferred. Use Trade name CAUTIOUSLY! Generic names are preferred. Use Trade name CAUTIOUSLY!

Tips cont… Be specific on treatment (e.g. give route of administration of medications and fluids) Be specific on treatment (e.g. give route of administration of medications and fluids) Be specific on investigations (e.g. must specify abdominal ultrasound not just ultrasound) Be specific on investigations (e.g. must specify abdominal ultrasound not just ultrasound)

Tips cont… Read the questions carefully Read the questions carefully Be specific on laboratory investigations (e.g. CBC and lytes not acceptable since is a series of tests, must specify the desired parameter such as hemoglobin, white blood cell count, potassium) Be specific on laboratory investigations (e.g. CBC and lytes not acceptable since is a series of tests, must specify the desired parameter such as hemoglobin, white blood cell count, potassium)

Summary Take your time Take your time Read questions carefully Read questions carefully Be specific Be specific Avoid trade names Avoid trade names No abbreviations No abbreviations Relax!! This is material you know Relax!! This is material you know

SOOs

The Simulated Office Oral Designed to simulate a clinical encounter to test your ability to apply the patient centered clinical method Designed to simulate a clinical encounter to test your ability to apply the patient centered clinical method Examiners assume the role of Patient Examiners assume the role of Patient Five SOOs each 15 minutes Five SOOs each 15 minutes Each encounter usually deals with two patient issues (Problem A and Problem B) Each encounter usually deals with two patient issues (Problem A and Problem B) Consider:Consider: Medical condition with a psychosocial issue Medical condition with a psychosocial issue Multiple medical conditions in a cultural/psychosocial context Multiple medical conditions in a cultural/psychosocial context

Time Line Problem A is the presenting complaint Problem A is the presenting complaint Problem B is not initially apparent Problem B is not initially apparent if problem B not addressed by 5 minutes, then a prompt will be givenif problem B not addressed by 5 minutes, then a prompt will be given if problem B not addressed by 8 mins patient will blurt it outif problem B not addressed by 8 mins patient will blurt it out At 12 minutes you will be told to provide your action plan At 12 minutes you will be told to provide your action plan

Approach to problems Consider each problem by taking an appropriate Hx to include: Consider each problem by taking an appropriate Hx to include: an assessment of current statusan assessment of current status past treatmentspast treatments past investigationspast investigations risk factor analysisrisk factor analysis Then assess how this illness has affected the patient’s life by asking about Feelings, Ideas, Functions and Expectations (FIFE) Then assess how this illness has affected the patient’s life by asking about Feelings, Ideas, Functions and Expectations (FIFE)

Integration of the Problems Demonstrate insight into the patient’s condition by putting both conditions into context Demonstrate insight into the patient’s condition by putting both conditions into context restate what the patient has told yourestate what the patient has told you discuss it with regard to the individual’s family and community supportsdiscuss it with regard to the individual’s family and community supports

Management of the Problems Involve your patient!! Involve your patient!! Find common groundFind common ground Develop a shared action planDevelop a shared action plan Provide assurance Provide assurance Make arrangements for a physical examination Make arrangements for a physical examination Request old charts Request old charts Order investigations Order investigations Provide for follow up Provide for follow up

Assessment of Communication This is scored on the overall feel of the clinical interview This is scored on the overall feel of the clinical interview The candidate is assessed on: The candidate is assessed on: Para-verbal communicationPara-verbal communication Ability to put the patient at easeAbility to put the patient at ease Empathy and nonjudgmental demeanorEmpathy and nonjudgmental demeanor Avoidance of medical jargonAvoidance of medical jargon

Summary Each SOO has two problems Each SOO has two problems Once the problems are identified they need to be put in context of the patient’s life and supports Once the problems are identified they need to be put in context of the patient’s life and supports Management has to be mutually agreeable Management has to be mutually agreeable Communication skills are important Communication skills are important

Passing the Exam You are assessed on your overall score for each section of the examination You are assessed on your overall score for each section of the examination Consequently, a poor performance on one question may be negated by a good performance on others Consequently, a poor performance on one question may be negated by a good performance on others

Good Luck!! More information available:

Acknowledgements Dr. John Campbell (?CCFP), Past President, Section of Residents Dr. John Campbell (?CCFP), Past President, Section of Residents Communication Committee, Section of Residents Communication Committee, Section of Residents