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Free Practice Questions for ABFM Family Medicine

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Exam Review

Key Facts: ABFM Family Medicine Exam

300

One-Day Exam Questions

ABFM 2026 examination booklet

4 × 95 min

Testing Sections

ABFM 2026 examination booklet

35%

Acute Care and Diagnosis

ABFM 2026 blueprint

$1,300

Standard Initial Exam Fee

ABFM 2026 examination booklet

97.9% (2024)

First-Time Initial Pass Rate

ABFM 2024 pass sheet; 4,560 examinees

Continuing certification

FMCLA Eligibility Context

ABFM 5-Year Cycle

The ABFM one-day examination contains 300 multiple-choice questions in four 95-minute sections, with 100 minutes of pooled breaks. Initial candidates use this one-day route; eligible Diplomates maintaining certification may choose FMCLA. The 2026 blueprint is Acute Care and Diagnosis 35%, Chronic Care Management 25%, Emergent and Urgent Care 20%, Preventive Care 15%, and Foundations of Care 5%. The standard initial examination fee is $1,300, with a $100 late fee when applicable; initial re-examination is $650 under the 2026 booklet. ABFM uses a criterion-referenced passing standard and does not publish a current numeric minimum in that booklet.

Sample ABFM Family Medicine Practice Questions

Try these sample questions to review concepts for the ABFM Family Medicine exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 173+ question experience with AI tutoring.

1According to the 2024 USPSTF update, at what age should average-risk women begin biennial screening mammography?
A.Age 40
B.Age 45
C.Age 50
D.Age 55
Explanation: In April 2024, USPSTF updated its breast cancer screening recommendation (Grade B) to begin biennial mammography at age 40 and continue through age 74. The change was driven by rising breast cancer incidence in women in their 40s, particularly among Black women, and modeling that showed net benefit begins a decade earlier than the previous age-50 threshold.
2A 52-year-old asymptomatic man with no family history of colorectal cancer asks about colorectal cancer screening options. According to USPSTF 2021 guidance (reaffirmed), which screening approach is appropriate?
A.Begin screening at age 50 with colonoscopy every 10 years
B.Begin screening at age 45 with colonoscopy every 10 years or annual FIT
C.Screening is not indicated until age 55
D.Offer CT colonography only
Explanation: USPSTF Grade B recommendation (2021) lowered the colorectal cancer screening start age to 45 for average-risk adults and continues through age 75. Acceptable modalities include colonoscopy every 10 years, annual FIT, FIT-DNA every 1–3 years, flexible sigmoidoscopy every 5 years, or CT colonography every 5 years. Screening from 76–85 is individualized (Grade C).
3A 58-year-old man with a 25 pack-year smoking history (quit 10 years ago) asks about lung cancer screening. Per USPSTF 2021 criteria, what is the correct recommendation?
A.He does not meet criteria because he quit more than 10 years ago
B.Offer annual low-dose CT — he meets criteria
C.Screen with chest x-ray annually
D.Screen only if he resumes smoking
Explanation: USPSTF 2021 criteria (Grade B) for annual low-dose CT lung cancer screening: age 50–80, ≥20 pack-year smoking history, and currently smoking OR quit within the past 15 years. This patient is 58, has 25 pack-years, and quit 10 years ago — he meets all three criteria.
4A 68-year-old man, never-smoker, asks about abdominal aortic aneurysm screening. What is the USPSTF recommendation?
A.Offer one-time ultrasound screening routinely (Grade B) for all men 65–75
B.Selectively offer one-time ultrasound (Grade C) — not routine for all never-smokers
C.Screen every 5 years with ultrasound
D.Recommend against screening (Grade D) because he has never smoked
Explanation: USPSTF recommends one-time AAA ultrasound (Grade B) for men 65–75 who have ever smoked. For men 65–75 who have never smoked, the recommendation is Grade C (selectively offer based on risk factors such as family history of AAA, other vascular disease). Grade D (recommend against) applies to women who have never smoked — not to never-smoker men. Screening is a one-time ultrasound, not serial.
5Per the 2022 USPSTF statin primary-prevention recommendation, which patient should be offered a statin?
A.A 45-year-old man, 10-year ASCVD risk 12%, with hypertension
B.A 38-year-old woman, 10-year ASCVD risk 15%, with diabetes
C.A 78-year-old man with no prior CV disease
D.A 50-year-old man, 10-year ASCVD risk 8%, no other risk factors
Explanation: USPSTF 2022 (Grade B): prescribe a statin for adults age 40–75 with ≥1 CVD risk factor (dyslipidemia, diabetes, hypertension, or smoking) AND a 10-year ASCVD risk ≥10%. This patient meets both criteria. Grade C (selective) applies to those 40–75 with risk 7.5–10%. Grade I for age ≥76.
6At what age does USPSTF now recommend starting screening for prediabetes and type 2 diabetes in asymptomatic adults with overweight or obesity (2021)?
A.Age 30
B.Age 35
C.Age 40
D.Age 45
Explanation: The 2021 USPSTF update (Grade B) lowered the starting age for diabetes/prediabetes screening from 40 to 35 years in adults with overweight or obesity (BMI ≥25, or ≥23 in Asian Americans). Screening should continue every 3 years if normal.
7A 55-year-old healthy woman asks about cervical cancer screening. According to USPSTF (2018, reaffirmed), which strategy is recommended for women age 30–65?
A.Pap alone every 3 years, OR hrHPV every 5 years, OR co-testing every 5 years
B.Annual Pap smear
C.hrHPV every 10 years
D.No screening needed after age 50
Explanation: USPSTF recommends three equally acceptable strategies for average-risk women 30–65 (Grade A): (1) cytology alone every 3 years, (2) primary hrHPV testing every 5 years, or (3) co-testing (cytology + hrHPV) every 5 years. Screening can be discontinued at 65 if adequate prior negative screens.
8A 62-year-old man with no prior vaccinations presents to establish care. Per ACIP 2024 adult immunization schedule, which of the following is recommended?
A.Defer Shingrix until age 65; give pneumococcal vaccine now
B.Shingrix two-dose series now; pneumococcal only if he has risk factors (otherwise at ≥65)
C.Zostavax single dose; annual influenza
D.No vaccines indicated until age 65
Explanation: ACIP recommends Shingrix (RZV) two-dose series for all adults ≥50. Pneumococcal vaccination (PCV20 or PCV15 followed by PPSV23) is recommended at ≥65 OR at ages 19–64 with specified risk conditions (smoking, chronic heart/lung/liver disease, DM, immunocompromise, CSF leak, cochlear implant). Without risk factors at 62, defer pneumococcal until 65. Also address annual influenza, Tdap if due, and COVID-19 per schedule.
9A 67-year-old woman has never received a pneumococcal vaccine. Which ACIP-recommended regimen is correct?
A.A single dose of PPSV23 only
B.A single dose of PCV20, OR PCV15 followed by PPSV23 ≥1 year later
C.Two doses of PCV13 six months apart
D.PPSV23 every 5 years for life
Explanation: ACIP 2022 simplified pneumococcal adult recommendations: for those ≥65 who never received a pneumococcal vaccine, give either a single dose of PCV20 OR PCV15 followed by PPSV23 ≥1 year later (can be 8 weeks for immunocompromised). PCV13 is no longer preferred for adult primary series in this pathway.
10A pregnant woman at 30 weeks' gestation asks about vaccines. Per ACIP, which vaccine is recommended at THIS visit?
A.Tdap
B.MMR
C.HPV
D.Live-attenuated influenza (LAIV)
Explanation: ACIP recommends Tdap during EACH pregnancy between 27 and 36 weeks' gestation (preferably earlier in that window) to maximize passive transfer of pertussis antibodies and protect the newborn. MMR and LAIV are live vaccines contraindicated in pregnancy. HPV is deferred until after delivery. Inactivated influenza (IIV) is recommended any trimester during flu season.

About the ABFM Family Medicine Exam

The ABFM Family Medicine Certification Examination is the one-day board examination required for initial certification through the traditional pathway. It also remains an option for eligible physicians continuing certification. FMCLA is a separate longitudinal assessment for eligible Diplomates maintaining certification, not an initial-certification alternative.

Exam sponsor: American Board of Family Medicine (ABFM) / Prometric. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Questions

300 questions

Time Limit

Four 95-minute sections (≈6.3 hours testing + 100 min pooled break)

Passing Score

Criterion-referenced scaled score set annually by ABFM

Exam / Certification Fees

$1,300 initial certification examination fee; $100 late fee when applicable

Exam sponsor website

Reported exam pass rate: 97.9% (2024). First-time initial-certification cohort: 4,560 examinees; historical ABFM data, not a current guarantee This describes exam candidates, not OpenExamPrep users or results from using our resources. Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

35%

Acute Care and Diagnosis

Assessment and treatment of new symptoms and acute conditions across the lifespan

25%

Chronic Care Management

Longitudinal management, follow-up and coordination for chronic disease

20%

Emergent and Urgent Care

Recognition, stabilization and disposition of urgent and emergent problems

15%

Preventive Care

Screening, prevention, immunization and risk counseling

5%

Foundations of Care

Evidence interpretation, communication, professionalism, safety and systems of care

Preparing for the ABFM Family Medicine Exam

What You Need to Know

  • Passing score: Criterion-referenced scaled score set annually by ABFM
  • Exam length: 300 questions
  • Time limit: Four 95-minute sections (≈6.3 hours testing + 100 min pooled break)
  • Exam / certification fees: $1,300 initial certification examination fee; $100 late fee when applicable Official sources

Using Our Practice Resources

  • Work through all 173 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

ABFM Family Medicine: Suggested Study Strategy

1Prioritize preventive medicine and USPSTF grade A/B recommendations: breast mammography 40-74 biennial (2024 update), CRC 45-75, LDCT lung 50-80 with ≥20 pack-years, AAA 65-75 in male smokers, and statin therapy ≥10% 10-year ASCVD risk — these appear repeatedly across exam sections
2Memorize ACIP adult immunization numerics: Shingrix ≥50 (two doses 2-6 months apart), PCV15+PPSV23 or PCV20 ≥65, RSV shared decision ≥60, Tdap each pregnancy, influenza annual — these are high-yield and often tested with distractors
3Master the ADA 2024 algorithm: metformin first-line, then SGLT2 inhibitor or GLP-1 RA for ASCVD/HF/CKD regardless of A1c; add tirzepatide or semaglutide for obesity; individualize A1c targets (<7% typical, <8% in older/comorbid)
4For ACC/AHA 2017 hypertension questions, recall stage 1 (130-139/80-89) vs stage 2 (≥140/90), thiazide/ACEi/ARB/CCB first-line choices by race and comorbidity, and always add ACEi/ARB + SGLT2 in CKD
5Practice timed 75-question blocks at 75 seconds per question to match ABFM section pacing; use FMCLA-style open-book reference look-ups sparingly to build both recall and reasoning

Frequently Asked Questions

What is the ABFM Family Medicine certification exam?

The ABFM Family Medicine Certification Examination is the one-day board examination required for initial certification through the traditional pathway. It also remains an option for eligible physicians continuing certification. FMCLA is a separate longitudinal assessment for eligible Diplomates maintaining certification, not an initial-certification alternative.

What is FMCLA and how does it differ from the one-day exam?

FMCLA is a continuing-certification option for eligible ABFM Diplomates. It delivers 25 questions per quarter, totaling 300 over three to four years, with five minutes per question and permitted reference use. Initial-certification candidates take the one-day examination; FMCLA does not replace that initial examination.

How many questions are on the ABFM one-day exam?

The one-day examination contains 300 questions in four sections of 75. Each section lasts 95 minutes: 380 minutes of testing plus 100 minutes of pooled breaks.

How much does ABFM initial certification cost?

The 2026 booklet lists a $1,300 initial examination fee, a $100 late fee when applicable, and a $650 initial-certification re-examination fee. Check the relevant spring or fall application deadline; optional commercial preparation is not part of our free resources.

What are the eligibility requirements for the ABFM exam?

Candidates must hold an MD from an LCME-accredited U.S. or Canadian medical school, a DO from an AOA-accredited osteopathic college, or be an international medical graduate with a valid ECFMG certificate. They must complete 36 calendar months (12 months per training year) in an ACGME-accredited family medicine residency, with the last 2 years in the same accredited program. An AOA training pathway and international reciprocity (Canada, Australia, UK, New Zealand) are also available.

What is the ABFM exam passing score and pass rate?

ABFM uses a criterion-referenced standard and does not publish a current numeric minimum in the 2026 booklet. Its 2024 pass sheet reports a 97.9% pass rate for 4,560 first-time initial examinees. That dated cohort statistic does not predict an individual result or the 2026 pass rate.

What content is covered on the ABFM exam?

The current blueprint weights Acute Care and Diagnosis 35%, Chronic Care Management 25%, Emergent and Urgent Care 20%, Preventive Care 15%, and Foundations of Care 5%. Organ systems, age groups and care settings cut across those domains.

How do I maintain ABFM certification after passing?

ABFM began a rolling transition to the 5-Year Cycle in 2025. Diplomates enter when their next examination requirement is due, potentially as late as 2032, and must finish existing stage requirements before transition. The new cycle requires 200 approved CME credits (at least 50% Division I), 60 certification points with self-assessment and performance improvement, and the examination, licensure and other continuing requirements.