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Key Facts: Título de Especialista em Medicina de Família e Comunidade Exam

Set by edital

SBMFC publishes the paper structure, cut score and fee in a numbered edital for each edition; no standing figures are published

Edital TEMFC — SBMFC

4 Hours

Exam Duration

SBMFC Examination Guidelines

Set by edital

SBMFC publishes the paper structure, cut score and fee in a numbered edital for each edition; no standing figures are published

Edital TEMFC — SBMFC

SBMFC / AMB

Credentialing Bodies

Sociedade Brasileira de Medicina de Família e Comunidade

4 Core Attributes

Starfield APS Framework

Primary Care: Balancing Health Needs, Services, and Technology

4 Components

MCCP Framework (Stewart)

Patient-Centered Medicine: Transforming the Clinical Method

P4 Prevention

Quaternary Prevention

WONCA International Dictionary of General/Family Practice

PNAB 2017

Primary Care Policy Basis

Portaria GM/MS nº 2.436/2017

The TEMFC is the 100-question, 4-hour medical specialist board examination by SBMFC/AMB certifying Family and Community Physicians in Brazil, evaluating Primary Care Attributes & PNAB (18%), Person-Centered Method (12%), Family Assessment & Territorialization (15%), Prevalent Clinical Management in APS (25%), Life Cycle Care (13%), Mental Health in APS (9%), and Quaternary Prevention & Clinic Management (8%). Note: This practice bank is an English-language study adaptation.

Sample Título de Especialista em Medicina de Família e Comunidade Practice Questions

Try these sample questions to test your Título de Especialista em Medicina de Família e Comunidade exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1According to Barbara Starfield's internationally recognized Primary Health Care (Atenção Primária à Saúde - APS) conceptual framework, which set correctly differentiates the four essential (core) attributes from the three derivative attributes of primary care?

A.Core: First Contact Access, Longitudinality, Comprehensiveness (Integralidade), and Coordination of Care; Derivative: Family Orientation, Community Orientation, and Cultural Competence.

B.Core: Universality, Equity, Decentralization, and Social Participation; Derivative: Longitudinality, First Contact Access, and Multi-professional Matrix Support.

C.Core: Family Orientation, Community Orientation, Cultural Competence, and Territorialization; Derivative: First Contact Access, Comprehensiveness, and Problem Resolution.

D.Core: First Contact Access, Hospital De-hospitalization, Specialization, and Teleconsultation; Derivative: Longitudinality, Family APGAR, and Quaternary Prevention.

Explanation: Barbara Starfield established that strong Primary Health Care is defined by four core (essential) structural attributes: First Contact Access (acesso de primeiro contato), Longitudinality (longitudinalidade), Comprehensiveness/Integrality (integralidade), and Coordination of Care (coordenação do cuidado). The three derivative attributes that enhance and contextualize these core functions are Family Orientation (orientação familiar), Community Orientation (orientação comunitária), and Cultural Competence (competência cultural).

2In Family and Community Medicine (Medicina de Família e Comunidade - MFC), how is the core primary care attribute of 'Longitudinality' (Longitudinalidade do Cuidado) technically defined?

A.The exclusive provision of clinical care for chronic long-term diseases lasting more than five consecutive years in a specialized ambulatory setting.

B.The duration of each individual medical consultation, which must exceed 30 minutes to ensure comprehensive clinical examination.

C.The existence of an enduring interpersonal therapeutic relationship between the patient and the healthcare clinician/team over time, independent of the presence or absence of specific diseases.

D.The continuous digital storage and archiving of electronic medical records in the national health database across the patient's entire lifespan.

Explanation: Longitudinality (longitudinalidade / vínculo longitudinal) refers to a personal therapeutic relationship between the patient and a designated primary care clinician or Family Health Team (eSF) established over time. It creates trust, improves diagnostic accuracy, reduces unnecessary specialist referrals and hospitalizations, and operates continuously across different episodes of illness and wellness regardless of specific organ pathology.

3A Primary Care Health Center (Unidade Básica de Saúde - UBS) expands its operating hours into the evening, implements walk-in reception for acute undifferentiated complaints, and eliminates administrative barriers to schedule appointments. Which primary care attribute is directly strengthened by these measures?

A.Cultural Competence (Competência Cultural).

B.First Contact Access (Acesso de Primeiro Contato).

C.Coordination of Care (Coordenação do Cuidado).

D.Secondary Prevention (Prevenção Secundária).

Explanation: First Contact Access (Acesso e Utilização de Primeiro Contato) implies that the Primary Care Health Center serves as the accessible, easily reachable entry gate and preferred first resource whenever a person experiences a new health need or problem. Expanding opening hours, minimizing administrative barriers, and offering flexible same-day walk-in reception directly enhance accessibility and utilization.

4The attribute of 'Comprehensiveness' or 'Integrality' (Integralidade) in Primary Health Care requires the Family Health Team (eSF) to:

A.Perform every complex surgical procedure and high-cost tertiary diagnostic test within the primary care facility.

B.Limit medical attention strictly to biological diseases defined by the International Classification of Diseases (CID-10 / CID-11).

C.Refer every patient presenting with multi-system symptoms immediately to corresponding medical subspecialists.

D.Recognize the full spectrum of biopsychosocial health needs, delivering promotive, preventive, curative, rehabilitative, and palliative care appropriate for primary care, and arranging necessary outside services when indicated.

Explanation: Comprehensiveness (Integralidade) means that the primary care service must be equipped to recognize and address the vast majority of physical, emotional, and social health needs presented by its community across all stages of health (promotion, disease prevention, cure, rehabilitation, and palliation). When a needed service cannot be delivered within primary care, the team takes responsibility for arranging access to secondary or tertiary care.

5A 68-year-old patient with multi-morbidity is discharged from a tertiary cardiology hospital after an acute myocardial infarction. The hospital sends a comprehensive discharge summary to the local Family Health Team (eSF), and the family physician conducts a medication reconciliation visit within 7 days. This clinical integration best exemplifies which primary care attribute?

A.Coordination of Care (Coordenação do Cuidado).

B.Primary Prevention (Prevenção Primária).

C.Tertiary Autonomy (Autonomia Terciária).

D.Community Orientation (Orientação Comunitária).

Explanation: Coordination of Care (Coordenação do Cuidado) is the ability of primary care to harmonize and integrate all the care a patient receives across various components of the Health Care Network (Rede de Atenção à Saúde - RAS). It relies on effective information exchange (discharge summaries, counter-referrals) and seamless care transitions between specialized hospital services and the primary care medical home.

6According to the National Primary Care Policy (Política Nacional de Atenção Básica - PNAB, Portaria GM/MS nº 2.436/2017), what is the mandatory minimum multidisciplinary composition of a standard Family Health Team (Equipe de Saúde da Família - eSF)?

A.1 Physician (preferentially specialist in MFC), 1 Nurse, 1 Social Worker, and 1 Psychologist.

B.1 Physician (preferentially specialist in MFC), 1 Nurse, 1 Nursing Technician or Assistant, and Community Health Agents (Agentes Comunitários de Saúde - ACS) / Endemic Disease Control Agents (ACE).

C.1 Physician, 1 Nurse, 1 Physical Therapist, and 1 Pharmacist.

D.1 Family Physician, 1 Pediatrician, 1 Obstetrician-Gynecologist, and 1 General Surgeon.

Explanation: Under the PNAB (Portaria GM/MS nº 2.436/2017), the minimum staffing requirement for a standard Equipe de Saúde da Família (eSF) consists of: 1 physician (general practitioner or preferably specialist in Family and Community Medicine), 1 registered nurse, 1 nursing technician or assistant, and Community Health Agents (ACS). Endemic Disease Control Agents (ACE) may also be integrated into the team.

7Under the Brazilian National Primary Care Policy (PNAB), what is the primary role and population guideline for Community Health Agents (Agentes Comunitários de Saúde - ACS)?

A.Prescribe basic antimicrobial medications and independently manage low-risk chronic hypertension in the community.

B.Perform invasive wound dressings, administer intramuscular injections, and collect venous blood samples in home visits.

C.Reside in the adscribed community, map micro-areas, register families, conduct regular proactive home visits, identify health vulnerabilities, and serve as the direct link between families and the health team, covering a maximum of 750 individuals per ACS.

D.Provide formal psychotherapy sessions and perform specialized psychiatric evaluations for patients with common mental disorders.

Explanation: Community Health Agents (ACS) are vital frontline members of the eSF who live in the community they serve. Their duties include territorial mapping of micro-areas, registering all residents, carrying out proactive routine home visits, detecting health risks, promoting health education, and connecting community members with clinic services, with PNAB recommending a maximum ratio of 750 persons per ACS.

8Regarding the population adscription (adscrição de clientela) and territorial coverage of an Equipe de Saúde da Família (eSF) under PNAB 2017, what is the officially recommended parameter for the number of registered persons per team?

A.Between 2,000 and 3,500 people, adjustable to lower numbers in contexts of extreme socio-environmental vulnerability.

B.Strictly 10,000 to 15,000 people regardless of geographic dispersal or social vulnerability.

C.Exactly 500 people per team, regardless of whether the area is urban or rural.

D.No predefined population limit, allowing each physician to register an unlimited number of patients on a first-come, first-served basis.

Explanation: PNAB 2017 establishes that each Family Health Team (eSF) should be responsible for an adscribed population of 2,000 to 3,500 people in a defined territory. This range ensures team accessibility, manageable clinical workload, effective longitudinality, and active health surveillance, with flexibility to reduce the adscribed population in areas of high social vulnerability or geographical isolation.

9Federal Law nº 8.142/1990 institutionalizes community participation and social control (Controle Social) in the Brazilian Unified Health System (SUS). What is the mandatory composition rule for Health Councils (Conselhos de Saúde) at the municipal, state, and federal levels?

A.100% composed of elected municipal health managers and hospital directors.

B.50% healthcare professionals, 30% government representatives, and 20% private insurance executives.

C.70% physicians and 30% patient advocacy groups.

D.50% civil society users (usuários), 25% health workers/professionals, and 25% health managers and service providers (parity representation).

Explanation: Under Lei Federal nº 8.142/1990 and Resolução CNS nº 453/2012, Health Councils (Conselhos de Saúde) are permanent deliberative collegiate bodies with parity representation (paridade): 50% of members must be representatives of health service users (civil society), 25% health professionals/workers, and 25% government representatives and public/private contracted healthcare providers.

10Which option correctly categorizes the doctrinal (ethical/political) principles of the Brazilian Unified Health System (SUS) as defined by Article 198 of the 1988 Constitution and Lei nº 8.080/1990?

A.Decentralization, Regionalization, and Hierarchization.

B.Universality (Universalidade), Integrality (Integralidade), and Equity (Equidade).

C.Private Enterprise Subsidiarity, Fee-for-Service Reimbursement, and Centralization.

D.Cost-Effectiveness, Market Competition, and Selective Primary Care.

Explanation: The three foundational doctrinal (ideological/philosophical) principles of SUS are Universality (health is a universal right of all citizens and a duty of the State), Integrality (holistic care covering prevention, cure, and rehabilitation at all levels), and Equity (treating unequal needs unequally to reduce health disparities). Decentralization, regionalization, and hierarchization are organizational/operational principles.

About the Título de Especialista em Medicina de Família e Comunidade Exam

The Título de Especialista em Medicina de Família e Comunidade (TEMFC) is the official medical specialist certification in Family and Community Medicine (FCM / MFC) in Brazil, awarded by the Sociedade Brasileira de Medicina de Família e Comunidade (SBMFC) under the governance of the Associação Médica Brasileira (AMB) and Conselho Federal de Medicina (CFM). This examination tests a candidate's mastery across all foundational domains of Primary Health Care (Atenção Primária à Saúde - APS) and the Family Health Strategy (Estratégia Saúde da Família - ESF) within the Brazilian Unified Health System (Sistema Único de Saúde - SUS). Key areas evaluated include Barbara Starfield's essential and derivative attributes of primary care (First Contact, Longitudinality, Comprehensiveness, Coordination, Family and Community Orientation, Cultural Competence), the Person-Centered Clinical Method (Stewart / MCCP), clinical tools for family assessment (Genogram, Ecomap, Family APGAR, F.I.R.O., P.R.A.C.T.I.C.E., life cycle stages according to Carter & McGoldrick), territorialization and community health diagnostics, clinical management of prevalent acute and chronic conditions in low-prevalence settings, care across the entire life cycle (infants, children, adolescents, women, men, older adults, palliative and home care), mental health in primary care with brief interventions, and quaternary prevention (P4) with deprescribing and harm reduction. Note: This practice bank is an English-language study adaptation retaining official Brazilian Portuguese technical terms inline.

Assessment

National certification examination run by the Sociedade Brasileira de Medicina de Família e Comunidade with the AMB, numbered by edition — the 37th ran in April 2026 and the 38th on 08/11/2026, the latter applied entirely online. Approval allows the candidate to request the RQE from their Conselho Regional de Medicina. The SBMFC also operates a separate recertification cycle; this entry is scoped to first certification, and candidates should confirm which route the current edital covers.

Time Limit

Set by each edition's edital

Passing Score

Set by each edition's edital

Exam Fee

R$ 500,00 – R$ 1.700,00 depending on candidate category (Sociedade Brasileira de Medicina de Família e Comunidade (SBMFC) — Associação Médica Brasileira (AMB))

Título de Especialista em Medicina de Família e Comunidade Exam Content Outline

18%

Princípios da Atenção Primária à Saúde e PNAB

Starfield's core attributes (First Contact Access, Longitudinality, Comprehensiveness, Coordination) and derivative attributes (Family Orientation, Community Orientation, Cultural Competence), National Primary Care Policy (PNAB), SUS principles (Universality, Integrality, Equity, Decentralization, Social Control), and clinical epidemiology/reasoning in low-prevalence primary care settings.

12%

Método Clínico Centrado na Pessoa (MCCP)

Stewart's 4 components of the Person-Centered Clinical Method: exploring disease and illness experience (SIFE / FIFE dimensions), understanding the whole person and context, finding common ground, enhancing doctor-patient relationship, active listening, and communication strategies (e.g., SPIKES protocol).

15%

Abordagem Familiar, Ferramentas de Avaliação e Territorialização

Family assessment tools (Genogram, Ecomap, Family APGAR, F.I.R.O., P.R.A.C.T.I.C.E.), Carter & McGoldrick family life cycle stages and crises, territorialization, social cartography, micro-areas, community health diagnosis, and home visit criteria.

25%

Manejo Clínico de Condições Prevalentes na APS

Clinical management of acute undifferentiated complaints and prevalent chronic diseases: Systemic Arterial Hypertension, Type 2 Diabetes Mellitus, Dyslipidemia, Low Back Pain, Osteoarthritis, Asthma, COPD, Acute Respiratory Infections, Dyspepsia, GERD, Dengue, Hanseníase (Leprosy), Tuberculosis, Syphilis, and HIV/PrEP in primary care.

13%

Cuidado nos Ciclos de Vida (Criança, Adolescente, Mulher, Homem, Idoso)

Health supervision across life stages: child growth and development, PNI immunization, adolescent confidentiality and ECA, low-risk prenatal care, cervical/breast cancer screening, contraception eligibility, men's health, multidimensional geriatric assessment (IVCF-20, ADLs), and falls prevention.

Saúde Mental na Atenção Primária e Apoio Matricial

Assessment and management of Common Mental Disorders (depression, anxiety, somatization), alcohol and substance use disorders (AUDIT, brief interventions), suicide risk assessment and safety planning, Matrix Support (Apoio Matricial), collaborative care, and Singular Therapeutic Projects (PTS).

Prevenção Quaternária, Desprescrição e Gestão da Clínica

Quaternary prevention (P4 / Jamoulle), overdiagnosis and overtreatment mitigation, structured deprescribing (Beers, STOPP/START criteria), Advanced Access scheduling (Acesso Avançado), SOAP problem-oriented medical record (RMP/Weed), and care coordination.

How to Pass the Título de Especialista em Medicina de Família e Comunidade Exam

What You Need to Know

Passing score: Set by each edition's edital
Assessment: National certification examination run by the Sociedade Brasileira de Medicina de Família e Comunidade with the AMB, numbered by edition — the 37th ran in April 2026 and the 38th on 08/11/2026, the latter applied entirely online. Approval allows the candidate to request the RQE from their Conselho Regional de Medicina. The SBMFC also operates a separate recertification cycle; this entry is scoped to first certification, and candidates should confirm which route the current edital covers.
Time limit: Set by each edition's edital
Exam fee: R$ 500,00 – R$ 1.700,00 depending on candidate category

Keys to Passing

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Título de Especialista em Medicina de Família e Comunidade Study Tips from Top Performers

1Master Starfield's Attributes: Differentiate clearly between First Contact (accessibility/use), Longitudinality (interpersonal therapeutic bond over time), Comprehensiveness (holistic biopsychosocial care), and Coordination (managing transitions and information across the health network).

2Memorize the SIFE/FIFE Dimensions: In any clinical vignette featuring the Person-Centered Clinical Method (MCCP), map patient statements directly to Feelings (fear/anxiety), Ideas (patient's explanatory model), Functioning (impact on daily activities/work), and Expectations (what the patient hopes the doctor will do).

3Practice Family Assessment Instruments: Know standard Genogram symbols (squares for males, circles for females, double borders for index patient/proband, diagonal slashes for deceased, zigzag for conflict, triple lines for overinvolved), Ecomap energy flows, Family APGAR score ranges (7-10 functional, 4-6 moderate dysfunction, 0-3 severe dysfunction), and F.I.R.O. (Inclusion, Control, Intimacy).

4Focus on High-Yield Brazilian APS Guidelines: Review official guidelines from MS/SBMFC/SBC/SBD for Hypertension (target BP <130/80 mmHg in high risk, combination therapy), Diabetes (HbA1c targets, SGLT2i/GLP-1 RA for CVD/CKD), Low Back Pain (avoiding early X-rays/MRIs without red flags), and Neglected Tropical Diseases (Dengue staging A/B/C/D, Hanseniasis sensitivity testing and PQT-U, TB active search).

5Internalize Quaternary Prevention & Deprescribing: Look for clinical scenarios involving polypharmacy, cascades of unnecessary tests (overdiagnosis/incidentalomas), routine PSA/thyroid screening in asymptomatic patients, or long-term inappropriate benzodiazepine/PPI use.

Frequently Asked Questions

What is the TEMFC examination?

The TEMFC (Título de Especialista em Medicina de Família e Comunidade) is the national medical specialty board examination administered by the Sociedade Brasileira de Medicina de Família e Comunidade (SBMFC) and Associação Médica Brasileira (AMB) to grant official specialist certification in Family and Community Medicine in Brazil.

What is the language and format of this practice bank?

This practice bank is an English-language multiple-choice question study adaptation designed to thoroughly test the full technical syllabus of the TEMFC examination while keeping official Brazilian Portuguese health terms inline (e.g., PNAB, SUS, ESF, MCCP, SIFE, Genograma, Ecomapa).

What are the prerequisites to take the TEMFC exam?

Candidates must be physicians with an active CRM registration in Brazil who have completed either an accredited 2-year Medical Residency in Family and Community Medicine (PRMFC) or have documented at least 4 years of proven professional clinical experience working in Primary Healthcare (APS / ESF) as detailed in the official SBMFC edital.

What are Barbara Starfield's 4 core attributes of Primary Health Care?

The four core attributes defined by Barbara Starfield are: 1) First Contact Access (acessibilidade e utilização como porta de entrada), 2) Longitudinality (vínculo interpessoal e continuidade ao longo do tempo), 3) Comprehensiveness / Integrality (integralidade dos serviços para todas as necessidades biopsicossociais), and 4) Coordination of Care (coordenação e integração do cuidado entre diferentes níveis de atenção).

What is the Person-Centered Clinical Method (MCCP)?

Developed by Moira Stewart and colleagues, the MCCP (Método Clínico Centrado na Pessoa) is a consultative framework comprising 4 components: 1) Exploring health, disease, and the illness experience (SIFE: Sentimentos, Ideias, Funcionamento, Expectativas), 2) Understanding the whole person (individual, family, and developmental context), 3) Finding common ground on problem definitions and goals, and 4) Enhancing the doctor-patient relationship.

What is Quaternary Prevention (P4)?

Quaternary Prevention (Prevenção Quaternária - P4), defined by Marc Jamoulle and adopted by WONCA and SBMFC, is the set of actions taken to identify patients at risk of overmedicalization, to protect them from new medical invasions, and to suggest interventions that are ethically acceptable.