100+ Free CMSA FC Fam Med(SA) Part II Practice Questions

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2026 Statistics

Key Facts: CMSA FC Fam Med(SA) Part II Exam

100 Qs

Practice MCQs

OpenExamPrep Practice Bank

50%

Passing Mark

CMSA Part II Regulations

R21 500

Exam Fee

CMSA Fee Structure 2026

CMSA

Examining Body

College of Family Physicians of SA

verified

Metadata Status

CMSA Syllabus 2026

The FC Fam Med(SA) Part II validates specialist family physician competence in South Africa, covering district hospital clinical decision-making, clinical governance audit cycles, COPC team leadership, complex bio-psycho-social consultation skills, and South African medico-legal frameworks.

Sample CMSA FC Fam Med(SA) Part II Practice Questions

Try these sample questions to test your CMSA FC Fam Med(SA) Part II exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 34-year-old G2P1 at 38 weeks gestation presents to a rural district hospital emergency center in South Africa with a blood pressure of 170/110 mmHg, 3+ proteinuria, severe frontal headache, and hyperreflexia. Fetal heart rate is 140 bpm. What is the most appropriate initial pharmacological step to prevent eclamptic seizures according to South African ESMOE guidelines?

A.Administer a loading dose of IV magnesium sulfate 4 g slowly over 10-15 minutes plus 10 g IM (5 g in each buttock)

B.Administer IV diazepam 10 mg slow push every 15 minutes until headache resolves

C.Initiate oral methyldopa 500 mg immediately and recheck blood pressure in 4 hours

D.Administer IV phenytoin loading dose of 18 mg/kg in normal saline over 1 hour

Explanation: According to South African Essential Steps in Managing Obstetric Emergencies (ESMOE) guidelines, magnesium sulfate is the first-line anticonvulsant for severe pre-eclampsia and eclampsia. The standard loading regimen is 4 g IV over 10-15 minutes combined with 10 g IM (5 g deep IM into each buttock with 1 mL 2% lignocaine).

2A 45-year-old male with confirmed pulmonary tuberculosis (TB) and newly diagnosed HIV infection (CD4 count 42 cells/µL) is initiating antiretroviral therapy (ART) in a primary care clinic. According to South African National ART guidelines, when should TLD (tenofovir disoproxil fumarate / lamivudine / dolutegravir) be started relative to TB treatment, and how should dolutegravir dosing be adjusted if he receives rifampicin-based TB therapy?

A.Initiate TLD within 2 weeks of starting TB treatment; increase dolutegravir to 50 mg twice daily (adding an extra 50 mg dose 12 hours after TLD)

B.Start TLD immediately on day 1 of TB treatment without dose modification of dolutegravir

C.Delay TLD until 6 months of TB treatment is fully completed to prevent Immune Reconstitution Inflammatory Syndrome (IRIS)

D.Initiate TLD within 2 weeks of starting TB treatment; replace dolutegravir with efavirenz 600 mg once daily

Explanation: In HIV-positive patients with CD4 counts < 50 cells/µL, ART should be started within 2 weeks of starting TB therapy to reduce mortality. Rifampicin induces UGT1A1 and CYP3A4, reducing dolutegravir plasma levels; therefore, dolutegravir dosing must be doubled by adding an extra 50 mg dose 12 hours after the fixed-dose combination TLD.

3A family physician is leading a Community-Orientated Primary Care (COPC) initiative in a sub-district health catchment area. What is the first essential step in the 5-step COPC methodological framework?

A.Defining and characterising the target community (community profiling)

B.Prioritising health problems based on epidemiological burden

C.Implementing a targeted clinical intervention strategy

D.Evaluating the outcome of health outreach programmes

Explanation: The classic 5-step COPC cycle begins with Step 1: Defining and characterising the target community (community profiling and boundary definition), followed by prioritizing health problems, detailed assessment, intervention planning/execution, and evaluation.

4In a South African district hospital, the clinical governance committee reviews a clinical audit cycle regarding diabetes care at primary care clinics. Which stage of the audit cycle immediately follows the collection of baseline clinical data against established standard treatment guidelines?

A.Comparing baseline results against agreed standard targets and identifying care gaps

B.Writing a new clinical protocol for primary care nurses

C.Re-auditing the clinical records after 12 months

D.Reporting staff members who failed to meet performance targets to the HPCSA

Explanation: The clinical audit cycle steps are: 1) Select topic/standards, 2) Collect baseline data, 3) Compare data against criteria/targets to identify gaps, 4) Implement changes, and 5) Re-audit. Comparing results to standards directly follows baseline data collection.

5Under the South African Mental Health Care Act (Act 17 of 2002), what is the mandatory requirement for initiating a 72-hour assessment of an involuntary mental health care user in a designated district hospital?

A.Application by a spouse, relative, or healthcare provider, followed by independent examinations by two healthcare providers (at least one being a medical practitioner)

B.A formal court order issued by a High Court judge prior to admission

C.Written consent signed by the patient's employer or local ward councillor

D.Unanimous approval by a panel of three specialist psychiatrists

Explanation: The Mental Health Care Act 17 of 2002 stipulates that an application for involuntary care must be made by a spouse, next-of-kin, partner, associate, or healthcare provider, and requires independent physical and mental status examinations by two designated healthcare providers, at least one of whom must be a medical practitioner.

6A 28-year-old trauma victim is brought to a district emergency room following a motor vehicle collision with severe respiratory distress, tracheal deviation to the left, absent breath sounds on the right, and hypotension (BP 80/50 mmHg). What is the immediate life-saving intervention required prior to chest radiograph?

A.Needle decompression in the 2nd intercostal space anterior mid-clavicular line (or 4th/5th intercostal space anterior axillary line) on the right

B.Immediate endotracheal intubation and positive pressure ventilation

C.Urgent portable chest X-ray to confirm pneumothorax location

D.IntravOceanic bolus of 2 liters ringers lactate solution via rapid infuser

Explanation: This patient has a life-threatening right tension pneumothorax. Diagnosis is clinical, and immediate chest decompression (needle thoracocentesis or finger thoracostomy) must be performed without waiting for radiographic confirmation, as positive pressure ventilation or delay can cause cardiac arrest.

7A 58-year-old female with long-standing Type 2 Diabetes Mellitus, hypertension, and stage 3b Chronic Kidney Disease (eGFR 38 mL/min/1.73m²) presents for routine review. Her HbA1c is 8.8%. Which anti-diabetic agent is contra-indicated or requires strict dose reduction due to her impaired renal function under South African Primary Health Care guidelines?

A.Metformin (reduce maximum dose to 500 mg twice daily when eGFR is 30-45 mL/min; stop if eGFR < 30 mL/min)

B.Gliclazide 80 mg daily

C.Insulin Isophane (NPH) bedtime dose

D.Empagliflozin 10 mg daily

Explanation: Metformin risk of lactic acidosis increases with renal impairment. Guidelines recommend reducing metformin dose when eGFR is between 30 and 45 mL/min/1.73m² (maximum 1000 mg daily) and discontinuing metformin completely if eGFR falls below 30 mL/min/1.73m².

8Which member of the primary care team leads household health visits, screening for malnutrition, and tracking immunization dropouts as part of the South African Ward-Based Outreach Team (WBOT) structure?

A.Community Health Worker (CHW)

B.District Family Physician

C.Facility Medical Officer

D.Sub-district Pharmacist

Explanation: Community Health Workers (CHWs) form the core of WBOTs in South Africa. They conduct door-to-door household assessments, maternal-child health screening, TB/HIV treatment adherence monitoring, and refer individuals to local PHC clinics.

9A clinical manager at a district hospital investigates an unexpected intra-operative patient death. What formal reporting mechanism is mandated by the South African National Policy for Patient Safety Incident (PSI) reporting?

A.Categorise as a Sentinel Event (Severity Level 1), log on the national PSI web portal within 24 hours, and conduct a Root Cause Analysis (RCA) within 45 working days

B.File a confidential memorandum to the hospital board and close the case if no formal complaint is lodged by the family

C.Notify the local South African Police Service (SAPS) only if foul play is suspected and take no internal clinical action

D.Perform an informal discussion at the next departmental tea meeting without written documentation

Explanation: An unexpected intra-operative death is classified as a Severity Level 1 Patient Safety Incident (Sentinel Event). Under National NDoH PSI policy, it must be reported within 24 hours and undergo a comprehensive Root Cause Analysis (RCA) within 45 working days.

10Under the South African Choice on Termination of Pregnancy Act (Act 92 of 1996), up to what gestational age can a pregnant woman request a termination of pregnancy on demand without needing to provide specific medical reasons?

A.Up to and including 12 weeks of gestation

B.Up to and including 20 weeks of gestation

C.Up to and including 24 weeks of gestation

D.Up to and including 16 weeks of gestation

Explanation: The Choice on Termination of Pregnancy Act 92 of 1996 allows TOP upon request of a woman during the first 12 weeks of gestation. From 13 to 20 weeks, specific grounds (e.g. maternal physical/mental health, rape, incest, severe fetal defect) are required.

About the CMSA FC Fam Med(SA) Part II Exam

The FC Fam Med(SA) Part II is the final exit fellowship examination of the College of Family Physicians of South Africa. It assesses candidate competency across the 5 roles of the South African Family Physician: Care Provider, Consultant, Capacity Builder, Clinical Supervisor/Governance Leader, and Community-Orientated Primary Care Champion.

Assessment

Final specialist exit examination incorporating written clinical papers, objective structured clinical examination (OSCE), and learning portfolio assessment covering District Hospital Emergency Care, Complex Multi-morbidity, COPC, Clinical Governance/Audit, and Ethics/Medical Law.

Time Limit

180 minutes

Passing Score

Overall 50% with written subminimum

Exam Fee

R24 650 (College of Family Physicians of South Africa (Colleges of Medicine of South Africa))

CMSA FC Fam Med(SA) Part II Exam Content Outline

25%

District Hospital Emergency & Surgical Care

District hospital emergency airway management, procedural sedation, trauma resuscitation, obstetric emergencies (ESMOE, ruptured ectopic, emergency C-section indication), surgical emergency triage, and district-level acute care.

25%

Complex Multi-morbidity & Chronic Care

Advanced clinical decision-making in complex multi-morbidity, HIV/TB coinfection with organ dysfunction, drug-resistant TB, palliative symptom control, polypharmacy rationalization, and geriatrics in primary care.

20%

Community-Orientated Primary Care (COPC) & Health Systems

COPC principles, household assessments, ward-based outreach team (WBOT) supervision, community diagnosis, environmental health, social determinants of health, and National Health Insurance (NHI) implementation.

15%

Clinical Governance, Audit & Quality Improvement

Clinical audit cycles, morbidity & mortality (M&M) meeting leadership, patient safety incident management, infection prevention and control (IPC), clinical risk management, and district health statistics monitoring.

15%

Advanced Consultation Skills, Ethics & South African Medical Law

Complex bio-psycho-social consultation frameworks, HPCSA ethical guidelines, Choice on Termination of Pregnancy Act, Children's Act, Mental Health Care Act, informed consent, and end-of-life decision-making.

How to Pass the CMSA FC Fam Med(SA) Part II Exam

What You Need to Know

Passing score: Overall 50% with written subminimum
Assessment: Final specialist exit examination incorporating written clinical papers, objective structured clinical examination (OSCE), and learning portfolio assessment covering District Hospital Emergency Care, Complex Multi-morbidity, COPC, Clinical Governance/Audit, and Ethics/Medical Law.
Time limit: 180 minutes
Exam fee: R24 650

Keys to Passing

Work through all 100 available questions
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CMSA FC Fam Med(SA) Part II Study Tips from Top Performers

1Review district health hospital emergency management guidelines, including ESMOE algorithms for eclampsia and severe postpartum hemorrhage.

2Understand the 5 steps of Community-Orientated Primary Care (COPC) and how Ward-Based Outreach Teams (WBOTs) conduct household risk assessments.

3Master the clinical audit cycle stages and HPCSA guidelines on informed consent, medical negligence, and patient rights under the National Health Act.

Frequently Asked Questions

What components make up the official FC Fam Med(SA) Part II examination?

The official exit examination includes written papers, a clinical OSCE (Objective Structured Clinical Examination), and evaluation of the 4-year registrar portfolio of learning.

What is the passing criteria for the FC Fam Med(SA) Part II examination?

Candidates must achieve an overall mark of at least 50%, with subminimum requirements met across individual written papers and clinical examination components.

How does this practice bank adapt the FC Fam Med(SA) Part II content?

This study bank provides 100 clinically sophisticated single-best-answer MCQs aligned with the South African Family Physician exit curriculum, focusing on district health care, COPC, clinical governance, and ethical practice.

100+ Free CMSA FC Fam Med(SA) Part II Practice Questions

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