NBOME

Family Medicine

Content Outline and Assessment Objectives

The Family Medicine examination is designed for end-of-course or end-of-clinical rotation/clerkship assessment for students enrolled at a college of osteopathic medicine (COM). Individual COMs may also administer the examination at other times in accord with their curriculum goals and mission. This examination emphasizes core knowledge and elements of osteopathic principles and practice in the discipline of Family Medicine that are essential for the pre-doctoral osteopathic medical student.

The exam blueprint below contains the Family Medicine topics covered in two dimensions: Dimension 1 – Patient Presentation and Dimension 2 – Physician Tasks.

Dimension 1: Patient Presentation

Topic%
General3–10%
Hematology/Oncology & Immune Disorders5–15%
Genitourinary/Renal & Gynecologic/Reproductive 7-17%
Gastrointestinal 7-17%
Endocrine 5-15%
Musculoskeletal/Dermatology7-17%
Psychiatry/Neurology7-17%
Cardiovascular9-20%
Respiratory 9-20%
*10-20% patients under 18 years old on each form

Dimension 2: Physician Tasks

Topic%
Health Promotion / Disease Prevention / Health Care Delivery5–20%
History & Physical/Diagnostic Technologies40–60%
Management20–40%
Scientific Understanding of Mechanisms5–15%
*10-20% patients under 18 years old on each form

General Learner-Centered Objectives

Based on general learner-centered objectives, as outlined in the Family Medicine Examination Blueprint, the examinee will be required to demonstrate the ability to apply:

  1. Foundational content knowledge to situations and patient presentations encountered in clinical settings and important to Family Medicine.
  2. Foundational content knowledge and clinical problem-solving ability related to particular physician tasks critical to Family Medicine.
  3. Knowledge and clinical problem-solving as related to the Fundamental Osteopathic Medical Competency Domains, including osteopathic principles and practice and OMT, osteopathic medical knowledge, interpersonal and communication skills, practice-based learning and improvement, systems-based practice, professionalism and patient care.
  4. Osteopathic principles and practice in commonly encountered patient care scenarios.

Selected Specific Learner-Centered Objectives for Family Medicine

For Family Medicine, the examinee will be required to demonstrate the ability to diagnose and manage selected patient presentations and clinical situations involving, but not limited to:

  1. General: Patients presenting for routine examinations, patients presenting for routine screening, patients presenting for vaccinations/preventive care, patients presenting with health care delivery concerns
  2. Cardiovascular System Disorders & Presentations: Asymptomatic patient with a cardiovascular disorder, symptomatic patient with undifferentiated symptoms related to the cardiovascular system, arrhythmias, coronary artery disease, heart failure, hypertension/hypotension, left ventricular hypertrophy/cardiomyopathies, pericarditis, valvular heart disease, murmurs & congenital heart disease, vascular (venous, arterial, lymph) disorders
  3. Endocrine System Disorders & Presentations: Asymptomatic patient with an endocrine disorder, symptomatic patient with undifferentiated symptoms related to the endocrine system, adrenal disease, diabetes-related issues, dyslipidemia, electrolyte & serum mineral disorders, growth/puberty & weight-related presentations, gynecologic & male hypogonadism/gynecomastia, heat/cold intolerance or heat-related conditions, osteoporosis/osteomalacia, pituitary disease, thyroid/parathyroid disease
  4. Gastrointestinal System Disorders & Presentations: Asymptomatic patient with a gastrointestinal disorder, symptomatic patient with undifferentiated symptoms related to the gastrointestinal system, anorectal disorders/hernias, gastric disorders, hepatobiliary disorders, mouth/oropharynx/esophageal disorders, nutritional & vitamin deficiencies/nutritional replacement, pancreatic disorders, poisonings/ingestions/foreign bodies, small large bowel disorders
  5. Genitourinary/Renal & Gynecologic/Reproductive System Disorders & Presentations: Asymptomatic patient with a GU/GYN/reproductive disorder, symptomatic patient with undifferentiated symptoms related to these systems, abnormal vaginal bleeding/menstrual-related disorders, boy’s/men’s health, breast disorders, contraceptive management, developmental/sexuality, incontinence, menopause/hormone replacement therapy, ovarian/uterine disorders, pregnancy-related presentations, renal disease/disorders, sexually transmitted infections, urinary tract infections, vulvovaginal & cervical disorders
  6. Hematology/Oncology & Immune System Disorders & Presentations: Asymptomatic patient with a hematology/oncology or immune disorder, symptomatic patient with undifferentiated symptoms related to these systems, anemias, bleeding disorders, hypercoagulability disorders/hereditary thrombophilias/proliferative disorders, autoimmune disorders, HIV/AIDS/immune deficiencies, cancers of the blood/lymph systems, endocrine cancers, gastrointestinal cancers, genitourinary cancers, gynecologic cancers, respiratory cancers, skin cancers, bone/muscle cancers, breast cancer, neuro/ophthalmologic cancers
  7. Musculoskeletal/Integumentary System Disorders & Presentations: Asymptomatic patient with a musculoskeletal or dermatologic disorder, symptomatic patient with undifferentiated symptoms related to the musculoskeletal or integumentary systems, elbow & lower arm disorders/somatic dysfunction, head & neck disorders/somatic dysfunction, hip & upper leg disorders/somatic dysfunction, lumbar, pelvic & sacral disorders/somatic dysfunction, shoulder & upper arm disorders/somatic dysfunction, thoracic and rib disorders/somatic dysfunction, wrist & hand disorders/somatic dysfunction, ankle/Foot disorders/somatic dysfunction, arthritis/vasculitis/inflammatory conditions, knee & lower leg disorders/somatic dysfunction, soft tissue syndromes
    Dermatology: Benign & premalignant growths/lesions, hair, nail, sweat gland & keratinization disorders, hypersensitivity/allergic/autoimmune skin disorders, infectious skin disorders, infestations/bites/burns/trauma, inflammatory skin disorders, pigmentation disorders, skin manifestations of systemic disease
  8. Psychiatry/Neurology System Disorders & Presentations Asymptomatic patient with a psychiatric or neurologic disorder, symptomatic patient with undifferentiated symptoms related to the psychiatric or neurologic systems, abuse/substance abuse/eating disorders, anxiety disorders, developmental/behavioral & neurologic problems in children/adolescents, mood and adjustment disorders, personality disorders, schizophrenia & other psychotic disorders, sleep-related disorders, somatoform disorders
    Neurology: Cerebrovascular disease/TIA/CVA/syncope, dementia/delerium, demyelinating/degenerative & neuromuscular conditions, headaches, meningitis/infectious disorders, neuropathies/neuropathic disorders/chronic pain syndromes, seizure disorders
  9. Respiratory System Disorders & Presentations Asymptomatic patient with a respiratory disorder, symptomatic patient with undifferentiated symptoms related to the respiratory system, ear disorders, eye disorders, neck/salivary gland disorders, nose/sinus disorders, oral/pharynx disorders, pulmonary infectious disorders, pulmonary obstructive disorders, pulmonary restrictive & occupational disorders, pulmonary vascular disorders & pulmonary edema

Selected Student and Faculty Learning Resources for Family Medicine

In addition to the aforementioned objectives, examples of supplementary resources used by the NBOME to inform the development of the Family Medicine exam are listed below:

Practice Examination

The Family Medicine Practice Exam is primarily designed to assist the candidate in navigating through the examination, and it is provided to facilitate the actual testing experience. It is not designed to give the candidate a score or provide information about how a candidate might actually perform on the examination. When an answer choice is selected, it will not be recorded for scoring and the selection will not be saved once another item is viewed. If you wish to track your answer choices, you must record them on your own. A special function is provided that allows you to view the correct answer for each item by clicking on the “Show Answer” button located below the answer choices. The “Show Answer” button will not appear on the actual examination.

Launch the Family Medicine Practice Exam

Additional Resources

Following is a select number of resources related to the discipline of Family Medicine:

Title/SiteAuthorEditionYear
Textbook of Family MedicineRakel9th Edition2016
Current Medical Diagnosis & TreatmentPapadakis55th Edition2016
DynaMed PlusRegularly updated
Essential Evidence PlusRegularly updated
US Preventive Services Task ForceRegularly updated
MedURegularly updated
Foundations of Osteopathic MedicineAOA3rd Edition2010
Somatic Dysfunction in Osteopathic Family MedicineNelson2nd Edition2015
ACOFPRegularly updated
An Osteopathic Approach to Diagnosis and TreatmentDiGiovanna3rd Edition2004
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