Family Medicine

Core Knowledge & Elements of Osteopathic Principles in the Discipline of 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 predoctoral 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	%
General	3–10%
Hematology/Oncology & Immune Disorders	5–15%
Genitourinary/Renal & Gynecologic/Reproductive	7-17%
Gastrointestinal	7-17%
Endocrine	5-15%
Musculoskeletal/Dermatology	7-17%
Psychiatry/Neurology	7-17%
Cardiovascular	9-20%
Respiratory	9-20%

*10-20% patients under 18 years old on each form

Dimension 2: Physician Tasks

Topic	%
Health Promotion / Disease Prevention / Health Care Delivery	5–20%
History & Physical/Diagnostic Technologies	40–60%
Management	20–40%
Scientific Understanding of Mechanisms	5–15%

*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 and 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 and 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 and 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 and 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 and 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 and 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 and 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 and 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 and somatoform disorders
   Neurology: Cerebrovascular disease/TIA/CVA/syncope, dementia/delerium, demyelinating/degenerative & neuromuscular conditions, headaches, meningitis/infectious disorders, neuropathies/neuropathic disorders/chronic pain syndromes and 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 and 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:

• Society of Teachers of Family Medicine (STFM) – National Clerkship Curriculum
• American Association of Colleges of Osteopathic Medicine (AACOM) – Educational Council on Osteopathic Principles (ECOP)
• American Osteopathic Association (AOA) – Family Medicine
• American Osteopathic Association (AOA) and American College of Osteopathic Family Physicians (ACOFP) – Basic Standards for Residency Training in Osteopathic Family Medicine and Manipulative Treatment

Practice Questions

The Family Medicine Practice Questions are 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.

Launch Family Medicine Practice Questions

Additional Resources

Title/Site	Author	Edition	Year
Textbook of Family Medicine	Rakel	9th	2016
Current Medical Diagnosis & Treatment	Papadakis & McPhee	61st	2022
DynaMed Plus		Regularly updated
Essential Evidence Plus		Regularly updated
US Preventive Services Task Force		Regularly updated
MedU		Regularly updated
Foundations of Osteopathic Medicine	Seffinger	4th	2019
Somatic Dysfunction in Osteopathic Family Medicine	Nelson	2nd	2015
ACOFP		Regularly updated
An Osteopathic Approach to Diagnosis and Treatment	DiGiovanna, Amen, & Burns	4th	2020