[A COMPARISON OF THE BLUEPRINT FOR THE STEP 1 FAMILY MEDICINE CERTIFICATION EXAMINATION AND THE CONTENT OF FAMILY...

Since 1970, written (Step 1) and oral (Step 2) examinations have been part of the requirements for board certification in Israel.

To compare the content of Step 1 examinations in family medicine, that was derived from their blueprints in 2010-2016, with the content of family practice in the Jerusalem district in 2015, that was derived from the electronic database of Clalit Health Services.

(a) The blueprints indicated that a Step 1 examination totaled 150 items. Of these, 20 (13%) were on general issues (health and disease, family, epidemiology, organization of practice); 25 (17%) items were on pediatric emergencies, acute and chronic problems. The remaining parts of the examination consisted of 5 to 10 items on each of the various clinical categories (subspecialties or organ systems). (b) The analysis of the electronic database of Clalit Health Services revealed that as many as 34% of the primary care diagnoses were related to administrative problems (filling out forms and renewal of prescriptions) and another 18% were defined as unspecified. Our comparison relates to the clinical problems: 18% of them were respiratory, 15% orthopedic and 11% ENT disorders. Dental problems comprised 1% of the encounters.

About half of the clinical problems in family practice consist of respiratory, orthopedic, ENT, gastrointestinal and skin disorders. Professional leaders may wish to consider whether these disorders should have greater representation in board examinations, and whether common dental problems and trauma should be part of the family practice curriculum and certifying examinations.