Philippine Academy of Family Physicians, Inc.

Specialty Board

Diplomate Board Examinations 2010-2011

PRIMER FOR EXAMINEES

The Certifying Examination for the title of Diplomate in Family Medicine is administered yearly by the Specialty Board of Examiners of the Philippine Academy of Family Physicians. EXAMINATION DATES The written examination will be held simultaneously in 3 testing sites on December 5, 2010 Manila, Cebu and Davao. The exact venues will be announced. The written examination is divided into two parts: PART I - 8:00 11:30 AM PART II - 1:00 4:30PM The oral examination will be conducted in 2 batches. Each batch will accommodate 280 examinees only. Those who wish to take the oral examination will need to coordinate with the PAFP main office and reserve a slot. The venue for the examination will be at the UST Medicine Building. The oral examination is divided into two parts: the projection examination and the Objective-Structured Clinical Examinations (OSCE). The oral examination dates will be on: September 17, 18, 19 (First batch) November 12, 13, 14, 2010 (Second batch) Part 1 Projection exam, 5:00 6:00 pm (First batch- Sept 17; Second Batch Nov 12) Part 2 OSCE- from 8 am onwards (First batch Sept 18 (set A); Sept 19 (set B) Second batch Nov 13 (set C); Nov 14 (set D) Deadline for Application: Aug 30 for Sept oral exams; Oct 25 for the Nov oral exam and Nov 15 for the written examination. Application shall be made through the PAFP Secretariat.

TESTING CENTERS The three venues for the written examinations are - Manila, Cebu and Davao. The Projection examination will be conducted at the Computer Laboratory of the UST Faculty of Medicine Building. For the OSCE, 4 rooms at the UST Medicine Building will be utilized. The room assignments will be posted at the main lobby of the said building and at the Department of Preventive, Family and Community Medicine bulletin board, 3rd floor, beside Room 329 on the morning of testing day. ORIENTATION An orientation for the written examination will be conducted a day before the examination December 4, 2010 from 3:30 to 5:00 PM - venue for it will be ANNOUNCED. For the OSCE, it will also be the day before the examination datesJanuary 17 for the September 18/19 examination and November 12 for the November 13/14 examinations from 8:30 to 10:00 am, Computer Laboratory of the UST College of the Medicine Building. The examinee must bring 2 copies of 2x2 recent ID picture for the examination permit and a valid ID with picture. (PRC card, Drivers License, Passport) THE EXAMINATIONS All examinees will be allowed to take the written examination. Passing the written examination is NO longer a pre-requisite for taking the oral examination. However, if there will be more than 560 applicants for the 2 oral examination dates, those who will not be accommodated in the quota will be booked for the next schedule of examination for 2011-2012. The applicant for the oral examination will be required to pay the full examination fees to be given a schedule for the oral examination.

I. THE WRITTEN EXAMINATION A. CONTENT The examination paper consists of four hundred (400) questions in two (2) sets of 200. Each set of 200 questions is allotted 3 and hours to complete. The content is as follows: 1. Clinical Topics (Various Disciplines) - 60% 2. Family Medicine Topics - 40% B. GENERAL BLUEPRINT FOR THE WRITTEN EXAMINATION I. CLINICAL 240 questions SYSTEMS Child Health (Pediatrics) Adult Medicine Geriatrics

Respiratory Cardiovascular Endocrine GI/Nutrition Hematology/Immunology/Oncology Dermatology Musculoskeletal Genitourinary Developmental/Psychiatry/Behavioural /Neurology Surgery HEENT Reproductive/Sexual Health

15% (12) 5% (4) 5% (4) 15% (12) 5% (4) 10% (8) 5% (4) 5% (4) 10% (8) 10% (8) 8% (6) 7% (6)

15% (12) 15% (12) 15% (12) 5% (4) 5% (4) 3% (2) 7% (6) 5% (4) 10% (8) 5% (4) 5% (4) 10% (8)

10% (8) 15% (12) 8% (6) 8% (6) 10% (8) 3% (2) 10% (8) 15% (12) 5% (4) 12% (9) 2% (3) 2% (2)

II. FAMILY MEDICINE TOPICS 160 questions

POPULATION-BASED Research/PAFP Journal

PATIENT-BASED 15% (24) Home Care/Supportive/Palliati ve Care/End-of-life care Counseling Ethics/medico-legal 15% (24)

4. Surgery Schwartz 5. Obstetrics Williams 6. Gynecology Novak 7. Psychiatry WHO Manual for Mental Health 8. ENT Boies 9. Ophthalmology Newell 10. Neurology- latest local and international CPGs Currently utilized local and international Clinical Practice Guidelines (CPG) are included in the references for the examinations. All of the must references especially the CPGs can be downloaded for free at the PAFP website and Specialty board website http://sites.google.com/site/specialtyboard/ C. CONDUCT OF THE WRITTEN EXAMINATION 1. Qualified examinees should submit the complete requirements to the PAFP Office on or before the deadline set by the PAFP secretariat. They will be asked to express their intent to take the oral examination regardless of the results of the written examination. 2. At the venue, they will register in the assigned room 30 minutes prior to the start of the examination. The examinee must present a valid ID with most recent picture ( PRC card, Drivers license, Passport). 3. Each examinee will be given an examination ID and examination permit. Examination permit will be submitted to the registration area after every examination. 4. All examinees should sign the attendance sheet and submit the permit for verification. 5. Seats for the candidates are pre-numbered. Any change in seating arrangements is allowed.

5% (8)

Public Health/Environmental issues/occupational (from the PAFP Proceedings) FM Principles/ Wellness/Preventive Health Maintenance/Biopsychosocial approach Health Policies and Trends such as cheaper medicine bill, reproductive health, etc.

5% (8)

45% (72)

15% (24)

The questions will be divided into the following: 10% Recall, 30% Comprehension, 50% Application and 10% analysis. Recall is calling to mind terms, facts, classification and categories and methodologies. Comprehension is demonstration of understanding of facts, comparing, translating, interpreting, and giving descriptions to specific concepts. Application is knowledge to solve problems in new situations by applying acquired knowledge, facts, techniques and rules in a different way. Analysis is knowledge to identify causes and find evidences to support generalizations. The following are the recommended references: 1. Family and Community Medicine Family medicine book by Rakel and/or Maglonzo / PAFP Journals/PAFP orientation Course Manual/PAFP Annual convention Proceedings 2. Internal Medicine Harrison 3. Pediatrics Nelson

6. All personal belongings including cellular phones and personal computers should be turned off or put on silent mode and must be placed in front of the room. 7. The Examinee Information Sheet (EIS) and Examinee Answer Sheet (EAS) should be filled up and the stubs are detached. The stubs will be kept by the examinee. 8. No identifying marks shall be placed on the answer sheet. 9. Only Mongol Pencils No. 2 should be used. These will be provided during the exam. Shading should not be too light or too heavy.

a. GENERAL BLUEPRINT OF THE PROJECTION EXAMINATION 30 pts Clinical skills Disease recognition Work-up, interpretation and analysis Management Adult/Elderly 43% (6) 33% (5) 24% (4) Pediatrics 33% (5) 33% (4) 34% (6)

b. CONDUCT OF THE PROJECTION EXAMINTION 1. Seating arrangement will be according to the name list posted in the assigned room.

10. Candidates should make sure that they have the same seat number for Part 2. 11. They are allowed to leave the room only for personal necessities and have to be accompanied by a proctor. 12. Examinees will be required to sign a medical condition waiver during the conduct of the examination.

2. Answer sheets will be provided. Black or Blue pens should be used. 3. You automatically get zero (0) if you miss this part of the oral
examinations. No special projection exam will be given. Part 2: Station-Based Test (OSCE)

II. THE ORAL EXAMINATIONS The OSCE and Projection examinations aim to evaluate the examinee in situations which reflect the roles of a 5-Star Family Physician: as a health care provider, educator, manager, social mobilizer, and researcher, where applicable. Part 1: Projection Examination All examinees will take the Projection exam at the same time in one room or may be given simultaneously in 2-3 rooms. This may include pictures of diseases (ex. skin lesions, fundoscopic findings, etc.); ancillary procedures (ex. Chest X-ray). Questions will be on diagnosis and management. This part of the exam is allotted 30 minutes and each item is timed. The Projection examination for each examination date will be given after the orientation.

The OSCE (Objective, Structured Clinical Examination) set-up is used. There will be at least 3 groups of OSCE conducted at 3 separate rooms simultaneously. The examinees will be grouped according to the rules set by the Specialty Board. a. GENERAL BLUEPRINT OF THE OSCE STATIONS Station 1: History, Physical Examination and Working Diagnosis Station 2- Procedural skills (Common office procedures, communication skills, ethical reasoning, special maneuvers such as PE for low back pain, diabetic neuropathy, etc...)

Station 3 Clinical Decision- Making (such as interpretation of diagnostic test results) Station 4 Clinical Decision Making (Pharmacologic and Non-Pharmacologic Treatment strategies) Station 5 Family Management/Interventions (such as counseling, disclosure, family health education, family wellness, etc) **Station 6 Family Assessment (such as family assessment tools) **Station 7 Clinical Application of a Clinical Practice Guideline ** These are unmanned stations that will be given during the projection examination. B. CONDUCT OF THE OSCE 1. A series of booths known as 'stations' will comprise the OSCE testing area. Each station requires the examinee to undertake a particular task or tasks. Some tasks will involve talking to or examining patients, some will involve demonstrating a procedure. You are expected to perform all tasks as instructed. 2. A bell will ring at the start of the 1-minute rest station. You will be given 1 minute to read the case & instructions before you enter the station. You may make notes only on the back of your exam permit. The case and Instructions will also be posted at the table inside the station. 3. At the end of the 1-minute period, another bell will ring to signal the start of the 9minute period when you should enter the station and start discussing or performing the tasks required. The examiner will evaluate you based on a prepared checklist. You should only direct questions to the examiner if the given instructions specifically ask you to do so. 4. The bell will ring at the end of the 9-minute period. At this point, you must stop immediately and go to the next rest station and start reading the case information in preparation for the next OSCE station. If you finish before the end of the 9minute period, you must wait inside the station but you should not speak to the examiner or to the patient during this time.

5. You should continue in this way until you have completed all the tasks. You will then have finished all the OSCE stations. 6. No cellular phones will be allowed inside the examination room. 7. Books, notes or reference materials and personal computers are not allowed inside the holding and testing areas. All things will be deposited in a designated place, while the necessary care one vigilance will be exercised. Any personal belonging misplaced will not be the responsibility of the examiners, PAFP or the institution where the examination is conducted. 8. The examinee must bring only their writing pens. 9. Examinees should report to their assigned rooms 30 minutes before the start of the examination. 10. No person or companion is permitted to stay or loiter at the premises of the examination areas. III. POLICIES 1. CME and QA requirements for the examinees (list to be provided by the Membership Committee) will be waived for 3 years (2010 to 2012). 2. Validity of the Examination: Three (3) years. The 3-year validity rule as enforced in the 2007 examinations is being followed. The examinee should pass both the written and oral exams during an uninterrupted 3year period otherwise he/ she will be required to take a refresher course or its equivalent before he is allowed to take the written and oral examinations again. 3. Examination Fees: Written and oral P 3,500. 00 Written only P 1,800. 00 Oral only P 1,800. 00 No refund can be claimed.

4. The following policies apply for requests to change of examination dates: i. Letter of request addressed to the Specialty Board thru the Chair of the Commission is required. ii. Change of examination dates are granted only to those with valid (humanitarian) reasons such as illness, death, accidents, natural disasters, cancellation of trips/flights. Proof will be required. Approved request is valid only within the calendar year when the application is made. The calendar year will be determined by the Specialty Board of Examiners. Reapplication is required for those examinees (with or without approved request) who were not able to take the examinations within the designated dates. Reapplication for examination policies set by the Membership committee of PAFP will be followed.

11. Results and decision of the Board are final and executory. 12. Upon taking the examination, the examinee agrees with the policies stipulated in the Primer and agrees that the decision of the Specialty Board of Examiners is final.

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IV. RELEASE OF RESULTS The list of successful candidates will be released after presentation at the PAFP National Board meeting before the Annual Convention. Letters will be sent by mail to successful candidates. Inquiries may also be directed to the PAFP Secretariat.

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5. A copy of the proceedings will be available at PAFP secretariat upon full payment of examination fee. 6. Examinees will be required to sign a medical condition waiver during the conduct of the examination. 7. Examinees are not allowed to perform any procedure on the standardized patients (SP) not required in the tasks of the station. 8. Only those examinees who have taken both the written and oral portions for the first time and during the same year will be considered for the purpose of selecting the board topnotcher. 9. The Specialty Board of Examiners, through the Chair, shall recommend to the Board of Directors the candidates for the title of Diplomate in Family Medicine. 10. Upon approval by the National Board of Directors, the candidates will be notified of the results of the examination.

Prepared by: Leilanie Apostol-Nicodemus, M.D. Chair, Commission on Specialty Board