Studying for SAMPs
Become familiar with the SAMP format: The CFPC has released 18 SAMPs used on previous examinations in order to help prepare for the Certification Examination. These questions and answers can be found on CFPC website (www.cfpc.ca) in the Exams and Certification section.
Some people find it helpful to review commercially available question banks. You should be aware that these “ghost banks” are not official CCFP questions and there is no guarantee that it covers the breadth of content on the examination.
Focus on your weaknesses: Reviewing the 99 priority topics outlined by the CPFC is a good place to start in trying to identify any areas of weakness. Many physicians preparing for the exam have found it useful to quickly review the current edition of their favourite textbook in each of the major clinical disciplines contributing to family medicine: obstetrics, pediatrics, medicine, surgery and psychiatry.
Journals focusing on general practice such as the Canadian Family Physician, the American Family Physician, the Journal of the American Board of Family Practice, and the BJGP: British Journal of General Practice also offer opportunity for review. Journals such as Journal Watch and the ACP Journal Club provide critical summaries of the original research literature, and are intended to help apply relevant, high-quality research to the practice of medicine.
SAMP exam day tips
When working through the cases please keep the following things in mind:
For each case, the setting in which you are practicing will be described.
You can answer most questions in ten words or fewer.
You will be scored only on the number of answers required (e.g. if you are asked to provide three responses and put down five, only the first three will be scored).
Be specific on treatment (e.g. give route of administration of medications and fluids).
Give details about procedures only if directed to do so.
Studying for SOOs
Become familiar with the SOO format: The CFPC has produced a video of a SOO which can be helpful in preparing for the Certification Examination. It can be found on CFPC website (www.cfpc.ca) in the Exams and Certification section.
Reviewing “ghost banks” of previously used SOOs is generally not useful. Practicing SOOs in the context of a CCFP Preparation Course is however very helpful in understanding how SOOs are constructed.
Become familiar with SOO scoring: A SOO script and marking sheet can be found on CFPC website (www.cfpc.ca) in the Exams and Certification section. Anyone considering sitting the exam should review this.
A SOO is divided in several sections. The first two sections Problem 1 & 2 are the two main issues to be dealt with in the SOO. This was designed this way in recognition that there is often more than one issue when a patient presents. The presence of two problems is a standardization to allow for consistent marking. These problems can be any combination of “bio-medical” & “psycho-social”. There may be 2 medical issues, 2 psychosocial issues or a combination.
For each problem, the candidate must collect information in order to arrive at a reasonable differential. The candidate must also explore the patient’s ideas and feelings about their illness and the impact on function. Using the mnemonic FIFE (FEELINGS, IDEAS, FUNCTION, and EXPECTATIONS) is helpful in ensuring that this is adequately explored. Experienced physicians often do very well at gathering data to arrive at the differential diagnosis; however they often do not explicitly explore the patient’s illness experience.
The third section of the SOO is the social and developmental context. It is important to know who the patient’s significant contacts are, what their social situation is including their work and their finances in a basic way. It is also essential to reflect how the patient’s illness and their context influence each other (context integration).
The fourth and fifth sections involve management of each of the two problems. The candidate must propose and negotiate a reasonable management with the patient. In a SOO, the candidate will not be completing a physical exam but candidates should verbalize that they would complete an appropriate physical examination and verbalize how this might impact the management. Candidates should provide patients with a diagnosis or differential just as might do in real life. The management plan may include further investigations, medications, therapy and all elements should be verbalized. It is important to recognize that the patient may have specific ideas about tests or treatments and this must be explored. Candidates should check back with the patient on what they think is a reasonable plan and listen to what the patient thinks about it. Whatever the issues are the candidate must elicit and address them until both agree on a management plan.
The final section is a general score that reflects the overall flow and organization of the interview.
Practice the SOO format in your everyday practice: consider using everyday interactions with patients in your practice as opportunities to test the SOO format.
SOO exam day tips:
Read the instructions carefully and repeatedly. They contain a varying amount of information about the patient, including at least his/her name and age.
Use a natural conversational tone and an organised approach to taking a history.
Establish what the problems are by using a thorough history. As you identify the problems, discuss with the patient how the problems are affecting him or her. (Remember FIFE).
Make notes even if they comprise no more than a listing of the problems that you identify during the interview and use these notes to assist you during your summation. This will prevent you from forgetting to deal with any problems that you have identified in the course of the interview.
Listen for prompts and follow those leads.
Identify the patient’s social context (work, family members, supports) and reflect back to the patient your impression of how the illnesses are impacting on his world.
Negotiate a reasonable treatment plan.
Always suggest that the patient come back for a complete physical exam. Try to get old reports if there are any.
Be aware of your own timing. The examiner is also timing you and will give you a warning when there are three minutes left. Try to conclude smoothly in the last three minutes. At 15 minutes, the examiner will signal the end of the examination..
Move on to the next SOO and forget the one you are leaving behind.