FMCLA Practice Test

The Family Medicine Certification Longitudinal Assessment (FMCLA) is taken by board-certified family physicians who are keeping their certification current with the American Board of Family Medicine. This page gives you free practice sets by topic, the official content areas with their weights, worked explanations, a study plan and answers to common questions. Our questions are written with AI tools and are not real exam items.

FMCLA Exam at a Glance

What changed for FMCLA in 2026

• Oct 24, 2026: Delivery changed to Online in MyABFM Portfolio, anywhere, any time (previously Online in MyABFM Portfolio, anywhere, references allowed).^[1]
• Oct 24, 2026: Exam fee changed to No additional cost; annual certification fee still required (previously No extra cost; annual certification fee still required).^[1]
• Oct 24, 2026: Number of questions changed to 25 timed questions per quarter, 300 total (previously 25 questions per quarter, 300 in total).^[1]
• Oct 24, 2026: Passing score changed to Same minimum passing standard as the one-day exam (previously Scaled score; same passing standard as the one-day exam).^[1]
• Oct 24, 2026: Retake fee changed to $650 reduced one-day exam fee (previously $650 reduced one-day exam fee if both included attempts are used).^[2]
• Oct 24, 2026: Retake policy changed to Fail → one-day exam at a proctored test center by end of year 4 or 5 (previously Fail → one-day exam at a proctored test center by year 4 or 5).^[2]

What the FMCLA is and how it works

According to American Board of Family Medicine, “You will receive 25 timed questions each quarter for a total of 300 questions over three to four years.”^[1]

The FMCLA is the American Board of Family Medicine's way of checking and building knowledge over time. You answer it as part of continuing certification instead of sitting a single long exam.

It is delivered online in your MyABFM Portfolio. The Board says questions can be answered anywhere, at any time. You receive 25 timed questions each quarter, for a total of 300 questions across the assessment period. Questions are multiple-choice, and you have 5 minutes to answer each one.

There is no additional cost for the longitudinal assessment, but your annual certification fee is still required. The FMCLA is one part of the 5-Year Cycle, which also asks you to earn 60 certification points through Self-Assessment and Performance Improvement activities.

The minimum passing standard is set at the same standard as the one-day exam. If your performance falls below that standard, you will need to pass the one-day exam at a secure proctored test center before the end of year 4 or 5 of your cycle. If your included exam attempts have already been used, the reduced one-day exam fee is $650.

Details can differ with your certification timeline and your personal portfolio, so check your own MyABFM account and the official ABFM longitudinal assessment page for what applies to you.

FMCLA content outline and where to practise each area

The content areas below are copied from the official FMCLA content outline published by American Board of Family Medicine, with the share of the exam each area carries. The right-hand column shows which of our practice sets covers it.

Worked examples: how to reason through FMCLA questions

These are practice questions written for this site, not questions from the real exam. Each explanation shows why the right answer is right and why the others are wrong.

Example 1

Question: A patient presents with anaphylaxis after a bee sting. What is the first-line treatment?

1. Diphenhydramine IV
2. Epinephrine 0.3 mg IM
3. Methylprednisolone IV
4. Albuterol inhaler

Answer: B. Epinephrine 0.3 mg IM

Explanation:

Epinephrine 0.3 mg IM is correct because anaphylaxis is a life-threatening reaction, and intramuscular epinephrine, given in the anterolateral thigh, reverses airway swelling, low blood pressure and bronchospasm quickly. Diphenhydramine IV relieves itching and hives but does not treat airway or circulatory collapse. Methylprednisolone IV works too slowly to help in the first minutes and is only an add-on. An albuterol inhaler treats wheeze but not shock or swelling of the airway. The rule to remember: in anaphylaxis, epinephrine comes first and everything else is secondary.

Example 2

Question: Which drug class is considered first-line for reducing cardiovascular mortality in patients with reduced ejection fraction heart failure?

1. Loop diuretics
2. Beta-blockers
3. Calcium channel blockers
4. Nitrates

Answer: B. Beta-blockers

Explanation:

Beta-blockers are correct. Carvedilol, metoprolol succinate and bisoprolol have been shown in large trials to lower deaths in heart failure with reduced ejection fraction. Loop diuretics relieve congestion and symptoms but do not improve survival. Calcium channel blockers are generally avoided in reduced ejection fraction, because some can worsen heart failure. Nitrates ease symptoms such as chest pain or congestion, but they are not the drug class used to lower cardiovascular mortality here. The rule to remember: separate drugs that make the patient feel better from drugs that help the patient live longer.

Example 3

Question: What is the CHA2DS2-VASc score used to determine in patients with atrial fibrillation?

1. Rate vs. rhythm control strategy
2. Risk of stroke and need for anticoagulation
3. Appropriate antiarrhythmic drug selection
4. Need for cardioversion

Answer: B. Risk of stroke and need for anticoagulation

Explanation:

The CHA2DS2-VASc score estimates the risk of stroke in atrial fibrillation and helps decide whether to start anticoagulation, so option B is correct. It does not choose between rate and rhythm control, which depends on symptoms, patient factors and the clinical picture. It does not pick a specific antiarrhythmic drug, and it does not decide whether cardioversion is needed. The rule to remember: this score is about stroke prevention, while rate, rhythm and cardioversion questions are separate decisions.

How to use these practice tests

Start with the official ABFM longitudinal assessment page and your MyABFM Portfolio, so you know how delivery, timing and your own requirements work. Then use the content areas above to decide where your time goes. The areas with the largest weights deserve the most practice, but do not skip the smaller ones.

1. Take a practice set from Cardiovascular and Pulmonary Medicine or Managing Chronic Disease and answer each question before reading the explanation.
2. Keep a short list of questions you missed and write the rule behind each one in a sentence.
3. Add Acute Care and Emergency Medicine and Preventive Care so the heavier areas are all covered.
4. Use the remaining sets, such as Pediatric Care and Geriatric Care and Elder Medicine, to fill gaps.

Practise with a timer set to 5 minutes per question, since that is the limit on the real assessment. Return to your missed-question list before each quarterly session and check anything unclear against current guidelines.

Sources & last verified

1. American Board of Family Medicine — number of questions, time limit, passing score, exam fee (official source). “You will receive 25 timed questions each quarter for a total of 300 questions over three to four years.” Verified Oct 27, 2026 · source checked Oct 27, 2026.
2. American Board of Family Medicine — retake fee, retake policy (official source). “If both available examination attempts included in the process fees have already been used, a reduced examination fee of $650 (or 50% of the current…” Verified Oct 27, 2026 · source checked Oct 27, 2026.
3. American Board of Family Medicine — renewal (official source). “Earn 60 certification points through Self-Assessment and Performance Improvement activities.” Verified Oct 27, 2026 · source checked Oct 27, 2026.
4. American Board of Family Medicine — other (official source). “acute care and diagnosis 35%” Verified Oct 28, 2026.

How we verify: editorial & fact-checking policy. Report an error: contact us.