Specialty board certification and the maintenance of certification process can be a nerve-wracking process for the busy clinician. The entire process can lead to a significant financial outlay, especially for newly graduating residents. The American Board of Family Medicine (ABFM) was one of the first specialty boards to mandate maintenance of certification (MOC) as well as a mandatory certification exam. For all specialties, the combination of a certification exam and the maintenance of certification process has become big business. This has come with a significant degree of controversy for the American Board of Internal Medicine (ABIM) whose maintenance of certification process was deemed to be too onerous and expensive without evidence of significant benefit. The ABIM responded by changing the requirements to appease its members.

The maintenance of certification process allows for periodic examination of a specialty board’s members. In family medicine, this is typically 7-10 years between certification exams. When the time comes to take or retake the certification exam (I recertify in April), family physicians currently have a multitude of options for board review preparation. Options currently available include: materials completed during the MOC process (Knowledge Self-Assessment Activities (formerly SAMs), CME quizzes available through the American Academy of Family Physicians (AAFP), including those in their journal, The American Family Physician), attend a board-review course offered by state or national family medicine organizations including the AAFP (I am going to attend one next month), purchase a CD-ROM of questions from various medical and educational organizations, practice for the exam using the official ABFM app (or their new Continuous Knowledge Self-Assessment app), or review questions from board review books (such as Swanson’s) or other apps. The options are nearly limitless, but few have been studied or proven to improve success on the certification exam. In fact, the ABFM discourages the use of preparing for the exam by studying questions alone. They regularly report outcomes on the exam at the annual Program Directors Workshop and state time and again that those who only prepare via completing board review questions do worse than those who have a robust reading program as part of their preparation plan.

Previously, we reviewed the outstanding NEJM’s Knowledge Plus for Family Medicine as well as their similarly high-quality version for internal medicine. I found the content of the NEJM apps to be outstanding, but I experienced a number of technical glitches during my time using them. I still plan to use the NEJM Family Medicine Board Review app, but I currently am using UWorld Boards Family Medicine. This app came highly recommended by several of my residents who used it this past year before the April exam. All raved about it and all passed their boards!

I found the attention to detail of the NEJM app to be superior to that of UWorld, but I have had no issues using the UWorld app on my computer, iPhone, or iPad. I prefer the detailed learning plans of the NEJM app, but enjoy the simple yet robust answer sections of the UWorld app. The UWorld app lacks the nifty feature of the NEJM Knowledge Plus system (and the ABFM CKSA app) — the ability to rate your own “pre-test” confidence about the category and subcategories and individual questions.

The UWorld app is well-referenced but lacks the NEJM links to resources within the NEJM family of publications. Both give you the option to email directly to the app developers to comment on a particular question or its answer.

Both apps lack any usable offline mode. It is perhaps simply not feasible when you consider the scope of questions available/tracking capabilities to offer access to some sections when offline or in airplane mode. It would be highly useful to answer questions on your device when traveling out of cellular or Wi-Fi access such as an airplane or parts of the hospital without any usable cell phone or wireless connectivity.

Video Review

Evidence-based medicine

The app comes from a reputable company that makes numerous exam preparations materials (SAT/MCAT, etc.). Very little information is provided about the authors of the exam/questions. The app is well referenced with links to many current sources in PubMed.

What providers would benefit from this prep app?

Medical students, residents, mid-levels, family medicine, internal medicine, or any provider in primary care could benefit. Ideally suited for those preparing for taking their certification exams, the app still could have appeal for those simply wanting to stay current and challenge their knowledge in an exam format.

Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.

  • Price
    • Varies based on time available to access content. 30 days at $249 to 2 years at $599.
  • o Comprehensive board review content for primary care providers

    o Easy to use interface especially on the iPad

    o Ability to sync exams in progress across the web, iPhone and iPad applications

    o Available for Android

  • Dislikes

    o Pricing seems arbitrary

    o Minimal information on who creates/updates content

    o No offline mode to view/answer questions while in airplane mode or when offline

  • Overall

    An outstanding board review resource for primary care providers looking for an alternative to an expensive board review course or other textbook based methods of board review. However, the app’s odd pricing system may discourage some potential buyers.

  • Overall Score
  • User Interface

    Simple, but intuitive interface for creating practice exams/reviewing content.

  • Multimedia Usage

    Links to many references from within the app. Ability to send feedback on questions from within the app. Syncs across all your devices and the web.

  • Price

    Expensive and somewhat odd pricing structure

  • Real World Applicability

    Great resource for family physicians interested in a comprehensive, board review tool.

  • Device Used For Review

    iPhone 8 running iOS 11.2, iPad Pro 2.0 running iOS 11.2, Windows 10 laptop with IE 11 browser.

  • Available for DownloadAndroidiPhoneiPad