American Board of Family Medicine

CAQ – Sports Medicine Candidate Information Booklet

PLEASE READ THIS ENTIRE BOOKLET BEFORE STARTING THE APPLICATION

Schedule for December 2010

Application Registration Period September 23, 2010 through October 31, 2010 1,250 fee Late Registration Period for Application November 1, 2010 through November 17, 2010 $1,450 fee

October 31, 2010 Last Day to Submit Online Application Without Late Fee ($1,250) Priority Seating Ends – for best seating options select by this date.

(Beginning November 1, candidates will be selecting test dates and locations in competition with other Prometric clients.)

November 17, 2010 Last Day to Submit Application ($1,450; with Late Fee Assessed) Last Day to Submit Special Testing (ADA) Documentation November 24, 2010 Last Day to Clear All Application Deficiencies Last Day to Make Official Name Change with ABFM for Exam November 29, 2010 Test Center Selection Deadline (Note: limited seating available between November 1 and November 29) November 30, 2010 All Sports Medicine Fellowship Training Must be Completed 30 Days Prior to Last Day to Withdraw from the Exam without Cancellation Fee ($35) Scheduled Exam 5 Days Prior to Last Day to Withdraw from Exam without Seat Fee ($100) Scheduled Exam 48 Hours Prior to Last Day to Change Testing Date or Location Scheduled Exam EXAM DATES: Candidates select one of these dates for a half-day examination December 1, 2, 4

AMERICAN BOARD OF FAMILY MEDICINE• 1648 McGrathiana Parkway, Ste. 550• LEXINGTON, KY 405011-1247 (888) 995-5700

TABLE OF CONTENTS

Introduction...................................................................................................................1 Completing the Application............................................................................................2

Your Password...........................................................................................................2 Name and E-mail .......................................................................................................2 Personal Information..................................................................................................2 Fee Payment .............................................................................................................2 Defer/Refund Policy ...................................................................................................3 Physician Specific Information ..................................................................................3 Certification Requirements - Initial Examination .........................................................3 Demographics ...........................................................................................................4 Medical License ........................................................................................................4 Special Testing Accommodations .............................................................................5 Agreement Page of Application .................................................................................7 Approval of Application & Selection of Exam Date/Location .......................................7 Exam Test Sites..........................................................................................................8 E-Ticket......................................................................................................................8 Reschedule or Withdraw from the Exam.....................................................................9

Exam Information...........................................................................................................9 Content ......................................................................................................................9 Facts About the Examination......................................................................................9 Comfort Aids ............................................................................................................12 Study Materials ........................................................................................................12 Prometric Information ..............................................................................................13 Exam Day Schedule .................................................................................................13 ABFM Policies - Exam Administration Protocols and Procedures .............................13 Examination Results.................................................................................................18 Re-Examination ........................................................................................................18 Period of Certification ..............................................................................................18 Revocation...............................................................................................................19 Agreement ...............................................................................................................20

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INTRODUCTION Sports Medicine is a body of knowledge and a broad area of health care which includes: 1) exercise as an essential component of health throughout life; 2) medical management and supervision of recreational and competitive athletes and all others who exercise; and 3) exercise for prevention and treatment of disease and injury. The Sports Medicine Certification Program, jointly developed by the American Board of Family Medicine, the American Board of Emergency Medicine, the American Board of Internal Medicine, the American Board of Pediatrics and the American Board of Physical Medicine and Rehabilitation is designed to recognize excellence among those with special expertise in this field. The requirements for all Boards are similar. The examination will be administered to candidates from all five Boards at the same time in the same testing centers. The standard for passing the examination will be identical for all Boards. Family physicians must be certified by the American Board of Family Medicine and must be Diplomates in good standing at the time of the examination. This information booklet has been prepared by the American Board of Family Medicine for use by its Diplomates who are applying for the Certificate of Added Qualifications in Sports Medicine as certification or recertification candidates. The program will have three components:

• Satisfactory completion of training for certification candidates • Approval of formal application and accompanying documentation • Successful performance on a comprehensive, half-day examination

ALL FELLOWSHIP TRAINING REQUIREMENTS MUST BE MET BY NOVEMBER 30, 2010 Participation in the certification/recertification program is voluntary. The CAQ in Sports Medicine is not a requirement to provide care and the Board's certificate does not confer privilege to practice. In consideration of cost, we allow candidates to begin the application and pay the exam fee prior to the initial application filing deadline; however, all remaining requirements and deficiencies must be met by the published deadlines. Candidates will be notified via email of application approval or of any deficiencies immediately after the application is submitted. Although reminders of deficiencies or any missing materials will be sent by email, it is the candidate’s responsibility to frequently review the Physician Portfolio and submit all required items by the published deadlines. PLEASE REMEMBER TO COMPLETE EACH PAGE OF THE APPLICATION. Any application that remains deficient after November 24, 2010, will automatically be withdrawn and a partial refund will be issued. If you have further questions about the Sports Medicine Examination after you have read this booklet, you may contact the Support Center at (877) 223-7437 or help@theabfm.org. It is the sole responsibility of an ABFM candidate to be aware of and comply with registration deadlines. In fairness to all candidates, the Board adheres firmly to its published deadlines for registration and late registration for all examinations. Candidates are encouraged to apply early in the registration period to avoid late fees or problems. Issues arising from one’s inability to log on to the ABFM application system (e.g. forgotten ID/Password, computer technical difficulties or operator error) must be resolved and all components of the application completed prior to 11:59 pm Eastern Time on the deadline date. The ABFM staff and Support Center make every effort to assist with these issues promptly; however, candidates are responsible for contacting the ABFM for assistance well in advance of the deadline.

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COMPLETING THE APPLICATION

Your Password The password provided to you for accessing your Physician Portfolio should always be treated as “confidential”. Once you use the password initially provided, we strongly urge you to change it to something known only to you. There is a link in your Physician Portfolio that allows you to change the password. If you allow someone else access to your password they also have access to all secure information pertaining to you on our website. Keep in mind that your exam results will be accessible only on our website by using your ID and Password to enter your Physician Portfolio. Name and E-Mail Always make sure we have your current email address as this is how we will correspond with you. Furthermore, you are responsible for keeping both your postal and email addresses updated in your Physician Portfolio. Please remember you can update this information on our website at any time. Once you have confirmed your email address, you will need to go back to your application and complete all remaining pages. If you have a legal name change, we require a copy of the legal document (marriage, divorce, etc.) faxed to us before we can officially change your name. Keep in mind your name on record with the ABFM should be the same as the ID which you will present for admittance to the exam. Any discrepancy in your name will potentially delay or prevent your being admitted to the exam. All name issues should be resolved by November 24, 2010. If you need assistance with this, please contact our Support Center. Personal Information Enter your primary mailing address in this section. The additional address lines are provided only if your address contains more than one line (e.g., an apartment number, P.O. Box, or institution name). Please make sure everything is correct, and remember you are always able to update this information through your Physician Portfolio. All fields marked with an asterisk (*) are required. Fee Payment In order to expedite the processing of your application, you are encouraged to pay the exam fee of $1,250 (which includes a non-refundable $200 application fee) online with your credit card by the deadline of October 31, 2010. Applications can be filed after October 31, 2010 but no later than November 17, 2010; however, a late filing fee will be added after the initial payment deadline. When you pay by credit card online and complete all sections of your application and have no deficiencies, you will be prompted to pick your test date and location. The online payment option of the American Board of Family Medicine utilizes Secure Sockets Layer (SSL) technology to encrypt the personal and financial information being sent over the internet. Your browser will display the icon of a locked padlock near the bottom of the window to indicate that SSL encryption is being used. Consequently, you may rest assured that the easy-to-use online payment process is a highly secure payment option. Should you prefer to submit your credit card number in writing or pay by check, you will be required to print a payment page to complete and send with your payment. Once the ABFM has processed

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your credit card or check sent by postal mail, you will be able to complete your application and select a test center and date. Those who pay by credit card should be certain that the daily limit on the card is sufficient to permit charging the full examination fee. If the credit card is declined or a check is returned by the bank, your fee must be resubmitted for the original amount plus a bounced money fee of $50 and must be paid by certified check or money order. Any candidate whose credit card is declined or check is returned will have their testing appointment cancelled, and he or she will not be able to reschedule until all fees have been paid. No candidate will be allowed to take the examination until all fees are paid and all requirements have been satisfactorily met. Defer/Refund Policy Applications and exam fees are valid only during the calendar year in which the application is filed. If you are unable to complete the application requirements and wish to withdraw, please return to your Physician Portfolio and click on the link “Defer Participation to a Future Exam.” Candidates taking the December exam that are found to be ineligible to sit for the examination due to inability to meet the requirements will receive a partial refund. Candidates requiring a refund will receive it within 2-3 weeks of notification of withdrawing from the exam. Please remember the application processing fee ($200) and any late fees paid are non-refundable. Furthermore any cancellation or seat fee incurred due to late withdraw will be withheld from the refundable amount of exam fee. Physician Specific Information In this section you will select your qualifying plan and indicate if special testing accommodations under the ADA (Americans with Disabilities Act) are needed. Special testing accommodations will be considered only with appropriate documentation. Please refer to that section of the booklet for specific information. Certification Requirements - Initial Examination A candidate must have successfully completed, or will have completed by November 30, 2010, a minimum of one year in an ACGME-accredited sports medicine fellowship program associated with an ACGME-accredited residency in Family Practice, Emergency Medicine, Internal Medicine, Pediatrics or Physical Medicine and Rehabilitation. A letter from the fellowship Program Director is required verifying satisfactory completion of the sports medicine fellowship program, indicating beginning and ending training dates (month, day and year). Candidates who have not yet completed their fellowship program but will do so by November 30, 2010 should submit a preliminary letter of completion from the Program Director indicating the anticipated completion date. Upon completion of the fellowship, the Program Director should then submit to the ABFM a final letter verifying the date of satisfactory completion. The candidate’s examination results will not be released until the final verification letter is received.

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Demographics This section of the application must be completed as accurately as possible. The information will enable us to have more complete data on the scope of practice, geographical distributions, and interests of ABFM candidates. Medical License All candidates must hold a currently valid, full and unrestricted active license to practice medicine in the United States or Canada. Institutional, temporary, and training medical licenses are not acceptable and should not be entered on the application. All licenses held by a physician, in any state or territory of the United States or province of Canada must be currently valid, full and unrestricted, whether or not the physician practices in the state, territory or province. Candidates shall be required to maintain a full and unrestricted medical license in the United States or Canada even if they are out of the country for extended periods of time. Any action by a licensing authority potentially places a physician in jeopardy of losing Diplomate status and /or eligibility for certification or recertification. Should a physician be uncertain about the status of a medical license relative to ABFM policy, a written inquiry should be made to the Board prior to attempting an application. A violation of ABFM policy on licensure can be any action by a state licensing agency, agreement between a licensing agency and a physician, or voluntary action by a physician that revokes, restricts or suspends the physician’s medical license. In cases where a physician has changed his/her residence deliberately to avoid prosecution, loss of license, or disciplinary action by a state licensing agency, the Board reserves the right to revoke or suspend Diplomate status and/or prohibit application for certification. Should a license be revoked, restricted, or suspended following the submission of an application but prior to the examination, the application will be invalidated and the candidate will be prevented from taking the examination. A partial refund of fees will apply. Unrestricted licenses which have become inactive (e.g., expired, nonrenewal) are not a violation of the Board’s policy on licensure, as long as the physician maintains at least one other current, full, valid, and unrestricted medical license in the U.S. or Canada. Should a license be revoked, restricted, or suspended following the examination but prior to the notification of examination results, the application and certification will be simultaneously invalidated. The full examination fee will be forfeited. If and when the physician's revoked, restricted, or suspended license is reinstated in full (with no restrictions) and official written documentation of reinstatement is provided, the ABFM will honor the remainder of the current certificate and the Diplomate will not be required to be re-examined. If the current certificate has expired prior to the reinstatement of the license, the physician may make application for the next annual examination. Successful compliance with all application requirements in effect at that time will be expected. The ABFM will verify the license status of all candidates through the Federation of State Medical Boards. However, it is the responsibility of family physicians to inform the Board in writing immediately following action by a licensing authority. If the candidate fails to notify the Board of any action within 60 days after the effective date, the physician shall be ineligible to seek certification for up to one year following the reinstatement of full and unrestricted licensure. Applicants should respond "YES" to the question concerning revocation, modification, or restriction of your license, if there has been any actions taken. You will be required to provide specific

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information regarding the action, which will temporarily delay the processing/approval of your application until the issue has been resolved. Questions about licensure should be presented to the Board in writing. Special Testing Accommodations The American Board of Family Medicine (ABFM) provides reasonable accommodations in accordance with the Americans with Disabilities Act (ADA) and the ADA Amendments Act of 2008 (ADAAA) for individuals with documented disabilities who demonstrate a need for accommodation. In accordance with these Acts, ABFM does not discriminate against individuals with disabilities in providing access to its examination program.

For the purpose of requesting test accommodations, the ADA Amendments Act of 2008 defines a person with a disability as someone with a physical or mental impairment that substantially limits one or more major life activities such as walking, standing, seeing, hearing, eating, sleeping, speaking, breathing, learning, reading, concentrating, thinking, communicating or working.

The purpose of accommodations is to provide equal access to ABFM examinations for all individuals. Accommodations “match up” with the identified functional limitation so that the area of impairment is relieved by means of an auxiliary aid or an adjustment to the testing procedure. Functional limitation refers to the aspects of a disability that interfere with an individual’s ability to function in some capacity on a regular and continuing basis

The purpose of documentation is to validate that an applicant for test accommodations is a disabled individual as defined by the ADAAA and to provide guidance in determining effective accommodations. Comprehensive information by a qualified professional is necessary to allow ABFM to understand the nature and extent of the applicant’s disability and the resulting functional impairment that limits access to its examinations. It is essential that an applicant’s documentation provide a clear explanation of the functional impairment and a rationale for the requested accommodation.

No candidate shall be offered an accommodation that would compromise the ABFM examination’s ability to test accurately the skills and knowledge it purports to measure and no auxiliary aid or service will be provided which will fundamentally alter the examination or will result in an undue burden to ABFM. General Guidelines for all Disabilities The following guidelines are provided to assist the applicant in documenting a need for accommodation based on an impairment that substantially limits one or more major life activities. The examinee must personally initiate a request for accommodations within the on-line application, or for release of information relative to an accommodations request. Documentation submitted in support of a request may be referred by the ABFM to experts in the appropriate area of disability for a fair and impartial professional review. Accommodations requests by a third party (such as an evaluator or a program director) cannot be honored.

• Documentation of disability assists the ABFM in determining reasonable accommodations and/or services, which are provided on a case-by-case basis. If the submitted documentation is incomplete or does not support the request, the applicant will be asked to provide additional documentation. The cost of obtaining all documentation is borne by the applicant.

• The documentation submitted should be as comprehensive as possible in order to allow the ABFM to make an informed decision on the accommodation request and to avoid delays in the decision-making process.

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• Documentation in support of a request for accommodations should be submitted to the ABFM early enough to allow sufficient time to review the request and implement reasonable accommodations and/or services. • Documentation must be provided by a licensed or otherwise properly credentialed professional who has undergone appropriate and comprehensive training, has relevant experience, and has no personal relationship with the individual being evaluated. The individual making the diagnosis must be qualified to do so (e.g., an orthopedic limitation might be documented by a physician, but not a licensed psychologist). • Documentation should be typed or printed on official letterhead with the name, title, professional credentials, address, phone number, and signature of the evaluator, as well as the date of the report.

The documentation must be current. Because the provision of reasonable accommodations is based on an assessment of the current impact of the applicant’s disability on the testing activity, it is important that the individual provide recent documentation. As the manifestations of a disability may vary over time and in different settings, it is expected that an evaluation will have been conducted within the past three years. Certain conditions such as some physical and psychiatric conditions are subject to change and should be updated for current functioning. To support a request for test accommodations, please submit a detailed, comprehensive written report from your treating professional describing your disability and its impact on your daily functioning. The report should also explain the need for the requested accommodations relative to your impairment. The report and accompanying documentation should clearly state the following:

• A specific, professionally recognized diagnosis of the disability using diagnostic codes from the Diagnostic and Statistical Manual of Mental Disorders (DSM) or other professionally recognized formulation.

• A description of the functional limitations resulting from the diagnosed disability, including the identification of the major life activity that is limited by the disability, and how that major life activity is impacted.

• A description of the specific diagnostic criteria and names of the diagnostic tests used, including date(s) of evaluation, specific test results and a detailed interpretation of the test results. This description should include the results of diagnostic procedures and tests utilized and should include relevant educational, developmental, and medical history.

• Specific test results using standard scores should be reported to support the diagnosis. Diagnostic methods used should be appropriate to the disability and current professional practices within the field. Any additional informal or non-standardized evaluation procedures should be described in enough detail that other professionals could understand their role and significance in the diagnostic process.

• Copies of records relating to and documenting the candidate’s disability, including a complete educational, developmental, and/or medical history relevant to the disability for which testing accommodations are being requested.

• A recommendation of specific accommodations and/or assistive devices for the ABFM examinations including a detailed explanation of why these accommodations or devices are needed and how they will reduce the impact of the identified functional limitations.

• Identification of the professional credentials of the evaluator that qualify him/her to make the particular diagnosis, including information about license or certification and specialization

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in the area of the diagnosis. The evaluator should present evidence of comprehensive training and direct experience in the diagnosis and treatment of adults in the specific area of disability.

If accommodations have not been requested previously, provide a detailed explanation to why no accommodations were sought in the past and why accommodations are needed now.

Send your documentation to: Accommodations Coordinator American Board of Family Medicine 1648 McGrathiana Parkway, Ste. 550 Lexington, KY 40511-1247

All required documentation must be received by the final deadline for submitting an application. The last day to approve requests for special testing accommodations is the final deadline for clearing application deficiencies. After that date, requests that are lacking information or are incomplete for any reason will not be processed and the candidate will be required to take the exam under normal testing conditions or defer to a future examination. For further information regarding Special Testing Accommodations, specifically disabilities such as learning and cognitive disorders, ADHD, physical disabilities, vision disabilities, and psychiatric disabilities, please refer to the Policy Statement for Americans with Disabilities Act (ADA) Compliance available on our website. Agreement Page of Application On this page of the online application, you are asked to attest to having read the Candidate Information Booklet including the full Agreement at the end of the Candidate Information Booklet, and are agreeing to be bound by the conditions therein. You are also confirming that all the information provided in the application is complete and true. Your full name and ABFM ID number will be presented to identify that you are the person signing the agreement. You are asked to electronically sign the agreement by clicking, “Yes” I Agree and by providing the last four digits of your social security number. Approval of Application and Selection of Exam Date/Location Once all components of your application are completed and all deficiencies are cleared, we consider you as approved for the exam and the ABFM notifies Prometric that you are eligible to select your testing date, time and location. We strongly urge candidates to select a testing date and location as early as possible prior to October 31, 2010. Although we will allow test center selections after October 31, 2010, there will be very limited availability as candidates will be selecting their centers in competition with other Prometric examinees. On the Prometric website you can check availability of seats prior to making your final selection of date/location. You may check for available seats at any time during the application process; however, seats are assigned on a first come, first served basis, therefore availability is constantly changing. To search for available seats, click on the link www.prometric.com/abfm, select “start” and select your state then “Search for Seat Availability”. Once your application is approved, you may select a date/location through your ABFM application where you will be redirected to the Prometric website to see the most current available test dates

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and locations. Once you have made your selection, within 24 hours you will receive a confirming email from the ABFM with your selected date/location. When you have the confirming email for the selected date/location, you can return to your Physician Portfolio and print your E-Ticket. If you need to reschedule, please refer to the “Reschedule or Withdraw from the Exam” section below for instructions. Please note that you must select a test date and location no later than November 29, 2010. Be advised that not all test centers are available on all exam dates. Exam Test Sites: United States, U.S. Territories and Canada Prometric provides testing in approximately 330 U.S. locations as well as 13 locations in Canada. The full list of locations is always available on their website and is updated for each exam administration to add new locations or delete those no longer being utilized. For specific locations of available testing centers go to www.prometric.com/abfm and click on “Locate a Test Center”. International Test Centers The ABFM and Prometric offer testing at several international locations. Prometric has in place an established network of professional test centers providing the same high level of security, candidate verification and secure exam administration as their U.S. testing locations. To search for available international locations, go to www.prometric.com/abfm and click on “Locate a Test Center” and select the country you prefer to see if there is a location there. Once you select an international testing location, you will be prompted to submit the international testing fee of $200. This is an additional cost beyond the normal application fee and is applicable only to the international sites. After confirmation of your appointment at an international location, please return to your online application to pay this fee. If after paying the international testing fee, you withdraw or cancel your exam appointment 5 days or more from the exam date, the $200 fee may be refunded; however, any withdraw or cancellation less than 5 days from the scheduled exam date will result in forfeiture of the $200 international testing fee. On exam day, all candidates will be required to sign the logbook, show a valid government-issued identification (bearing a signature and photo) and a fingerprint scan to be admitted for testing. If primary ID does not contain a signature and photo a secondary form of ID may be required at the international locations.

E-Ticket (Electronic Admission Ticket) The E-Ticket for the exam will be available to print as soon as you receive the test center selection confirmation email from the ABFM. The receipt of this email may take up to 24 hours from the time you make a selection of date/time/location. Upon receipt of this email, you can then return to your Physician Portfolio and click on the “E-Ticket” link. By clicking the “E-Ticket” link you will be presented with the E-Ticket on your screen with a prompt to “Print E-Ticket” in the upper right corner of the screen. You must have this ticket with you at the exam because it contains a six-digit Validation Code that must be entered into the computer to begin the exam. Please review the E-Ticket thoroughly since it contains critical information about the examination, your Validation Code,

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Exam Confirmation Number, and the location of the testing center. Please note your name on record with the ABFM must be the same as the ID which you will present for admittance to the exam. Any discrepancy in your name will potentially delay or prevent your being admitted to the exam. The last day to make a name change is November 24, 2010. If you need to reprint your E-Ticket, there is always a copy in your Physician Portfolio. Reschedule or Withdraw from the Exam Reschedule Exam Candidates who need to reschedule their exam date and/or location for the exam may do so through the ABFM website which will redirect you to Prometric’s website. To reschedule you will be required to enter your Exam Confirmation Number from your Test Center Selection Email or your E-Ticket. You may reschedule an exam appointment at no cost if done at least 30 days or more prior to your scheduled exam date. Rescheduling within 29-5 days prior to your scheduled exam will result in a reschedule fee of $35. Any reschedule within 4 days to 48 hours prior to your scheduled exam will result in a reschedule fee of $60. The deadline to reschedule an exam is 48 hours prior to your scheduled exam appointment. All reschedule fees will be payable to Prometric at the time of reschedule. Cancelling Exam If you choose to withdraw from the exam, you must do so on the ABFM website. Do not contact Prometric directly to cancel your exam. In order to prevent a cancellation fee you must withdraw 30 days or more prior to your scheduled exam date. Cancelling or withdrawing from the exam within 29 to 5 days prior to your scheduled exam date will incur a cancellation fee of $35. Any cancellation/withdraw less than 5 days prior to your scheduled exam date will result in a seat fee of $100 and forfeiture of $200 paid for international testing fee (if applicable). Please refer to our Refund policy for additional information regarding a refund.

EXAM INFORMATION

Content The practice of Sports Medicine is the application of the physician's knowledge, skills and attitudes to all persons engaged in sports and exercise. The content of the examination will include: • Physiology and biomechanics of exercise

• Basic nutritional principles and their application to exercise • Psychological aspects of exercise, performance and competition • Guidelines for evaluation prior to participation in exercise • Physical conditioning requirements for various activities • Pathology and pathophysiology of illness and injury as it relates to exercise • Effects of disease on exercise and the use of exercise in the care of medical problems • Prevention, evaluation, management, and rehabilitation of injuries

• Understanding pharmacology and effects of therapeutic, performance-enhancing, and recreational drugs

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• Promotion of physical fitness and healthy lifestyles • Functioning as a team physician • Ethical principles as applied to exercise and sports • Medical-legal aspects of exercise and sports • Anatomy related to exercise • Growth and development related to exercise

Facts about the Examination The examination is offered in computer-based format. Key points concerning the computer-based examination are as follows: 1. Extensive familiarity with computers is not required, but the use of a computer keyboard and

computer mouse should be within the experience of all candidates

2. An online tutorial (exam orientation) is available on our website. Candidates are strongly encouraged to gain familiarity with the computer-based testing system by logging on to https://www.theabfm.org/examtutorial.htm. You can also access the tutorial from the ABFM home page: www.theabfm.org, by clicking on “Certification/Recertification Exam”, then “Exam Preparation”, and then select “Exam Tutorial” from the list of documents at the bottom of that page.

3. On exam day there will be a brief orientation/tutorial prior to starting the exam allowing

candidates to re-familiarize themselves with the exam process.

4. The examination is proctored by staff from the Prometric Company. In view of the numerous exams administered by Prometric, all of which are unique in their function and format, testing center staff are not expected to provide detailed assistance for ABFM candidates. It is not the responsibility of Prometric staff to provide assistance on things such as navigating through the exam or resolving any misjudgments made by the candidate. Candidates need to carefully read the on-screen messages in order to respond correctly. To do otherwise may result in loss of exam or break time, which cannot be altered by Prometric staff. Prior to your exam day, you should become familiar with the operational procedures of the exam through the online tutorial and make yourself fully aware of the exam schedule.

5. Computer-based testing options include the ability to navigate forward and backward through the exam, mark items for further review, review answered, unanswered and marked items. Items must be reviewed or changed prior to expiration of time for that section. Once an exam section is ended by the candidate or the exam has timed out, you cannot return to questions in that section.

The examination screen contains a timer in the top right corner showing the time remaining for the current exam section. A listing of completed questions, incomplete questions, and marked items can be accessed by clicking the “Review” button at the bottom of the exam screen. From the Review screen, you are able to:

• click the button “Review All,” which returns to question one ,

• click the button “Review Incomplete,” which returns to the first incomplete (unanswered) question,

• click the button “Review Marked,” which returns to the first question you marked for review, or

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• double-click on any of the numbered questions listed which returns you to that specific question.

When you have selected Review All, Incomplete or Marked items, the “NEXT” button will take you to the next item in the type questions you have chosen to review. If you opted to review “Incomplete” questions you will only be presented with the next sequential question that is incomplete. You may end the exam by clicking “End”. If you click “End” you will not be able to return to any of the questions in that section. Note: there is a pop-up box for you to confirm that you truly wish to end the exam section. Clicking “No” will return you to the review screen for further review of that section.

Candidates should report promptly to the assigned test center at least 30 minutes prior to the appointment time listed on the E-Ticket. This allows time for completing the registration process which includes verifying ID, E-Ticket, signature, and a fingerprint scan (which will be discarded after the examination). The E-Ticket and one form of positive identification must be brought to the test center in order to be admitted. The ID must be a government-issued, non-expired ID, containing both a photo and signature. The ID must be one of the following: driver’s license, passport, or a state/county identification card. The name on the ID must be the same as the name on your E-Ticket. Employee IDs/work badges, school IDs, and credit cards are NOT acceptable as an ID. Candidates presenting with an ID that does not match the name of record with the ABFM or with an expired ID or one that does not contain a photo and signature will not be admitted to the exam. Personal items, such as cellular phones, hand-held computers/personal digital assistants (PDA’s), a watch or time piece of any kind, or other electronic devices, pagers, any writing instrument or paper, purses, hats, bags, books, and notes are not allowed in the testing room and we strongly encourage you to leave them at home or in your car. If you take a cellular telephone or any electronic device into the examination room (even by accident), you risk invalidation of your entire examination. Sweaters or jackets must be worn if taken into the exam room. You must store all personal items in a locker. Candidates are NOT permitted to take any examination materials from the test center or to make written notes of the contents of the exam. Candidates found to be violating these rules will have their test performance voided. During an active exam, examinees may not use telephones, leave the examination center (except for scheduled breaks), or communicate with one another in any way. Furthermore, examinees may not discuss the content of the questions with anyone during or following the examination. Candidates who do so will have their test performance voided. An erasable note board and marker will be provided at your workstation during the exam for any work preparatory to answering a specific question. All note boards and markers must be turned in at the conclusion of the exam. No other writing instrument (pen or pencil) or papers are permitted in the exam room. Prometric, the ABFM’s computer-based testing vendor, administers examinations for a variety of clients. Consequently, ABFM Diplomates and candidates may be testing with others who are required to use the computer keyboard to type their answers. Any noise due to keyboard clicking can be minimized by use of ear plugs or headphones available at the exam. Once the examination begins, if the examinee fails to complete and/or attempt any part of the exam, he/she must understand that any questions not answered, will be counted as incorrect. When there

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are unanswered items, or exam sections that are not attempted, additional time will not be allowed for completion, nor will there be any refund of the exam fee or credit toward future fees. Failure to follow instructions on the computer or instructions provided by the test administrator can result in an examinee's entire test being voided. Comfort Aids Items allowed in testing room (all other personal items must be stored in locker)

• Eyeglasses • Hearing aids • Earplugs • Neck Braces or collars • Insulin Pump • Sweaters, sweatshirts, blazers must be worn at all times; they cannot hang on the back of

the candidate’s chair – if removed must be placed in locker. • Pillows for back/neck support due to injury are permitted but require advance notification

and inspection. • Motorized cart/chair • Wheel Chair • Crutches, Cane, Walker • Religious Headwear/Scarf/Hat • Transcutaneous Electrical Nerve Stimulation (Tens) Unit • Test Monitors without blood letting / attached to candidate • Extra chair or footstool to support injured leg is permitted but requires advance notification

Items that must be stored in the locker or left with the Test Center Administrator

• Cough drops and throat lozenges • Required oral medication • Chewing Gum – Not allowed in test room • Eye drops (prescription or over the counter) • Diabetic Test Equipment (Glucose Monitor) and Source of Rapid Glucose • Lip Balm • Asthma Puff Inhalers

The following items are provided by Prometric

• Tissues • Dry erase board and marker (no other writing surface or writing instrument allowed)

Study Materials

The Board does not provide bibliographies or review materials. However, you may find it helpful to read a section on our website titled “Exam Preparation”. This can be found on our website: www.theabfm.org by clicking on Certification/Recertification and then selecting “Exam Preparation”. Here you will find videos as well as documents regarding “study tips”. Candidates may wish to contact the American College of Sports Medicine (317) 637-9200 for information on team physician courses.

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Prometric Information Prometric is the computer-based testing vendor the ABFM uses to administer the exam. To locate a test center or to obtain specific directions to your test site, please visit their website at www.prometric.com/abfm. If you need further assistance, we ask that you do not call Prometric directly; instead, please contact the ABFM Support Center at (877) 223-7437 or at help@theabfm.org. EXAM DAY SCHEDULE Please note that exam start times may vary due to the fact that candidates can schedule their exam appointment at different times. Candidates who arrive 30 minutes or more after their scheduled time will be considered tardy and will not be permitted to test. SAMPLE FOR 8:30 AM START TIME – 2010 Sports Medicine Exam 8:00- 8:30 AM Registration, Checking ID, and Seating

Approx. 8:30 - 8:50 AM Enter Validation Code, Review of ABFM rules, Exam Tutorial, Instruction for Exam

Approx. 8:55 AM Exam - 200 Multiple Choice Questions (4 Hours)

Approx. 12:55 PM Brief Exam Survey

Approx. 1:00 PM End of exam day

NOTE: The examination is timed, and once completed, voluntarily quit, or timed out; the questions cannot be accessed again.

ABFM Policies Examination Administration Protocols and Procedures Violation of Written Procedures - Registration Process

• E-Ticket Any candidate who is unable to present a valid E-Ticket at the testing site must telephone the ABFM to obtain the validation code and other pertinent information. Prometric will not have this information. The candidate will not be permitted to use the testing center phone but should call from the lobby by using their personal cell phone or locate and use the nearest pay phone.

• Government-Issued Form of Identification

A candidate is required to present a non-expired government-issued, photo and signature bearing ID in order to be admitted to the exam. Anyone unable to present a valid ID with signature or whose name does not match the name on the eligibility file provided to Prometric, will be denied admission to the examination. Acceptable identification in this category includes: driver’s license, passport, state/county identification card, or other government-issued ID.

• Fingerprint

As a secure means for the candidate to enter and exit the testing room a single fingerprint will be required. Any candidate who refuses to provide a single fingerprint on exam day will be denied admission. All fingerprint data is deleted at the end of the exam day.

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Violation of Written Procedures within the Testing Room Areas within a testing vendors’ jurisdiction and control are generally recognized as the examination registration area, waiting area, locker area, and testing room. “Active testing” is any period during which a candidate’s exam time clock is running.

• Possession or Use of Prohibited Instructional Information or Personal Items If a candidate while actively testing is observed to have prohibited instructional information or personal items in his or her possession, which may include but not be limited to reference materials, texts, articles, review materials, written notes, electronic media, devices designed to augment knowledge or recall, a watch or timepiece of any kind, cellular telephone, pager, personal digital assistant (PDA), mini-computer, camera, paper/writing surface or writing instrument (not provided by Prometric) the test administrator will immediately advise the candidate that a violation of the ABFM testing policy has occurred. The candidate will not be permitted to continue testing and a final determination of the matter will be withheld pending the results of the ABFM investigation. All materials found in the examination room will be inventoried by the test administrator and listed in a detailed written Candidate Problem Report following the examination.

• Communication with Others

If a candidate while actively testing is observed communicating with another ABFM candidate in the examination room, regarding medical information, exam content, or unknown topics, regardless of mode of communication, the test administrator will advise the candidates that a violation of the ABFM testing policy has occurred. The candidates will not be permitted to continue testing and a final determination of the matter will be withheld pending the results of the ABFM investigation. The test administrator will provide a detailed written Candidate Problem Report following the examination.

• Looking at the Answers of Another Candidate

If a candidate while actively testing is observed looking at the answers of another ABFM candidate, the candidate will be advised that a violation of ABFM testing policy has occurred. The candidate will not be permitted to continue testing and a final determination of the matter will be withheld pending the results of the ABFM investigation. The test administrator will provide a detailed written Candidate Problem Report following the examination.

Violation of Written Procedures within the Registration, Waiting, or Locker Areas

• Possession or Use of Prohibited Instructional Information or Personal Items If a candidate while actively testing (e.g. on an unscheduled break) removes prohibited instructional information or personal items which may include but not be limited to reference materials, texts, articles, review materials, written notes, electronic media, devices designed to augment knowledge or recall, a watch or timepiece of any kind, cellular telephone, pager, personal digital assistant (PDA), mini-computer, camera, paper/writing surface or writing instrument (not provided by Prometric) from his or her locker and the removal of items is observed by testing personnel the test administrator will immediately instruct the candidate to return the prohibited item to the locker. If the candidate is not compliant, the test administrator will remind the candidate of the requirements for testing during an active exam. If the material or personal items have not been accessed the candidate may continue testing without penalty. However, if the prohibited information or personal item has been accessed, the candidate will not be permitted to continue testing and a final determination of the matter will be withheld pending the results of the ABFM investigation. All materials removed from the locker by the candidate will be inventoried by the test administrator and listed in a detailed written Candidate Problem Report following the examination.

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• Communication with Others If a candidate while actively testing is observed communicating with other persons, including but not limited to other candidates, regarding medical information, exam content, or unknown topics, regardless of mode of communication, the test administrator will immediately determine the nature of the conversation and remind all parties involved that no communication of any kind is permitted during active testing. The candidate(s) will be warned that testing will continue without penalty, but a repeat violation will terminate the testing process. The test administrator will provide a detailed written Candidate Problem Report following the examination. Violation of Written Procedures in External Areas External areas are defined as locations within the building that houses the testing center which are not under the vendor’s direct purview, such as bathrooms, lobbies, foyers, and cafeterias, but are observable by interested parties such as other candidates or test center personnel.

• Possession or Use of Prohibited Instructional Information or Personal Items

If a candidate while actively testing (e.g. on an unscheduled break) is observed to have prohibited instructional information or personal items in his or her possession, which may include but not be limited to reference materials, texts, articles, review materials, written notes, electronic media, devices designed to augment knowledge or recall, a watch or time piece of any kind, cellular telephone, pager, personal digital assistant, mini-computer, camera, paper/writing surface or writing instrument (not provided by Prometric) the test administrator will immediately advise the candidate that a violation of the ABFM testing policy has occurred. The candidate will not be permitted to continue testing and a final determination of the matter will be withheld pending the results of an ABFM investigation. All materials found in the examination room will be inventoried by the test administrator and listed in a detailed written Candidate Problem Report following the examination.

• Communication with Others

If a candidate while actively testing (e.g. on an unscheduled break) is observed communicating with other persons, including but not limited to other candidates, regarding unknown topics, the test administrator will immediately attempt to determine the nature of the conversation and remind all parties involved that no communication of any kind is permitted during active testing. The candidate(s) will be warned that testing will continue without penalty, but a repeat violation will terminate the testing process. The test administrator will provide a detailed written Candidate Problem Report following the examination. Examination Administration Parameters

• Failure to Comply With Specific Test Administrator Instructions During the testing day, candidates must comply with the directions/instructions of the test administrator. Any candidate who does not follow the instructions of the test administrator may be subject to dismissal from the testing center and/or having his or her examination invalidated.

• Late Arrivals

Candidates who arrive 30 minutes or more after his/her scheduled exam start time will be considered tardy and will not be seated or permitted to test.

• A Vendor-Caused Delay If a candidate arrives at the test center on time but begins the exam later than the scheduled appointment time due to a technical issue or other vendor-caused delay, the candidate will be given the full amount of testing time. Any candidate in this situation will be seated as quickly as possible.

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• Unscheduled Breaks During Testing The ABFM recognizes that candidates may need to take an unscheduled break from testing while the exam clock continues to run. Extended absences, multiple breaks, or excessive cumulative time away from testing will be subject to scrutiny by the ABFM. Guideline for the Handling of Critical Irregularities During Exam Administration

• An Interruption Not Controlled by the Candidate An examination interrupted by external causes or technological problems not controlled by the candidate will be continued if at all possible. All interruptions in testing greater than one hour will be reported to the ABFM by the test administrator or other designated employee. If the examination is predicted to resume within the next hour, candidates will be encouraged to remain at the testing center to complete the examination. Candidates who wish to leave will have their examination rescheduled at a mutually convenient time for the candidate, the ABFM, and the Vendor. Any exam section that is not completed will be replaced for any subsequent testing. (e.g., if a candidate has completed 100 of 200 questions, the entire test form will be replaced and the candidate will subsequently take a new 200 question form.) Should an interruption exceed two hours, candidates will be advised that testing for the day has terminated and the examination will be rescheduled at the earliest possible mutually convenient time for completion of the examination.

• Scoring the Examination Following an Interruption

Any candidate whose examination was interrupted longer than one hour for non-candidate issues, whether or not the candidate was able to finish the examination, will be contacted by the ABFM prior to scoring to determine if the candidate wishes the examination to be scored. The candidate must indicate in writing that he/she wishes to have the examination scored, or the results invalidated. If a candidate elects to proceed with scoring, their test performance result will stand as valid and consequential. If a candidate chooses to negate the examination, their results will be erased without scoring and no performance feedback will be provided. The candidate will be rescheduled at the earliest possible mutually convenient time for retesting. Candidates will not be charged for the retest experience. Post Examination Issues

• Statistical Analysis of Performance Statistical evidence of suspicious results, a grossly statistical significant improvement from one examination to another, and response patterns of incorrect answers significantly similar to another examinee at the same or different testing center, would strongly suggest that the content of the test has been exposed prior to or during the examination. The ABFM has the option to nullify exam results without refund if any of the above suspicious results are found through the use of software programs generally accepted among the psychometric community for detecting such results. A cutoff of sixty days following an examination has been established by the ABFM for follow-up with the candidate, review of statistical data, examination of log files, and review of audio/video as needed.

• Review and Analysis of an Irregularity Following the observation of and the action taken for an irregularity the ABFM staff will review and analyze all information at its disposal to confirm the occurrence of a testing violation. Such information will include, but may not be limited to: Candidate Problem Reports from test administrators, audio recording records, video recording records; notations and descriptions of prohibited instructional material or personal items in the possession of the candidate, and an explanation of the event/irregularity from the candidate. If the ABFM determines in its sole discretion that a violation of testing policy has occurred, the candidate will be notified in writing by certified

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mail. The candidate will be advised that the sanction for such a violation is ineligibility for a period of not less than six continuous years as of the date of the examination. The physician will be informed also that he or she may request reconsideration of the action by the Credentials Committee of the ABFM. As with all Credentials Committee cases, the physician may submit written material for review by the Committee.

Candidate Problem Reports

• Communication, Notification, and Documentation Procedures Included in the report of an irregularity, test administrators will make specific notation of the time of day, the part of the exam version at the time an incident was noted. Consequences of Violating the ABFM’s Examination Protocols and Procedures

Following the observation of and the action taken for an irregularity, ABFM staff will review and analyze all information at its disposal to confirm the occurrence of a testing violation. If the testing violation is confirmed, the candidate will be notified in writing by certified mail. The candidate will be advised that the sanction for such a violation is ineligibility for a period of not less than six continuous years as of June 30 of the year of the certification, recertification, CAQ or MC-FP examination for which the candidate is applying. The physician will be informed also that he or she may request reconsideration of the action by the Credentials Committee of the ABFM. Policy for Examination Retakes Occasionally problems occur during the administration of examinations that may impede the examination process. Weather problems, mechanical failures, hardware and software problems, and human errors have the potential of interfering with some part of the examination process. When such problems occur, the ABFM will review all information at its disposal. An opportunity for reexamination will be offered should the ABFM in its sole discretion determine that an incident or irregularity could have affected a candidate’s performance. A re-examination shall be the candidate's sole remedy. The ABFM shall not be liable for inconvenience, expense or other damage caused by any problems in the administration or scoring of an examination, including the need for retesting or delays in score reporting. In no circumstance will the ABFM reduce its standards as a means of correcting a problem in examination administration.

• Physicians who experience incidents or irregularities during testing must inform the ABFM by letter, fax, or email within one (1) week following the examination. A detailed explanation of the circumstance or event that occurred during testing is required.

• If it is determined that an incident or irregularity had the potential of influencing a candidate’s

examination performance, the physician will have two options: (1) to be retested at the earliest possible time; or, (2) to have the examination scored.

• If the retest option is chosen, the response data from the recently completed examination will

be invalidated and expunged from the ABFM records. Make-up examinations are based on the following time-frame:

o Summer Exam – deadline for retake is October 31 of same year. o Winter Exam – deadline for retake is December 31 of same year.

• For incidents resulting in the invalidation of a summer exam and retest:

o Successful performance on the retake exam will apply to the previous exam date. o Unsuccessful performance on the retake exam will be recorded as an unsuccessful

attempt and the candidate will be allowed to apply for the winter examination.

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• For incidents resulting in invalidation of a winter exam and retest:

o Successful performance on the retake exam will apply to the previous examination date, allowing for continuous certification.

o Unsuccessful performance on the retake exam will be recorded as an unsuccessful attempt. If the candidate is in their final year of certification at the time of the winter exam, this will also result in the loss of certification effective December 31st. The candidate will remain eligible to apply for the following summer examination.

• Candidates who choose the option of having their examination scored will receive a report of

their performance and a letter indicating whether they were successful or unsuccessful. The examination fee will be applied toward the examination.

• Candidates who are unable or unwilling to be reexamined within the above timeframes will be

permitted to make application and sit for the next regularly scheduled examination without additional fees. If the physician’s certification is due to expire, there will not be an extension and the certificate will expire at the regularly scheduled time. Candidates who are unable to take the next regularly scheduled examination will receive a fee refund consistent with published policy.

Examination Results It takes approximately 6-8 weeks for candidates to receive their examination results, which can be accessed in your Physician Portfolio when available. In addition to pass/fail information, candidates receive their overall scaled score and scaled scores for the different content areas. Re-Examination There is no limit to the number of times a qualified candidate may take the examination. An application is valid only for the examinations held in a single calendar year. Candidates who fail the examination will be given the opportunity to take it again. Full fees are charged for each examination. Period of Certification Those successful on the examination will be awarded an ABFM Certificate of Added Qualifications in Sports Medicine. The certificate will bear a date limiting the duration of its validity to ten years. Reassessment will be required for renewal of the certificate. If, for any reason, primary certification in family medicine is not maintained (e.g., expiration, revocation, etc.), certification in Sports Medicine will simultaneously be withdrawn at the time of the loss of the primary certificate. Upon restoration of the family medicine certificate, the CAQ in Sports Medicine will simultaneously be restored for the remainder of the current certificate. In order to maintain primary certification, the Diplomate must successfully complete the program of Maintenance of Certification for family physicians (MC-FP). Diplomates who complete the MC-FP process in accordance with published timelines will have their primary certification extended from seven to ten years. Please review the requirements of the MC-FP program at: www.theabfm.org.

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Revocation Each certificate issued by the Board of Directors of the American Board of Family Medicine shall be subject to revocation in any of the following circumstances. General The issuance of such certificate or its receipt by the person so certified shall have been contrary to, or in violation of, any provision of the Articles of Incorporation of the American Board of Family Medicine, Inc., or of the Bylaws of the American Board of Family Medicine. The person so certified shall not have been eligible to receive such certificate, irrespective of whether or not the facts constituting such ineligibility were known to, or could have been ascertained by, the Directors of the Corporation or its representatives. The person so certified shall have made a misstatement of fact in the application for such certificate or in any other statement or representation to the Corporation or its representatives. The person so certified shall at any time have neglected to maintain the degree of competency in the field of family medicine established by the Board. The person so certified has fraudulently altered, copied, or changed a certificate of the American Board of Family Medicine, or has fraudulently presented, or allowed to be presented on behalf of the individual, an altered, copied, or changed certificate of the Board. In such cases, the Board reserves the right to revoke, suspend, and/or prohibit subsequent certification of the offending party for a period not to exceed six (6) years from the date of discovery of the offense. In the event the individual appeals or otherwise challenges the suspension, the six (6) year period shall be tolled until the action of the Board is determined to be final and enforceable. Licensure Status A Diplomate of the American Board of Family Medicine shall be required to hold a currently valid, full and unrestricted license to practice medicine in the United States or Canada. Furthermore, every license to practice medicine held by a Diplomate in any state or territory of the United States or province of Canada must be currently valid, full and unrestricted, whether or not the Diplomate in effect practices in such state, territory, or province. Diplomates shall be required to retain a full and unrestricted medical license in the United States or Canada even if they are out of the country for extended periods of time. Failure to retain a license will result in loss of Diplomate status and will result in the loss of the ability to make application for certification, recertification, or other examinations offered by the Board. In the event a Diplomate's license to practice in ANY state or territory of the United States or province of Canada is revoked, restricted or suspended, the Diplomate's certificate is simultaneously rescinded at the time of the licensure revocation, restriction or suspension. The physician must advise the American Board of Family Medicine within 60 days and cease immediately identifying himself/herself in any way directly or indirectly as a Diplomate of the American Board of Family Medicine. If the physician fails to notify the American Board of Family Medicine of any revocation, restriction or suspension within 60 days after the effective date, he/she shall be ineligible to seek reinstatement of Diplomate status for up to one year following the reinstatement of full and unrestricted licensure. Candidates for the Certification Examination and Diplomates of the ABFM should be aware that the ABFM receives periodic Disciplinary Action Reports from the American Medical Association of actions by states against medical licenses.

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Any adverse action by a state licensing agency, agreement between a licensing agency and a physician, or voluntary action by a physician, that revokes, restricts or suspends the physician’s medical license is a violation of ABFM policy. In cases where a physician has changed his/her residence deliberately to avoid prosecution, loss of license, or disciplinary action by a state licensing agency, the Board reserves the right to revoke or suspend Diplomate status and/or prohibit application for certification. Questions about licensure should be presented to the Board in writing. If and when the physician's revoked, restricted or suspended license is reinstated in full (with no restrictions) and official written documentation of reinstatement is provided, the ABFM will honor the remainder of the current certificate and the Diplomate will not be required to be reexamined. If the current certificate has expired prior to the reinstatement of the license, the physician may make application for the next available examination. Successful compliance with all application requirements in effect at that time will be expected. At the time the application is submitted for review, each candidate is required to verify that he or she complies with the Board’s policy on licensure. Any candidate’s license that requires additional documentation and correspondence with the licensure board must be resolved by November 24, 2010. Authority The Board of Directors of the American Board of Family Medicine shall have sole power and authority to determine whether or not the evidence or information before it is sufficient to constitute grounds for revocation of any certificate issued by this Corporation. The Board of Directors may, however, at its discretion, require any person so certified to appear before the Board of Directors, upon not less than thirty (30) days written notice by registered mail, and to show cause, at the time and place specified in such notice, why the certificate should not be revoked. The failure of any person so notified to appear as required in such notice shall, at the discretion of the Board of Directors, constitute cause for revocation of the certificate. The decision of the Board of Directors in all such matters shall be final. Agreement Please read the following conditions regarding the administration of the examination. You will need to verify on the application that you have read and understand this agreement. Your application will not be processed without this acknowledgement. I certify that all the information in this Application is complete and correct to the best of my knowledge and belief. I further certify that every license to practice medicine which I hold in any U.S. state or territory or Canadian province is currently full, valid and unrestricted, unlimited in scope and not temporary. Furthermore, I understand that the examination for which I am applying is voluntary on my part and I voluntarily accept and agree without reservation to the conditions set forth in the Application and this Candidate Information Booklet. I understand that in making this Application I am voluntarily requesting that the Board review and assess my professional standing and that the decision of the Board in making such review and assessment shall be final. I further understand and agree that the American Board of Family Medicine may withhold or rescind approval of this Application, and in the event I am recertified as a Diplomate of the American Board of Family Medicine (ABFM), such recertification may be revoked and my name deleted from the roll of ABFM Diplomates by order of the Board should it determine, in its absolute discretion, that:

1. any of the information in this Application is false or contains material misrepresentations or omissions;

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2. my license to practice medicine has been revoked, restricted or suspended in any state or territory of the U.S. or province of Canada;

3. I fail to satisfy the criteria for certification. I understand that in the event I am recertified, such recertification shall be for a limited period of time and shall not be valid beyond the date on my certificate, and further, that should I withdraw from the recertification process for any reason after paying the required fee, the policy set forth in the Candidate Information Booklet for the current Certificate of Added Qualifications in Sports Medicine Examination shall apply. If my Application to sit for the Sports Medicine Examination is approved, I understand and agree to the following conditions:

1. All the examination questions and all other examination materials are the sole property of the American Board of Family Medicine. Questions or other materials have not been available for review by examinees before taking the examination and they will NOT be available for review by the examinees after taking the examination. No one is permitted to take any of the examination materials from the examination room. No one is permitted to reproduce the test questions in whole or in part, make written notes of the test content, or electronically copy, record and/or transfer test questions or preparatory material. Any notes taken during the exam and removed from the workstation will be considered exam content. No reference materials (texts, articles, or review materials) shall be permitted in the examination area. Following the examination, examinees may not discuss the content of exam questions with anyone.

2. I understand that I am expected to complete all sections of the exam and attempt all questions.

Should I neglect to complete any section of the examination; I understand that any questions not answered will be counted as incorrect, I will not receive additional time, nor will I receive a refund of the exam fee or credit toward future fees.

3. I understand that during an examination, (when actively testing and the exam clock is running) I am prohibited from bringing into the testing room anything unauthorized by the Prometric testing staff. Prohibited instructional information or personal items include, but are not limited to: reference materials, texts, articles, review materials, written notes, electronic media, devices designed to augment knowledge or recall, a watch or time piece of any kind, cellular telephone, pager, hand held computer, personal digital assistant (PDA), mini-computer, camera or any writing instrument except the writing instrument provided by Prometric testing staff. Furthermore, I will not be permitted to communicate with other examinees or any individual, except members of the test administration staff. During an active exam, I will not be permitted to leave the testing center except for scheduled breaks. Following the examination, I may not discuss the content of the exam questions with anyone. Further, I will make no effort to observe the answers of other examinees or have anything at my workstation except materials provided by the administrators at the test center. Only the distributed note taking materials provided by the testing center (i.e. note board, paper, writing instruments, etc.) may be used in the exam room. The use of telephones or leaving the testing area during an examination is prohibited except as permitted by the test administrators.

4. I understand that I risk failing the entire examination if I do not follow instructions on the examination itself.

5. The American Board of Family Medicine reserves the right to refuse admission to any examinee after any session of the examination has actually begun.

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6. The test administrators at my assigned test center are authorized by me to take all action they deem necessary and proper to administer the test securely, fairly and efficiently.

7. Smoking will not be permitted in the examination room.

8. In addition, should I do anything prohibited by the ABFM, or should I be in violation of ABFM policy set forth within this agreement and Candidate Information Booklet, my test scores will be invalidated.

9. I understand that after the exam, I may not discuss the exam with anyone.

10. If after the examination the ABFM receives reports from the test center staff or video/audio surveillance taped during my examination which provides evidence of any violation of policies or accessing prohibited materials described herein or removing notes from the workstation area, the ABFM has the right to invalidate my exam, forfeit the full exam fee and pursue necessary legal action.

I agree that if I wish to have my examination rescored, I must make the request, in writing, within 14 days of the release of the test results. This request must include both a completed ABFM Rescore Request Form and a check made payable to the ABFM for $200. I understand that this review will be limited to verifying (1) that the responses scored were indeed made by me and (2) that the scoring process correctly transformed my responses into a scaled score. I further understand that this review will not be a review of the content of the items or a reconsideration of what the correct answer should be. In addition, I understand that the review will not be a reconsideration of the passing standard or of the acceptability of the testing conditions. I agree that the Board may, at its discretion, release information contained in this Application, my examination results and/or my examination scores to researchers selected by the Board to study the testing and evaluation programs of the Board under appropriate conditions of confidentiality established by the Board. Aside from research purposes, I understand that my individual examination results and scores will be considered by the Board to be confidential, and, unless authorized by me, will not be released to others except pursuant to legal process. I agree to hold the American Board of Family Medicine, its members, examiners, officers and agents free from any complaints, claims or demands for damage or otherwise by reason of any act of omission or commission that they, or any of them, may take in connection with this Application, the availability of testing centers, exam administration, the grade or grades given with respect to my examinations or the failure of the Board to issue me such certificate. I hereby understand and agree that in the event I am granted a Certificate of Added Qualification in Sports Medicine by the American Board of Family Medicine, that certification shall continue only for so long and during such time as I have a current, valid, full and unrestricted license to practice medicine in the U.S. or Canada. I further understand and agree that in the event my license in any state or in Canada is revoked, restricted or suspended for any reason or any term, I shall within 60 days so advise the American Board of Family Medicine at 1648 McGrathiana Parkway, Suite 550, Lexington, Kentucky, 40511-1247 and cease immediately identifying myself in any way directly or indirectly as a Diplomate of the American Board of Family Medicine. I FURTHER UNDERSTAND AND AGREE THAT IF I FAIL TO NOTIFY THE AMERICAN BOARD OF FAMILY MEDICINE OF ANY SUSPENSION, REVOCATION OR RESTRICTION ON ANY OF MY MEDICAL LICENSES, WITHIN 60 DAYS AFTER THE EFFECTIVE DATE, I SHALL BE INELIGIBLE TO SEEK REINSTATEMENT OF MY DIPLOMATE STATUS FOR UP TO ONE YEAR FOLLOWING THE REINSTATEMENT OF FULL AND UNRESTRICTED LICENSURE. When official written documentation of reinstatement of license is provided, the ABFM will honor the remainder of the current certificate. If the current certificate has

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expired prior to the reinstatement of the license, an application for the next examination may be submitted. Compliance with all application requirements in effect at that time will be mandatory. It is understood that the decision as to whether my examination qualifies me for a certificate rests solely and exclusively with the American Board of Family Medicine and that its decision is final. Arbitration of Disputes Any case, controversy or dispute which may arise between the applicant and ABFM in connection with the application process and/or examination shall be settled and resolved by binding arbitration under the then prevailing rules of the American Arbitration Association (“AAA”). The decision of the arbitrators shall be final and binding, and judgment may be entered on the award of the arbitrators and enforced in any court of competent jurisdiction. Notwithstanding the foregoing, ABFM may seek injunctive relief in any court of competent jurisdiction as ABFM determines, in its sole and absolute discretion, to be necessary or appropriate to protect the integrity and/or content of the examination. Governing Law Any case, controversy or dispute which may arise between the applicant and ABFM in connection with the application process and/or the examination shall be governed in all respects by the laws of the Commonwealth of Kentucky, without regard to the choice of law rules of such jurisdiction. The applicant hereby submits and irrevocably consents to the exclusive jurisdiction and venue of the state and federal courts located in Lexington, Kentucky for purposes of any legal action which may arise in connection with the application process and/or the examination. By my acknowledgment on the online Application Form, I intend to be legally bound by the foregoing.