ABFM CME requirements depend on which certification structure you are in right now: the older 3-year stages or the new 5-Year Cycle that every family physician moves into when their next exam is due. Here is what each one asks for and which CME credit types ABFM accepts.
We checked these requirements against the American Board of Family Medicine’s website in October 2026. Rules change, so confirm with ABFM (your MyABFM Portfolio shows your exact requirements) before your deadline.
The short answer
- In the 5-Year Cycle, you earn 200 CME credits, with at least 50% from Division I.
- You also earn 60 certification points through self-assessment and performance improvement activities, including at least one of each.
- For the exam, you answer 25 longitudinal assessment questions per quarter, or you can choose the one-day exam in year four.
- If you are still in a 3-year stage, the targets are 150 CME credits and 50 certification points per stage.
- ABFM accepts AMA Category 1, AAFP Prescribed, AAFP Elective, and several AOA credit types toward Division I, subject to its final approval.
3-year stages vs. the 5-Year Cycle
From 2011 to 2024, ABFM diplomates kept their certification through repeating 3-year stages plus an exam every 10 years. ABFM is now moving everyone to a 5-Year Cycle to meet American Board of Medical Specialties standards, which require boards to check at intervals of no more than five years whether a diplomate is meeting continuing certification requirements.
You switch to the 5-Year Cycle in the year your next exam requirement is due. ABFM says it will honor your current 10-year exam, so you won’t be moved earlier than 10 years after you last met the exam requirement. Its own example: if you met your exam requirement in 2022, you transition in 2032. Until then, you keep completing 3-year stages.
| Requirement | 3-year stage | 5-Year Cycle |
|---|---|---|
| CME credits | 150 | 200 (at least 50% Division I) |
| Certification points | 50 | 60 |
| Activity minimums | At least 1 self-assessment and 1 performance improvement activity | At least 1 self-assessment and 1 performance improvement activity |
| Exam | Due in the year you transition to the 5-Year Cycle | 25 longitudinal assessment questions per quarter, or the one-day exam in year 4 |
| Professionalism | Continuous compliance with ABFM guidelines, including a valid, active, full license | Same |
| Annual fee | Yes | Yes |
One perk of the new structure: ABFM says you get a fifth year off if you finish all requirements in four years.
How many CME credits ABFM requires
ABFM describes its CME expectation as an average of 50 credits a year, with at least half coming from Division I activities. Under the 5-Year Cycle that works out to 200 credits per cycle. In a 3-year stage it is 150 credits.
You can report CME two ways. If you are an AAFP member, your credits can be verified through that membership. Otherwise, you enter them manually in your MyABFM Portfolio. ABFM notes that all CME credits are subject to its final approval.
Which credit types ABFM accepts
ABFM splits CME into Division I and Division II. Division I must make up at least 50% of your total. Division II can make up no more than 50%.
Division I
Division I covers formal, accredited CME. ABFM’s list includes conferences and workshops, home study courses, and other CME activities that carry AMA Category I credit, AAFP Prescribed credit, AAFP Elective credit, or AOA Category 1-A or 1-B credit (home study and conferences can also carry certain AOA Category 2 credit). ABFM’s page uses the older “AMA Category I” wording; the AMA’s current name for this credit is AMA PRA Category 1 Credit™. If you want a refresher on what that designation means, see our AMA PRA Category 1 Credit™ explainer.
So yes, both AMA and AAFP credit count, and AAFP Elective credit counts in Division I alongside Prescribed. If you are also tracking AAFP membership requirements, the two AAFP credit types work differently there. Our guide to AAFP Prescribed vs. Elective credit covers that side.
Division I also includes scientific sessions run by accredited medical schools or groups such as the AAFP, AOA, or ABMS boards, some hospital and medical society meetings with documentation, residency and fellowship training (with caps), and certain university programs and faculty development fellowships (also capped).
Division II
Division II covers learning that isn’t formally accredited. It includes teaching and presenting, judging case presentations or posters, journal clubs, podcasts, medical journal reading, reviewing manuscripts, and publishing (up to 10 credits per published project). ABFM says it does not accept CME for writing a personal blog or taking part in chat rooms or social media.
Self-assessment and performance improvement activities
Certification points are separate from CME credits, though many ABFM activities earn both. You need at least one self-assessment activity and one performance improvement activity. After that, any mix of approved activities can fill out the rest of your points.
| Activity | Points | CME |
|---|---|---|
| Knowledge Self-Assessment (KSA) | 10 | 8 |
| Continuous Knowledge Self-Assessment (CKSA) | 2.5 per quarter | 2.5 per quarter |
| National Journal Club | 1 per article | 1 per article |
| Completing the longitudinal assessment | Up to 10 | Up to 30 Division I |
A KSA has 60 questions on one family medicine topic, and you need 80% correct to pass. You can resubmit missed questions until you reach a passing score. The CKSA delivers 30 questions per quarter, and ABFM gives you a performance report after 100 questions over four quarters. National Journal Club asks you to read a selected article and answer four questions about it.
ABFM also partners with outside organizations on alternative activities. These count toward your point total, but they do not satisfy the self-assessment requirement, and some carry an extra cost.
Performance improvement asks you to find a gap in care, collect baseline data, make a change, and measure the result. You can use an ABFM-directed activity, design your own self-directed project (alone or with up to nine other physicians), or join an organizational or external project. Physicians without direct patient care responsibilities can self-designate as clinically inactive, which exempts them from the performance improvement requirement but not from the point total.
The longitudinal assessment and the one-day exam
The longitudinal assessment is now the default exam path. You get 25 multiple-choice questions each quarter, with five minutes per question, for a total of 300 questions over three to four years. You can answer them whenever and wherever you like, use references (but not another person), and see right away whether you got each one right.
A few rules matter. You can’t answer more than 25 questions in a quarter to catch up, and unopened questions roll forward. If more than 100 are deferred, you can’t finish all 300 in the four-year window, and questions never attempted count as incorrect. You must answer at least 275 questions in total to stay in the program.
If you would rather test once, the one-day exam is 300 multiple-choice questions in four 95-minute sessions of 75 questions each. It is given each April and November at proctored test centers. In the 5-Year Cycle, you can choose it in year four. Either way, passing the exam only covers the exam requirement. You still need your CME and certification points.
Where self-study CME fits
Most family physicians need a steady supply of Division I credit, and self-study is one of the categories ABFM names (home study courses that qualify for AMA Category I or AAFP credit). Our Audio-Digest family practice courses come in 10-credit and 20-credit versions, each designated for AMA PRA Category 1 Credit™, and you complete testing online at your own pace. Some Audio-Digest Family Medicine volumes are also reviewed for AAFP credit, so check each program’s materials for current approval. ABFM makes the final call on any credit you report.