CCFP: question practice and revision.

Choose a topic for focused revision and check your plan against the official specification.

• Cardiovascular — hypertension, IHD, AF, heart failure, syncope, dyslipidemia
• Respiratory — asthma, COPD, pneumonia, smoking cessation, lung cancer screening
• Mental health — depression, anxiety, suicide risk, addictions, ADHD, psychosis
• Women's health — contraception, menopause, pregnancy care, abnormal uterine bleeding
• Pediatrics — well-baby care, immunisations, common childhood presentations, growth
• Diabetes and endocrine — T2DM (Diabetes Canada), thyroid disorders, osteoporosis
• Musculoskeletal and chronic pain — low back pain, OA, opioid prescribing
• Geriatrics — dementia, falls, polypharmacy, end-of-life, frailty
• Cancer screening and prevention — CTFPHC recommendations, smoking cessation
• Gastroenterology — GERD, IBS, IBD, hepatitis, common Canadian GI presentations
• Dermatology — common rashes, skin cancer recognition, eczema/psoriasis
• Indigenous health, cultural safety, social determinants of health
• Procedural skills — minor procedures, joint injections, IUD insertion
• Behavioural medicine — counselling, motivational interviewing, behaviour change
• Public health — infectious disease, harm reduction, immigrant/refugee health

Drawn from the CFPC 99 Priority Topics and Key Features, Canadian Family Physician (CFP) journal, and CFPC SOO marking framework.

• CFPC 99 Priority Topics — these are the central revision framework. Each topic has Key Features (the must-know clinical decision points). Cover them systematically; SAMP questions test these decision points directly.
• Patient-Centred Clinical Method (PCCM) — the 6 components: exploring health/disease/illness, understanding the whole person, finding common ground, incorporating prevention, enhancing patient-doctor relationship, being realistic. SOO marking maps directly to these.
• Canadian Task Force on Preventive Health Care (CTFPHC) — Canadian cancer screening recommendations (breast 50-74, colorectal 50-74 with FIT every 2 years, cervical with HPV primary), and screening recommendations that differ from US norms
• Diabetes Canada algorithm — T2DM management with A1C-individualised targets, SGLT2i and GLP-1 for CV/renal protection, sick day rules, screening intervals. Tested directly.
• Opioid prescribing in chronic pain — Canadian opioid prescribing guidelines (CDPHCA), opioid use disorder management, opioid agonist therapy (methadone, buprenorphine/naloxone, slow-release oral morphine), naloxone access
• Indigenous health and cultural safety — Truth and Reconciliation Commission recommendations applied to clinical practice. Recognising historical trauma, intergenerational effects, and barriers to care. Increasingly emphasised in CCFP exam content.
• Common SOO scenarios — chronic disease review, mental health (depression with suicide risk), substance use, perinatal mental health, paediatric well-baby check, end-of-life family conversations. Practise PCCM application to each.
• Canadian women's health — SOGC guidelines for contraception, antenatal care, perimenopause, abnormal uterine bleeding, hormone therapy. Differs slightly from UK FSRH framework.

Observations from recent CCFP candidates. Verify against the current CFPC 99 Priority Topics, Key Features, and SOO marking framework.

Candidate-reported observations — not official guidance.

1. Using an old SAMP response format — check the CFPC transition notice and sample questions for your sitting. Practise the requested response task, rather than assuming every case requires a write-in answer.
2. SOO communication ≠ PCCM technique — the SOO is marked specifically against the Patient-Centred Clinical Method, not generic OSCE communication skills. Practise the 6 PCCM components explicitly with mock cases.
3. CFPC vs RCPSC scope — the CCFP tests breadth of family medicine, not depth of internal medicine subspecialty knowledge. Avoid drifting into tertiary care detail in your answers.
4. Canadian guidelines vs US/UK — Canadian sources for prescribing (RxFiles), cancer screening (CTFPHC), preventive care, diabetes management. Confusing with US/UK guidance is a common error.
5. Indigenous health under-preparation — increasing emphasis in recent diets. Knowing the Truth and Reconciliation Commission Calls to Action relevant to health (especially TRC #18-#24 on health) is high-yield.
6. Mental health and addictions — common SAMP and SOO themes. Suicide risk assessment, depression management, opioid use disorder, substance use are routinely tested.
7. Time management — the SAMP has many problems in limited time. Each problem needs efficient identification of what is being asked, brief answer, and move on. Stamina under time pressure matters.
8. Procedural skills — basic procedures are part of family medicine scope (joint injections, IUD insertion, IUD removal, minor skin procedures, ECG interpretation in primary care). May be examined directly in SAMP.

A pragmatic phased approach used by recent CFPC certificants, integrated with residency clinical rotations.

1. Months 1–4 (R1)

   Begin systematic 99 Priority Topics coverage. 30 questions/day with the iatroX adaptive engine. Map each Priority Topic to its Key Features. Read Canadian Family Physician journal monthly.

2. Months 5–8 (R1-R2 transition)

   Targeted weak-area drilling. Daily PCCM consultation practice with peer feedback. CTFPHC, Diabetes Canada, SOGC guideline integration. Indigenous health and cultural safety reading.

3. Months 9–11 (R2)

   Use question-bank practice to review clinical decisions, and CFPC sample SAMPs to rehearse the response formats for your sitting. Practise SOOs in pairs/triads (each acting as patient, doctor, observer). Map PCCM components explicitly in your debriefs.

4. Month 12 (pre-exam)

   Bookmark review only. Targeted reading on weakest Priority Topics. Final SOO mock under timed conditions. Confirm exam booking and logistics. Sleep, hydrate, do not learn new material in the final week.

Dedicated CCFP question practice with answer explanations, guided Tutor review and study planning.

• Focused question practice — Choose the relevant bank and use your answers to identify what to study next.
• Guided reasoning — Explore a difficult answer with Tutor, then apply the distinction independently.
• Review and timed practice — Return to important mistakes and choose a timed practice set where available.

Choose the relevant bank and use the official exam guidance to plan your preparation.

Family Medicine residents in the final year of a CFPC-accredited 2-year residency program. Also Practice Ready Assessment (PRA) candidates — IMGs who have demonstrated equivalent training via the PRA-IMG pathway in participating Canadian provinces. Specific eligibility requirements detailed on the CFPC website.

Two sittings per year — typically Spring (around May) and Fall (around November). Confirm 2026 dates and application windows on the CFPC website at cfpc.ca. Most family medicine residents sit during their R2 year.

The written SAMP component lasts four hours; the oral component has five 15-minute SOOs. In 2026, up to 25% of SAMP cases use multiple-choice or short-menu questions; from 2027 all cases use those formats. Both examination components must be passed.

The CCFP is awarded by the College of Family Physicians of Canada — it certifies family medicine. RCPSC (Royal College) certifies all other medical specialties (internal medicine, emergency medicine, pediatrics, surgery, etc.). They serve different specialty pathways. The MCCQE Part 1 is required for both before specialty certification.

Increasingly emphasised since the Truth and Reconciliation Commission. CCFP exam content includes recognising historical trauma, intergenerational effects, cultural safety, barriers to care, and the TRC Calls to Action relevant to health (especially #18-#24). Often tested in both SAMP and SOO.

Practise the Patient-Centred Clinical Method (PCCM) explicitly with peer feedback. Each SOO is marked specifically against PCCM components (exploring health/disease/illness, understanding the whole person, finding common ground, incorporating prevention, enhancing patient-doctor relationship, being realistic). Real residency clinics provide raw material — debrief consultations using PCCM language.

Full CCFP bank access is included in all-access. Up to 10 new sample questions per day are shared across exams, with no account required. A verified free account includes one guided Tutor session; continued Tutor use is included in all-access.