If you are applying to Family Medicine residency in Canada, you may be required to take the FMPROC as part of your application to CaRMS. This article aims to provide comprehensive insight into the Family Medicine Professional Reasoning and Communication (FmPROC) exam and equip you with effective strategies to conquer the test!

Decoding the FmProC

The FmPROC is a situational judgement test was designed to evaluate your professional reasoning, communication skills, and aptitude for responding effectively to diverse clinical situations specifically related to Family Medicine. The test is gaining in popularity. In 2022 6 programs were requiring the test, and as of 2023, 15 programs have added the test to their list of requirements.

The FmPROC is on online test that takes about 75 minutes to complete. You can take the test in English or in French.

The test is made up of 20-30 Family Medicine related scenarios consisting of two types of questions: ranking and rating scenarios. While these may seem challenging at first, a good understanding and some good practice will help boost your confidence for test day!

Rating VS Ranking Scenarios

Rating scenarios require you to assess the appropriateness of various response options independently, in relation to a given situation. You might be presented with up to 8 options of what a Family Medicine Resident might do in a given situation. Your task here is to judge each response independently from the others.

Ranking scenarios require you to order a set of up to 5 options based on their overall appropriateness or importance to the situation. This is a holistic view, wherein you assess all response options collectively and strategize the best course of action.

Effective Preparation through Practice

Practicing for any test is key. Familiarity with the question format, improvement in decision-making skills, and building confidence are all byproducts of consistent practice.

For this purpose, we have created the FmProC Practice Questions book, available on Amazon. It provides 30 realistic practice scenarios and answer explanations to help refine your confidence for test day.

Understanding the FmPROC Marking Scheme

In the FmPROC, you receive marks based on how closely your answers align with the standard responses set by a panel of Family Medicine professionals. Crucially, there is no negative marking, so attempt all questions!

For Rating Scenarios: Your response is marked based on how close or how far your answer is compared to the master score key. For example, if you choose “extremely desirable” and the answer key is the same, you score 4 points. But if you chose “somewhat desirable” and the answer key is “extremely desirable” you would score 3 points, and so on!

For Ranking Scenarios: Scoring is also compared to the master answer key for these scenarios.  Each item is given a score of 4 points. If your rank matches the master rank, you get full points, but points are deducted depending on how far off your rank position is from the master key. This is the official information given on the FMPROC website but no one knows 100% how the test is marked.

Hypothetically, here is how we think a ranking scenario might be marked: Let’s say there are 5 options for a scenario: ABCDE and the correct rank is ABCDE but your answer is ACBED. You would get 4 points for A, 3 for B, 3 for C, 3 for D and 3 for E so your total score would be 16. But someone who matched the correct rank (ABCDE) would get 20 points!

Examples: Rating and Ranking Scenarios

To help you visualize and comprehend the format of rating and ranking scenarios, here are a couple of examples:

Example of a Rating Scenario

Imagine that you are a physician in a Family Medicine Clinic. One of your patients, Mr. Williams, comes in, feeling low and depressed because he’s been recently diagnosed with a chronic disease. Mr. Williams is struggling to cope and is showing signs of emotional distress.

How desirable are each of the following responses in this situation? Rate each response as 1= “extremely undesirable” to “extremely desirable”

1. Tell Mr. Williams that everyone has problems and he needs to be strong.
2. Encourage Mr. Williams to express his feelings about the diagnosis.
3. Change the topic to distract him from his thoughts.
4. Acknowledge his feelings and reassure him that support is available to help him cope.
5. Offer him information about local support groups and counseling.

In this scenario, you’d rate each of the responses from ‘extremely undesirable’ to ‘extremely desirable’. For example, response 1 might be rated as ‘extremely undesirable’ as it belittles the patient’s feelings, whereas response 4 could be seen as ‘extremely desirable’ because it empathetically acknowledges the patient’s emotional state.

Example of a Ranking Scenario

You are a resident in a Family Medicine Clinic. A patient, Mrs. Brown, comes in with a list of various health concerns that she’s been having. She seems anxious and has a history of medical anxiety.

Rank in order of appropriateness the following actions that you could take in response to this situation:

1. Address each concern one by one, regardless of the time it takes.
2. Reassure Mrs. Brown that she’s not seriously ill without listening to all her concerns.
3. Listen attentively to all her concerns before making any judgments.
4. Suggest Mrs. Brown sees a mental health professional without addressing her physical health concerns.
5. Gently probe to understand her most pressing concerns and address them first.

In this situation, you’d assign each response a rank from 1 (most appropriate) to 5 (least appropriate). For instance, response 3 could be the most appropriate as it demonstrates active listening, and response 2 might be the least appropriate as it disregards the patient’s concerns.

These examples highlight the importance of empathy, patience, and attentive listening in medical practice and provide you a real-world glimpse of what to expect in the FmPROC exam.

Practice scenarios like these with answers and explanations can be found in our FmProC Practice Questions book

Best of luck in your preparation journey!

Official information and resources can be found on the official FMPROC website.

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