Clinical Science Examination Content Outline
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1 Clinical Science Examination Content Outline International Foundations of Medicine National Board of Medical Examiners
2 Table of Contents Physician Tasks/Competencies... 2 Test Specifications... 2 Medical Knowledge/Scientific Concepts... 2 Patient Care: Diagnosis... 2 Patient Care: Management... 2 Professionalism... 2 Patient Safety... 2 Practice-based Learning... 2 Content Categories... 3 Test Specifications... 3 Normal Age-related Findings... 3 Immune System... 3 Blood and Lymphoreticular System... 3 Behavioral Health... 4 Nervous System and Special Senses... 4 Skin and Subcutaneous Tissue... 5 Musculoskeletal System... 5 Cardiovascular System... 5 Respiratory System... 6 Gastrointestinal System... 6 Renal and Urinary Systems... 7 Pregnancy, Childbirth, and the Puerperium... 7 Female Reproductive System & Breast... 7 Male Reproductive System... 8 Endocrine System... 8 Multisystem Processes & Disorders... 8 Biostatistics, Epidemiology, and Public/Population Health... 9 Social Sciences
3 Physician Tasks/Competencies Test Specifications Topic Range Medical Knowledge/Scientific Concepts 13% 18% Patient Care: Diagnosis 43% 48% Patient Care: Management 32% 37% Professionalism 1% 2% Patient Safety 1% 2% Practice-based Learning 2% 5% Medical Knowledge/Scientific Concepts Applying foundational science concepts Patient Care: Diagnosis History and physical examination Laboratory and diagnostic studies Diagnosis Prognosis/outcome Patient Care: Management Health maintenance and disease prevention Pharmacotherapy Clinical interventions Mixed management Surveillance for disease recurrence Professionalism Professionalism/legal/ethical issues in interaction with patients and families Professionalism/legal/ethical issues in interactions with patients and families related to death and dying Professionalism/legal/ethical issues in interactions with other health professionals Patient Safety Practice-based Learning Understanding and application of principles of biostatistics, public health, and epidemiology Understanding of the principles of research ethics and regulatory issues 2
4 Content Categories Test Specifications Topic Range Normal Age-related Findings 1% 3% Immune System 2% 4% Blood and Lymphoreticular System 4% 6% Behavioral Health 3.5% 5.5% Nervous System and Special Senses 8.5% 10.5% Skin and Subcutaneous Tissue 3.5% 5.5% Musculoskeletal System 6% 8% Cardiovascular System 8% 10% Respiratory System 8.5% 10.5% Gastrointestinal System 8% 10% Renal and Urinary Systems 4.5% 6.5% Pregnancy, Childbirth, and the Puerperium 4% 6% Female Reproductive System & Breast 6% 8% Male Reproductive System 1% 3% Endocrine System 6% 8% Multisystem Processes & Disorders 6% 8% Biostatistics, Epidemiology, and Public/Population Health 3% 5% Social Sciences 1% 3% Normal Age-related Findings Infancy and Childhood (0 to 12 years) Adolescence (13-17 years) Adulthood (18-64 years) Senescence (65 years and older) Immune System Disorders associated with immunodeficiency HIV/AIDS Immunologically mediated disorders Adverse effects of drugs on the immune system Blood and Lymphoreticular System Infectious and immunologic Anemia, cytopenias, and polycythemia 3
5 Coagulation disorders (hypocoagulable and hypercoagulable conditions) Traumatic, mechanical, and vascular disorders Adverse effects of drugs on the hematologic and lymphoreticular systems Behavioral Health Psychotic disorders Anxiety disorders Mood disorders Somatoform disorders Factitious disorders Eating disorders and impulse control disorders Disorders originating in infancy/childhood Personality disorders Psychosocial disorders/behaviors Substance use disorders Adverse effects of drugs Nervous System and Special Senses Infectious, immunologic, inflammatory disorders (cerebral, spinal, and peripheral) Cerebrovascular disease Disorders relating to the spine, spinal cord, and spinal nerve roots Cranial and peripheral nerve disorders Neurologic pain syndromes Degenerative disorders/amnestic syndromes Global cerebral dysfunction Neuromuscular disorders Movement disorders Metabolic disorders Paroxysmal disorders 4
6 Sleep disorders and disorders of increased intracranial pressure Adverse effects of drugs on the nervous system Disorders of the eye and the eyelid Disorders of the ear Skin and Subcutaneous Tissue Adnexal disorders (hair and hair follicles, nails, sweat gland, sebaceous glands, oral mucous membranes) Oral disease Disorders of pigmentation Adverse effects of drugs on skin and subcutaneous tissue Musculoskeletal System Degenerative and metabolic disorders Adverse effects of drugs on the musculoskeletal system Cardiovascular System Dysrhythmias Heart failure Ischemic heart disease Diseases of the myocardium 5
7 Diseases of the pericardium Valvular heart disease Hypotension Hypertension Dyslipidemia Vascular disorders Adverse effects of drugs on the cardiovascular system Respiratory System Obstructive airway disease Pneumoconiosis/fibrosing/restrictive pulmonary disorders/interstitial lung disease Respiratory failure/respiratory arrest and pulmonary vascular disorders Metabolic, regulatory, and structural disorders Disorders of the pleura, mediastinum, and chest wall Adverse effects of drugs on the respiratory system Gastrointestinal System Infectious, immunological, and inflammatory disorders Signs, symptoms, and ill-defined disorders Disorders of the oral cavity, salivary glands, and esophagus Disorders of the stomach, small intestine, colon, rectum, and anus Disorders of the liver and biliary system, noninfectious Disorders of the pancreas Disorders of the peritoneal cavity 6
8 Adverse effects of drugs on the gastrointestinal system Renal and Urinary Systems Signs, symptoms, and ill-defined disorders Metabolic and regulatory disorders Vascular disorders Adverse effects of drugs on the renal and urinary system Pregnancy, Childbirth, and the Puerperium Prenatal care Obstetric complications Labor and delivery Puerperium, including complications Newborn (birth to 4 weeks of age), neonatal Adverse effects of drugs on pregnancy, childbirth, and the puerperium Systemic disorders affecting pregnancy, labor and delivery, and puerperium Female Reproductive System & Breast of the breast, cervix, ovary, uterus, vagina, and vulva Fertility and infertility Menopause Menstrual and endocrine disorders Sexual dysfunction 7
9 Adverse effects of drugs on the female reproductive system and breast Male Reproductive System Metabolic and regulatory disorders, including sexual dysfunction Adverse effects of drugs on the male reproductive system Endocrine System Diabetes mellitus and other disorders of the endocrine pancreas Thyroid disorders Parathyroid disorders Adrenal disorders Pituitary disorders Hypothalamic endocrine disorders Multiple endocrine neoplasia (MEN1, MEN2) Adverse effects of drugs on the endocrine system Multisystem Processes & Disorders and related disorders Signs, symptoms, and ill-defined disorders Nutrition Toxins and environmental extremes Venomous bites and stings Fluid, electrolyte, and acid-base balance disorders Abuse Multiple trauma (e.g., prioritization, blast injury) 8
10 Shock, cardiogenic, hypovolemic, neurogenic, septic; sepsis, bacteremia, systemic inflammatory response syndrome (SIRS), refractory, multiorgan dysfunction syndrome Genetic metabolic and developmental disorders Adverse effects of drugs on multisystem disorders Biostatistics, Epidemiology, and Public/Population Health Epidemiology and public/population health Measures of disease frequency: incidence/prevalence Measures of health status Population pyramids and impact of demographic changes Disease surveillance and outbreak investigation Communicable disease transmission Points of intervention Study design, types and selection of studies Measures of association (e.g., relative risk, odds ratio, other) Principles of testing and screening (e.g., sensitivity and specificity, predictive value, probability) Study interpretation (e.g., causation, validity, statistical vs. clinical significance) Research ethics (e.g., informed consent, privacy of patient data, regulatory issues) Social Sciences Medical ethics and jurisprudence Consent to treatment/decision-making capacity Death and dying and palliative care Physician-patient relationship Professional conduct/integrity Patient safety (including basic concepts and terminology) 9
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