Certification in family medicine: worth it for a general practitioner?

Many, many years ago, when it was time to apply for internships and residencies, I found myself in a family medicine program interview quoting a paper I had recently read that claimed no substantial differences in the practice patterns of general practitioners a few years after rotating internship and of family doctors a few years after family medicine residency.1 It was a tactless point to raise in a family medicine interview! Fortunately, I was accepted anyway. For personal reasons, I left the residency program after 1 year with the equivalent of a 1-year rotating internship. There has long been a way for practising general practitioners to achieve Certification in the College of Family Physicians (CCFP)—the practice-eligible route. This involves money, completion of a precertification program, studying, and sitting the same examinations as family medicine residents. Since the beginning of 2008, and up until the end of 2012, “older” general practitioners (ie, those who began practising in 1994 or earlier) and general practitioners who have been in full, unrestricted practice for the past 5 years have had another option: the Alternative Route to Certification (ARC).2 This route involves money, learning and applying evidence-based medicine to clinical questions using electronic resources (eg, ePearls), expanding some of those questions to larger literature searches and practice selfaudits, and completing a patient communication survey. It has the added bonus of no examination at the end, but still establishes a pattern of truly self-directed evidencebased learning.