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CFPC SAMP Tips

What Are The SAMPs?

The SAMPs are a 4.5-hour computer-based exam.  The exam is scenario-based, and requires the test-taker to type in short answers.  Test takers are given approximately 8 minutes to complete each SAMP scenario; there are approximately 32 scenarios on the exam.

A “SAMP” question is a “Short-Answer Management Problem.”  A SAMP is posed as a clinical scenario that is followed by a series of questions that test the writer’s knowledge on a specific topic.  Answers are typed into fields below each question.  Some questions may ask for several answers.  Points are awarded for correct answers.  Points are NOT deducted for incorrect answers.  Spelling mistakes are NOT penalized as long as the grader understands what the writer meant.  There may be more the one valid answer per question even if only one answer is required.  A list of standard laboratory values is included on the exam.

Here is an example of a typical SAMP question:

Anne Sullivan, age 29, is a schoolteacher who comes to your office complaining of 10 to 12 loose bowel movements a day for the past three to four weeks. The stools are sometimes bloody and often contain mucus. Ms. Sullivan feels fatigued and has lost about 3 kg in weight. She has not been febrile. She has no history of previous similar episodes.

You examine Ms. Sullivan. She has a few small, ulcerated lesions on her buccal mucosa; her abdomen is diffusely tender, with no guarding or rebound and no masses. The rectal examination is very painful. She has some small ulcerations just inside the anal canal, and there is fresh blood on your glove.

  1. What is the most likely diagnosis? State ONE.
  2. What initial laboratory investigations would you order? List FOUR.
  3. What is the most appropriate diagnostic investigation to do next? Be specific. State ONE.
  4. The investigation in question 3 confirms the diagnosis in question. What are the possible future gastrointestinal complications of Ms. Sullivan’s condition? List THREE.

 

The full practice exam, including answers to this question, is here.

SAMP Study Resources

Most of the material tested by the SAMP’s is listed in the CFPC 105 Priority Topics and Key Features.  This document should be your starting point for studying for the exam.   When studying, it is important to study from references that cover all 105 Priority Topics.  If you do not, you will have blind spots that may be exposed on the exam.

Q-Banks

Practice questions are the best way to learn how to write the SAMP exam.

  • Pass My Boards Q-bank on the iOS App Store or Google Play Store
    • Inexpensive: ~$15
    • Covers all 105 topics
    • 1700+ short-answer questions
    • Flashcard style for optimum learning
    • Similar in difficulty to the SAMPs
  • CFPC Practice SAMPs
  • CFPC Self-Learning
    • ~$246/yr for non-residents
    • More detailed than the exam
    • A few questions from the self-learning modules tend to appear on the exams every year.

 

Theory

  • Books
    • Guide to the Canadian Family Medicine Examination
      • ~$120/edition 
      • Does NOT cover all topics
      • The depth of material covered is similar to what is tested on the SAMPs
      • No practice questions
    • Case Files Family Medicine
      • $50/edition
      • Does NOT cover all topics
      • Questions are multiple choice, but if you can answer the questions without looking at the multiple-choice answers, then you know that you are ready.
      • Questions IDENTICAL to the SAMPs in difficulty.
  • In-person courses
    • The Review Course
      • Cost: ~$1100/course 
      • Covers all 105 topics
      • Some practice SAMPs
      • The course is taught by previous exam graders, and thus provides excellent insight into how to pass the exam.
    • Family Medicine Exam Prep Course
      • Cost: unknown
      • Completely covers all 105 topics
      • Some practice SAMPs
  • Podcasts

 

Tips on Selecting Study Resources

Practice SAMP questions are very important.  It is important to do as many as possible because: 1- help you understand the format of the exam, and 2- help you learn all the material. However, there are pitfalls to be aware of with certain question banks:

  • Beware of question banks that do not cover all 105 Topics and Key features.  These banks will leave blinds spots in your knowledge that will be exposed on the exam.  Everything listed in the “105 Topics” document is fair game on the CFPC SAMPs.  Currently, only one question bank covers all the material: “Pass My Boards”.  If a particular resource that you know of is not listed above, it is either because it is incomplete, or it is not close enough in difficulty to be included.
  • Beware of question banks that are more difficult than the exam.  These banks will make you think that you need to learn nitty-gritty details.  However, the CFPC SAMPs mainly test the important concepts as listed in the “105 Topics” document.  Do not waste time focussing of esoteric details, at the expense of important concepts.
  • Beware of question banks that test extra material that is not listed in the “105 Topics” document.  99% of the CPFC SAMP questions are based directly on the “105 Topics”.  Do not waste precious study hours learning material that is not in that document.

 

SAMP Study Tips

  • Start early.  Be aware of the dates and deadlines.
  • Study in groups. Testing each other is a great way to discover what your blind spots are.
  • Do lots of practice questions
  • Time yourself on the CFPC practice exams so that you know how to pace yourself on the exam.

 

SAMP Exam Instructions Clarified

The CFPC publishes the SAMP instructions.  Sadly, they can be misleading if you do not understand what you are being graded for.  The graders are trying to determine if you will be a safe physician.  With that in mind, the SAMP instructions are reproduced below with tips on how to maximize your score:

  1. When relevant, the setting in which you are practicing will be described.
    • 💡 Always be aware of the setting (i.e. Office vs. ED vs. inpatient) because this will affect your management. For example, if a patient presents to your office with unstable vital signs, the first step in management is always to call the ambulance to urgently transfer the patient to the ED.  However, if a patient presents to the ED with unstable vital signs, the first step in management is the ABC’s.
  2. You can answer most questions in ten words or less.
    • 💡 This is one of the most misleading instructions on the exam.  Do *NOT* try to shorten your answers. Make sure that your answers are as detailed and complete as possible.  Short answers always risk losing marks for lack of detail; long answers are never penalized unless they are wrong.  Write long, but don’t be wrong.  For example instead of “Hb” write “Serum hemoglobin”; instead of “pain over the medial malleolus” write “pain over the posterior distal 6cm of the tibia i.e. the medial malleolus”.
    • 💡 The graders of the SAMP exam are not looking for “short” – they are looking for “safe”. Their goal is to determine if you will be a safe physician.  The best way for you to demonstrate safety is to be as thoughtful, detailed, and complete in your answers as possible, no matter how long they are.  To help with this, most answers to the 1600+ SAMP’s in the app are crafted to be as complete and detailed as necessary.
    • 💡 Answer in full sentences if it is reasonable to do so.  Full sentences help the grader understand what you are trying to communicate.  Graders will penalize you if they think that you are using short generic answers to conceal your lack of knowledge.
  3. When ordering laboratory investigations be SPECIFIC. For example, CBC, electrolytes, lipid profile and arterial blood gases are not acceptable; you must list the specific indices/test you would like for that question.
    • Hemoglobin
      • 💡 Be more specific. Write “Serum hemoglobin”.
    • White blood cell count
      • 💡 Be more specific. Write “Serum white blood cell count”.
    • Potassium
      • 💡 Be more specific. Write “Serum potassium”.
    • Urinalysis is an acceptable answer
      • 💡 Be more specific.  Write “Urinalysis, including blood, ketones, leukocytes, pH, glucose, nitrites, and protein.”
  4. When ordering other investigations, be SPECIFIC. For example, ultrasound is not acceptable, you must specify abdominal ultrasound.
    • 💡 Instead of “X-ray” write “Chest X-ray with PA and lateral views”.
    • 💡 Instead of “CT head” write “Urgent CT head without contrast”.
  5. When listing medications, the use of generic names or trade names will be accepted.
    • 💡 Exam questions use generic medications names.  If you stick to learning the generic names of medications, you will not have to convert between generic and trade names.
  6. Give details about procedures ONLY IF DIRECTED TO DO SO.
  7. When providing values or measures only Systeme Internationale (SI) units will be accepted.
  8. Avoid abbreviations which are not commonly used and which may not be clear to an examiner.
    • 💡 Avoid abbreviations altogether – unless you really do not know how to spell “gamma-glutamyl transferase (GGT)”.
    • 💡 Spelling mistakes are not penalized!
  9. Put one answer per box, subsequent answers in the same box will not be considered.
    • 💡 It is not considered two answers to give a general and specific diagnosis e.g. hyperthyroidism secondary to Grave’s disease.
  10. If your answer to a question is “none”, please type “none”. Do not leave the answer box empty.
    • 💡 This does not occur frequently.  If you are writing “none” more than once/twice during the entire exam, consider rechecking your answer.
    • 💡 The exam is not meant to trick you.  All the questions are fairly straight forward. The goal of the exam is to determine if you will be a safe physician. Be thoughtful, detailed, and safe in your answers, and you will likely pass.

 

Exam-Day Tips

  • Relax: Harness your inner Zen.  No one has ever performed better by being overly anxious.
  • Be confident: You’ve studied your butt off, and now you are ready.  You would not have come this far without being able to perform under pressure.  Trust that all the information that you’ve learned is there, retained and ready to type out onto the page.
  • Avoid interruptions: Go to the bathroom before the exam.  Do not drink too much water during the exam.  Keep a snack available on your desk.
  • Click the mouse smoothly: some test takers have unwittingly skipped over exam questions because their mouse double-clicked without them realizing.
  • Do not sweat what you do not know: If you do not know the answer to an exam question, or are not understanding a scenario, then flag the question and return to it later.  There are a few extremely difficult questions on the exam that are only to differentiate the 99th percentile.
  • Review:  When you are done the exam, skim through all the scenarios, and make sure that you didn’t miss any.