Methods and Definitions

Sample

We separated all American Board of Family Medicine (ABFM) Diplomates (as of January 1, 2025) into three target populations: recent graduates (<3 years since residency graduation), early career (3-5 years), and mid-to-late career (6+ years). We then used ABFM questionnaire and survey data from 2022 to 2024 to describe the current state of family physician practice for each of these populations. This data includes self-reported information about scope of practice, ownership, income/payment models, and physician well-being.

Inverse probability weighting was applied to ensure demographic similarity with the target populations. Many of the results are for subgroups of target populations that meet specific criteria for inclusion. These inclusion criteria included restrictions such as reported provision of direct patient care, outpatient continuity care, or practice in the 50 U.S. states or District of Columbia. The true sample sizes are smaller than the target populations and varied depending on the subgroup and survey instrument. Our sample included questionnaire or survey data for 96% of recent graduates, 43% of early career graduates, and 59% of mid-to-late career Diplomates. The estimates presented throughout this Factbook have been scaled up to reflect the total counts within each population or subgroup.

For the Topical Trends chapter, we used data dating back to as early as 2013 to similarly construct a trends sample from which we infer about the target populations as of July 1 of each year.

Terminology

Family Physician: The Family Medicine Factbook presents data derived from ABFM internal survey datasets of board-certified family physicians (Diplomates)—the largest and most current dataset of U.S. family physicians available. For readability, these data are referred to throughout as “family physicians.” Unless otherwise specified, references to family physicians reflect ABFM board-certified family physicians represented in ABFM proprietary survey data.

ABFM: The American Board of Family Medicine is a not-for-profit, independent medical specialty board that sets rigorous standards for training, certifying, and continuously assessing family physicians, ensuring they demonstrate the knowledge, professionalism, and lifelong learning required to deliver high-quality, comprehensive care beyond basic state licensure.

IMG: We define International Medical Graduates (IMGs) as physicians who received their medical degree from a medical school located outside the United States or Canada, regardless of their citizenship at the time of training. This definition includes both U.S. citizens who attended medical school abroad (often referred to as U.S.-IMGs) and non-U.S. citizens who completed medical education in another country (non-U.S. IMGs). Thus, IMGs may be either U.S.-born or foreign-born; the defining feature is the location of their medical school, not their nationality. One can learn more about IMGs and their certification process to enter a U.S. residency here.

Data Sources

ABFM Continuous Certification Questionnaire

The ABFM Continuous Certification Questionnaire is a standardized questionnaire mandatory to practicing physicians who choose to continue or regain their ABFM certification.^1,2 The data were collected during the process of registration for the examination. In addition, there are five rotating question sets to sample physicians on topics relating to meaningful use of electronic health records, patient-centered medical home features, types of payment their practices accept, procedures performed, and physician wellness and burnout.¹ These rotating sets are distributed in a round-robin style, where recipients are only responsible for answering their assigned set to reduce questionnaire burden. In addition to the rotating question set between respondents, some questionnaire questions were only provided depending on a certain answer to a prior question. For example, for questions regarding practice, if a physician had previously indicated they were not practicing, these questions were omitted.

ABFM Initial Certification Questionnaire

The ABFM Initial Certification Questionnaire is a standardized questionnaire mandatory to family physicians who are seeking ABFM initial certification. The data were collected during the process of registration for the examination, 3-4 months prior to the actual date of the examination. For most candidates, this is midway through their last year of family medicine residency. Some questionnaire questions were only provided depending on a certain answer to a prior question.

ABFM National Graduate Survey

The ABFM National Graduate Survey is a standardized survey given to ABFM Diplomates three years following residency graduation.³ For example, the 2024 survey contains information regarding those who completed residency in 2021. This survey is voluntary; thus, survey responses do not represent the entire sample of eligible respondents. Some survey questions were only provided depending on a certain answer to a prior question. Additional information regarding the National Graduate Survey: Developing the National Family Medicine Graduate Survey in: Journal of Graduate Medical Education Volume 9: Issue 5 | Journal of Graduate Medical Education

Limitations and Caveats

Factbook data reflects the largest cohort of practicing family physicians in the United States, but only those certified by ABFM are included. Previous studies estimate that the total family physician population that is certified by ABFM is 82-85%.^4,5,6 While this does not represent the entirety of U.S. family physicians and is self-reported, it allows the most comprehensive lens on family medicine practice and trends available. Data in all sections other than “Topical Trends” are cross-sectional, allowing only a snapshot of diplomates at a given point in time.

Methods References

1. Peterson LE, Fang B, Phillips RL, Avant R, Puffer JC. The American Board of Family Medicine’s Data Collection Method for Tracking Their Specialty. Journal of the American Board of Family Medicine. 2019;32(1):89-95. doi:10.3122/jabfm.2019.01.180138

2. Cattoi R. American Board of Family Medicine Introduces Important Enhancements to Maintenance of Certification for Family Physicians. Journal of the American Board of Family Medicine. 2011;24(3):334. doi:10.3122/jabfm.2011.03.110042

3. American Board of Family Medicine. National Family Medicine Graduate Survey Reports. American Board of Family Medicine. Accessed July 14, 2022. https://www.theabfm.org/research/national-family-medicine-residency-graduate-reports

4. Peabody MR, Young A, Peterson LE, O’Neil TR, Pei X, Arnhart K, Chaudhry HJ, Puffer J. The Relationship Between Board Certification and Disciplinary Actions Against Board-Eligible Family Physicians. Academic Medicine. 2019;9(6):847-852. doi:10.1097/ACM.0000000000002650

5. Dai M, Peterson LE. Characteristics of Family Medicine Residency Graduates, 1994-2017: An Update. Annals of Family Medicine. 2020;18(4):370-373. doi:10.1370/afm.2535

6. FSMB Census of Licensed Physicians in the United States, 2024. Young A, Pei, X. Arnhart K, Abraham G, and Chaudhry H. Journal of Medical Regulation Aug 2025, 111 (2) 7- 17; doi: 10.30770/2572-1852-111.2.7