ABFM HALM study guide
ABFM HALM · Work through your exam, one topic at a time.
The ABFM Health and Life Maintenance (HALM) exam is a multiple-choice assessment built around the preventive and chronic-care work that fills most primary care visits: screening and immunization schedules, hypertension and lipid management, diabetes and metabolic risk, respiratory and mental health, musculoskeletal complaints, sex- and age-specific care, geriatrics, pediatrics, lifestyle counseling, and population-level health maintenance. It suits family physicians, primary care clinicians, residents preparing for independent practice, and advanced practice providers who want structured confirmation that their preventive-care knowledge is current. The ABFM HALM study guide has 12 sections and about 3,512 words.
01Health Promotion and Disease Prevention
Know the USPSTF grade framework cold: A and B services are recommended (and generally covered without cost sharing under the ACA), C is selective/individualized, D is recommended against, and I is insufficient evidence. Questions love to test whether you can distinguish a screening recommendation from a counseling recommendation for the same condition.
336 words, about 2 min02Cardiovascular Health and Hypertension
Anchor on the ACC/AHA 2017 framework: normal <120/<80, elevated 120–129/<80, stage 1 130–139/80–89, stage 2 ≥140/90. Confirm with out-of-office measurement (home or ambulatory) before committing to a diagnosis when feasible.
299 words, about 1 min03Diabetes and Metabolic Disorders
Diagnose diabetes by A1c ≥6.5%, fasting glucose ≥126, 2-hour OGTT ≥200, or random ≥200 with symptoms; prediabetes is A1c 5.7–6.4% or fasting 100–125. Screen adults 35–70 with overweight/obesity, and screen earlier with risk factors.
300 words, about 2 min04Respiratory Health
Asthma and COPD are the workhorses. Asthma is reversible airflow obstruction with episodic symptoms; confirm with spirometry showing ≥12% and ≥200 mL improvement post-bronchodilator (or peak flow variability).
287 words, about 1 min05Mental and Behavioral Health
Depression screening (PHQ-2 → PHQ-9) and anxiety screening (GAD-7) are expected in primary care, along with annual suicide risk screening . Know DSM-5 time criteria: major depressive episode requires ≥5 symptoms for ≥2 weeks with functional impairment; persistent depressive disorder is ≥2 years.
282 words, about 1 min06Musculoskeletal Health
Low back pain dominates. Most is mechanical and self-limited ; red flags (cauda equina, cancer history, fever, IV drug use, trauma, progressive neuro deficit, age 50 with new pain) mandate imaging or urgent referral.
304 words, about 2 min07Women's Health
Reproductive health spans contraception, screening, pregnancy, and menopause. Contraceptive counseling should match method to patient: LARC (IUD/implant) is most effective; estrogen-containing methods are contraindicated with migraine with aura, smoking age ≥35, hypertension, VTE history, and breastfeeding <3 weeks (per US MEC).
281 words, about 1 min08Men's Health
Prostate cancer screening is the classic shared-decision topic: PSA discussion starting at 50 (or 40–45 with high risk - Black men, family history, BRCA carriers), with the recognition that screening reduces mortality but carries overdiagnosis and overtreatment risk. Abnormal PSA → repeat PSA, then biopsy/MRI pathway.
301 words, about 2 min09Geriatric Health and Aging
Geriatrics is about function and goals , not just disease. Master the geriatric syndromes: falls, delirium, incontinence, frailty, polypharmacy, and failure to thrive.
292 words, about 1 min10Pediatric and Adolescent Health
Well-child care is dominated by growth, development, and immunization . Know the immunization schedule milestones: hepatitis B at birth, DTaP/IPV/Hib series in infancy, MMR/Varicella at 12–15 months, Tdap and HPV at 11–12, and meningococcal at 11–12 with boosters.
278 words, about 1 min11Lifestyle Medicine and Nutrition
Lifestyle medicine is the first-line treatment for many chronic conditions. The pillars: nutrition, physical activity, sleep, stress management, avoidance of risky substances, and social connection.
273 words, about 1 min12Population Health and Health Maintenance
Population health asks you to think beyond the individual: screening principles, prevention levels, and health equity . Know primary (prevent disease), secondary (early detection), and tertiary (limit disability) prevention, and be able to classify an intervention correctly.
279 words, about 1 min