How the CCFP SAMPs Exam Works: Complete 2026 Guide

The Short Answer Management Problems (SAMPs) component is one of two parts of the CCFP certification examination, alongside the Simulated Office Orals (SOOs). If you're preparing for the 2026 exam, here's everything you need to know.

What Are SAMPs?

SAMPs are written clinical scenarios followed by a series of short-answer questions. Unlike multiple-choice exams, you must generate your answers from memory — there are no options to choose from. This tests clinical reasoning and recall, not pattern recognition.

Each SAMPs case presents a realistic family medicine scenario: a patient walks into your office (or the ED, or a home visit) with a problem. You'll be asked to manage it — differential diagnosis, investigations, treatment, follow-up, counselling.

Exam Format

The exam is administered on a computer. You type your answers into text fields. There is no going back to previous cases once you move on (in the timed version), so time management is critical.

How SAMPs Are Scored

Each question has a marking scheme with specific expected answers and mark allocations. Examiners (experienced family physicians) grade your answers against this scheme.

Key scoring principles:

• Marks are for specific items — “Investigate appropriately” earns zero. “Order TSH and free T4” earns marks.
• No negative marking — write everything relevant. You won't lose marks for extra answers (unless they're dangerous).
• Canadian guidelines matter — answers must reflect current Canadian practice (Diabetes Canada, Hypertension Canada, CCS, SOGC, etc.).
• Abbreviations are accepted — “CBC, TSH, HbA1c” is fine. No need for full names.
• Key Features methodology — many questions target the CFPC Key Features for that topic.

The 105 Priority Topics

The CFPC defines 105 Priority Topics that represent the core of family medicine practice in Canada. The SAMPs exam draws cases from these topics. While not every topic appears on every sitting, over two exam cycles you can expect nearly all of them to be tested.

High-frequency topics that appear almost every year include: Diabetes Mellitus, Hypertension, Depression, Prenatal Care, Well-Baby Care, COPD, and Palliative Care. But don't neglect lower-frequency topics — they still carry the same marks when they appear.

Time Management Strategy

With ~12 cases in 120 minutes, you have roughly 10 minutes per case. This is tighter than it sounds. Here's what works:

• Read the stem once carefully — note the patient's age, sex, key history, and the specific question being asked.
• Answer what's asked — if they ask for 3 investigations, give 3. Don't write an essay.
• Use point form — no need for full sentences. “CBC, lytes, Cr, TSH” is perfect.
• Don't overthink — your first instinct is usually right. Write it down and move on.
• Flag and return — if stuck, write what you can and come back if time permits.

How to Prepare

The most effective SAMPs preparation involves:

1. Practice writing answers. Reading about diabetes isn't the same as writing a management plan for a diabetic patient under time pressure. You need to practice the output, not just the input.
2. Study current Canadian guidelines. The exam reflects Canadian practice. Know Diabetes Canada, Hypertension Canada, CCS, SOGC, CTFPHC, and CPS guidelines.
3. Cover all 105 topics. There's no shortcut. Use a topic tracker to ensure you've studied each one.
4. Get feedback on your answers. The biggest gap in SAMPs prep is not knowing whether your answers would actually score marks. Find a way to compare your answers against marking schemes.
5. Do full timed mock exams. Simulate the real conditions: 12 cases, 2 hours, no breaks.

2026 Updates

For the 2026 exam cycle, pay special attention to these guideline changes:

• Type 2 Diabetes: SGLT2 inhibitors now first-line for patients with cardiovascular disease, heart failure, or CKD — regardless of A1C (Diabetes Canada 2024).
• Sepsis: NICE NG51 replaced by NG253/254/255 (Feb 2026) — complete overhaul of sepsis recognition and management pathways.
• Asthma: Updated stepwise approach with emphasis on ICS-formoterol as reliever (GINA 2024/Asthma Canada).
• Obesity: Tirzepatide and semaglutide data reshaping the approach to weight management in primary care (CFP Nov/Dec 2025).

SAMPs vs SOOs

Final Advice

The SAMPs exam rewards systematic, guideline-based clinical reasoning. It doesn't reward memorizing obscure facts or writing beautiful prose. Be specific. Be Canadian. Be systematic. And practice writing — not just reading — before exam day.

Good luck on your 2026 CCFP exam. You've got this.