AFMC Certification Competency Case Study

Please read this entire page carefully in preparation for your case study submission.  We want you to succeed in your pursuit!  The most common reasons for failure to pass this portion of the certification process include

  1. attempting the process too early  (before having ample practice using the concepts learned in working with many patients/clients to bring refinement and maturity to the learning)
  2. using a patient or client case that is not complex or rich enough to allow demonstration of strong skills and competence
  3. giving only highly-simplified or generalized explanations of interconnectedness that (1) do not demonstrate a depth of technical knowledge, (2) show a lack of understanding the “devil in the detail” mechanisms that connect the interconnected points, and/or (3) not substantiating hypothesis with actual data from their particular case.
  4. including too many theoretically possible points of interconnectedness in the assessment, showing no discernment in choosing the points from the case that are most notably involved in creating, exacerbating, or resolving disease.

Yes, we want to see that your patient or client achieved significant health improvement in working with you.  Much more importantly, however, we want to see your strong, professional, and clear ability to thoroughly assess, explain, and prioritize a methodical response to a rich case.

Beyond successful completion of two SAFM semesters, eight required courses (and self-tests for each), and two examinations (Level 1 and Level 2), the AFMC certification also requires submission and approval of an actual case study that potently demonstrates the practitioner’s competence in using functional medicine principles.   All case content must be submitted to the certification administrator prior to the end of (and not beyond) the respective examination window.  A student case will not be evaluated until all components have been submitted.

A complete Case Study submission must include all of the following.  Please ensure that no personal identifying information is included at all for your patient or client in any of these documents (including specifically name, address, phone number or email address, date of birth, or place of work).  You must do all of the following prior to the end of the examination window.  You may start these submissions as soon as the certification administrator opens the exam preparation window (and not before) which is typically six weeks prior to the start of the examination window.  It is the candidate’s ultimate responsibility to ensure all these submissions are completed in advance of the deadline.  Be proactive and allow time to resolve any file or submission errors that may arise.  Late submissions will not be accepted for any reason.

  • Intake form which you may populate via a Word or PDF format (If you used another template with this client/patient initially, you will need to copy the information specifically to the linked template which must be submitted in a PDF format.)
  • SAFM Map which you may populate via a Powerpoint or PDF format.  Your map must all be captured on one single page which can be printed legibly on a single 8.5″x11″ piece of paper.  (If you used another template with this client/patient initially, you will need to copy the information specifically to the linked template which must be submitted in a PDF format.)
  • Relevant “before” and “after” labwork, if appropriate.   Be sure the words “before”, “during”, and/or “after” labs (as appropriate) are clearly labeled  on the documents in reference to the time relative to their work with you as a practitioner.  Be sure all identifying information is Fully removed.   All labwork must be scanned and compiled into a single PDF file (not a picture file and not multiple files;  note also that photos taken with a cell phone are almost never of sufficient resolution to be legible once enlarged to the size of a regular PDF file page).  If the lab report is in a language other than English, you will need to submit the original lab documentation but also transfer all lab data into a separate labwork template which must also be submitted (request template in advance from the program administrator via email at
  • Case Assessment questionnaire e.g. interconnectedness, how disease might begin in the gut, supplements you considered, key history observations, specific actions taken.  Once the preparation window begins, you are welcome to click on the link below at any point, so you can clearly see what questions you will be answering about your patient and prepare accordingly. Do not, however, populate the questionnaire until you are ready to submit officially your assessment demonstrating competence.  Please make note that the entry field for every question is purposefully limited in size.  This limitation requires that you prioritize your input and express yourself succinctly (a key practitioner skill).  Your submission should well demonstrate that you can express multi-factorial detail crisply.  You will want to prepare accordingly.  Be careful not to speak in vague generalities but to give very specific, detailed insight and thorough explanations for each of your points.  The Level 3 AFMC Review Course gives many examples of acceptable and unacceptable submissions.

Cases will be graded on a Pass/Fail basis.  Grading status (or a need for further information, if applicable) will be communicated to all students within two business weeks following the close of the examination window.  Most cases will be given a Pass/Fail grade in response to initially submitted materials.  If, however, a case study is simply missing key relevant or required data, a student will be given one opportunity over five calendar days after notification to submit what is required.  If a case study does not receive a Passing grade, a student will be given an opportunity to submit a different case study during a future examination window for further consideration (a separate Certification registration and fee will be required).  Grading decisions from the certification administrator are final.

To receive a passing grade for the submitted case study, all of the following criteria must be met.

  • The client or patient being described must be a paying customer from the practitioner’s own professional client/patient population (that is, not self or family/friends).
  • The patient must have been struggling with some type of chronic health challenge(s).  We recommend choosing a relatively complex case study that will give you ample opportunity to demonstrate your knowledge and skills.
  • The case must be one with which the student is very familiar and have supported the patient personally and long enough to have achieved significant improvement (specifically, at least three months).  The case must be one you have not presented at any time as part of any SAFM Open Coaching Call case review or reviewed with a teaching assistant during an SAFM Custom Consultation session (or previously submitted as an AFMC Competency Case Study submission).
  • There does not have to be full resolution of the patient’s challenges in the case, but there needs to have been enough patient improvement to demonstrate strong competence in using the functional medicine concepts the practitioner has learned.  The improvement must be explicitly demonstrated.  The case must be complex enough to demonstrate an understanding of a rich variety of concepts.
  • There must have been a detailed, documented informational intake that includes the patient’s health history, symptoms/challenges, and medications/supplements.   These documents must be successfully submitted in the required standard formats and timing for ease of consistent review (per above details).
  • Labwork observations and improvement can be very helpful in documenting a student’s understanding and a patient’s improvement.  Labwork, however, is not explicitly required for a successful case.  We do highly recommend the inclusion of labwork in your case.  If you use labwork in justifying your approach and/or results in any way, then original documentation of all relevant labwork data must be submitted, and you must speak to *all* notable data.  If you do not use labwork, you must still demonstrate detailed awareness and convincing evidence of extensive interconnected dynamics in your chosen case.
  • The documented case approach and assessment responses
    • Must demonstrate accurate and thorough identification of interconnected dynamics in the person’s aggregate system (e.g. medical history, life experiences, diet, behavioral choices, mindset/perspective, symptoms, medications, labwork, supplements).  The focus here is not on including every imaginable factor that might be theoretically involved but rather on a discerning selection of the most important factors in the patient’s unique case.  Depending on your case’s unique circumstances, you will likely need to demonstrate your research and understanding of functional medicine concepts that go outside the scope of the main SAFM courses covered in the scope of the AFMC certification exams (e.g. unique medications or key labwork specific to your unique case).
    • Must demonstrate the ability to think clearly and creatively about bio-individuality and what each unique patient or client might need most.
    • Must demonstrate the student’s ability to work accurately and thoroughly with the functional medicine concepts contained in the eight sources included within the certification scope and all the case studies covered within the Semester programs.
    • Must directly address the most likely root causes of their challenges.
    • Must include appropriate supplement recommendations in light of the root cause of the client’s challenges.
    • Must include an evident focus on rapid relief.
    • Must demonstrate effective patient interaction to ensure execution of recommendations that brings resolution to the client’s primary issue/goal.
    • Must demonstrate the student’s ability to succinctly describe and prioritize the most important functional medicine concepts at play in this unique client.
    • Must demonstrate the student’s ability to express oneself professionally in the english language with good grammar, punctuation, correct spelling, and appropriate language.

Most importantly, choose your Competency Case Study and the timing wisely.  Don’t attempt the Level 3 portion of the certification process until you are ready.  The goal of the case sharing is not to demonstrate your skills as a practitioner (re: actual client results).  The goal is to use your case to demonstrate an extensive and notable knowledge of functional medicine interconnectedness (in terms of both breadth and depth).  You will want to choose a case that gives you plentiful fodder to demonstrate this knowledge comprehensively.  You will also want to plan time to document your assessment thoroughly.

We are looking for your clear and detailed understanding of principles (not generalized “hand waving”) and an ability to explain thoroughly how they apply to your case.  You may need considerable time after completing your SAFM semesters (and experience using the concepts you have learned at SAFM in your own practice with many patients or clients) before you are able to create and share a suitably impressive case worthy of meeting this criteria.