CCFP priority topic 31 of 105
Domestic Violence on the CCFP exam
4 key features, the mistakes that cost marks, and a practice question.
Checked by a Canadian family physician, MD, CCFP. Updated October 20, 2026.
What the exam tests
Key features
The CFPC’s 4 key features for Domestic Violence. Each one below has how the exam asks it, the common mistakes and the approach.
Practice question
Try one before you read
A real case from the bank, in the new short-menu format. Answer it first. Then read the key features.
Key feature 1 of 4
When to ask
When new warning signs of partner abuse show up, use the right visits to ask about it.
CFPC skill Patient-centred approach, clinical reasoningPhase History
On the exam
A young woman, on edge and sleeping badly, with a partner who answers for her. Expect a short menu (pick several from a list).
Pick what to do next, and how.
Common mistakes
Asking about abuse with the partner in the room: she will deny it and may pay for it later. Taking the partner's account, or starting an antidepressant, misses the cause.
Approach
- Ask when the clues appear: anxiety, low mood, poor sleep, vague pain, injuries that do not fit the story, repeat emergency visits.
- A partner who answers for her, or never leaves the room, is a clue in itself.
- See her alone for part of the visit. Do not ask with a partner, a family member or an older child present.
- Use a trained interpreter, never a family member.
- Ask plainly, as a routine question: “Does anyone at home hurt you, or make you afraid?”
- A teen gets time alone too. A capable teen consents to her own care, so keep it private and explain the limits.
- If she says yes: believe her, tell her it is not her fault, and write down her own words.
Key feature 2 of 4
Danger and children
When abuse is suspected or known, judge the danger, check on the children, and warn that it worsens.
CFPC skill Selectivity, clinical reasoning, patient-centred approachPhase History, treatment
On the exam
A woman with a bruised arm, assaulted by her husband in front of her son. Expect a short menu (pick several from a list) of questions.
Pick the questions that measure her danger.
Common mistakes
Asking what started the fight, about his job loss, his childhood or his mood. None measures her danger. Raising charges or custody now displaces the danger questions.
Approach
- Ask about the markers of danger (table below). Choking even once is a strong sign of later severe violence.
- Ask if she is afraid to go home tonight. Her fear counts.
- Ask who lives at home, whether the children see or hear it, and whether they have been hurt.
- A child living with partner violence may need protection. Know your province's reporting rule, and make the report yourself.
- In most cases, a competent adult decides whether to report her own assault to police. Some provinces make you report a gunshot or stab wound. Reporting over her objection can raise her risk.
- Tell her plainly that this kind of violence usually becomes more frequent and more severe over time.
- Separation is often the most dangerous time. Plan before she leaves, not after.
| Question | Measures danger? | Why |
|---|---|---|
| Has your partner ever choked you? | Yes | A strong sign of later severe or deadly violence |
| Is it getting worse, or happening more often? | Yes | Rising violence points to more harm ahead |
| Weapons at home, or threats to kill? | Yes | Threats and weapons raise the risk of serious harm |
| Have you just left him, or plan to? | Yes | Separation is often the most dangerous time |
| What started the argument? | No | Frames the assault as provoked and deepens her self-blame |
| His job loss, mood or childhood | No | Explains nothing about tonight and invites excusing him |
Key feature 3 of 4
Safety plan
Work with the patient on a crisis plan that keeps them and everyone at home safe.
CFPC skill Clinical reasoning, patient-centred approachPhase Treatment
On the exam
High risk, and she has decided to go home tonight. Expect a short menu (pick several from a list) of steps.
Pick the steps for her plan today.
Common mistakes
Insisting on a shelter, or calling police she did not ask for. Both override her and can end the visit with no plan. A joint visit with the partner is wrong too.
Approach
- Accept her decision and plan around it. Pushing can end the visit with no plan at all.
- Call 911 without her consent only if her life, or a child's, is in immediate danger.
- Plan a quick exit: a bag of ID, health cards, medicines, keys and money for her and the children, kept somewhere safe.
- Agree where she will go, and a code word that tells a trusted person to call 911.
- Teach the children when and how to call 911, and where to go.
- Give shelter and crisis line numbers in a form the partner will not find. Ask whether her phone is safe, and offer your office phone.
- Book follow-up within days, not weeks, and agree on a safe way to reach her.
- No couples counselling and no joint visit. What she says can lead to retaliation.
- On a call where she cannot talk freely, switch to yes-or-no questions: is she safe now, where is she, does she need 911?
Key feature 4 of 4
The cycle and children
Explain how the abuse repeats, the feelings it brings, and the harm it does to children.
CFPC skill Patient-centred approach, communicationPhase Treatment
On the exam
Six calm weeks after her partner's assault, and her son wets the bed again. Expect one best answer.
Pick the best counselling for her today.
Common mistakes
Reading the calm as safety, or advising her to avoid his triggers. Treating the boy's bed-wetting with a drug, or stopping at a urine test, misses what he is living with.
Approach
- Explain the cycle: tension builds, an assault, then remorse and calm, then tension again. Calm does not mean the risk has fallen.
- Say that the violence is about control, not stress or temper. It is not her fault.
- Never advise her to avoid his triggers. It puts the blame on her.
- Name the feelings: fear, shame, guilt, helplessness, and still loving him. These keep many people in the relationship.
- Leaving often takes many tries. Keep the door open, without judging.
- Seeing or hearing violence harms children, even if they are never hit. Look for sleep problems, fears, behaviour change, school trouble and bed-wetting.
- Offer the children support or counselling. A safe, steady parent helps them cope.
Flashcards
Answer it first, then check.
KF 1A woman is anxious, and her partner answers every question for her. What next?
See her alone for part of the visit. Then ask directly if anyone at home hurts or frightens her.
KF 1A 17-year-old wants birth control and seems afraid of her boyfriend. Do you call her mother?
No. A capable teen consents to her own care. Keep it private and ask about him alone.
KF 2He choked her once, then cried and promised never again. Is her risk low?
No. Choking even once is a strong sign of later severe violence. Treat her risk as high.
KF 2Name four questions that measure how much danger she faces tonight.
Any four: afraid to go home, getting worse, choking, weapons, threats to kill, a recent separation.
KF 3She is at high risk but will go home tonight. What do you do?
Respect her choice. Make a safety plan with her today, and see her again within days.
KF 3On a booked phone visit, she whispers that she cannot talk. What now?
Switch to yes-or-no questions. Ask if she is safe now, where she is, and whether she needs 911.
KF 4Six calm weeks since the assault. Has her risk fallen?
Not on its own. Remorse and calm usually follow an assault, then tension builds again.
KF 4Her son saw the assault, and now wets the bed again. Urine test is normal. What next?
Look past the bladder. Ask if he is safe, follow your province's child protection rule, and offer him counselling.
FAQ
Should I ask every patient about partner violence?
Ask whenever clues or new risks appear: low mood, anxiety, injuries that do not fit, repeat emergency visits, a controlling partner. Always ask with the patient alone.
Do I have to call the police when an adult discloses abuse?
Not for her own assault, in most cases. For a competent adult, reporting is her choice. Calling over her objection can make her less safe tonight.
What if children live in the home?
Ask about them every time. A child living with partner violence may need protection, even if never hit. Know your province's rule on reporting to child protection.
Does this apply to men, same-sex couples and older adults?
Yes. Anyone can be abused by a partner or family member. Ask alone, judge the danger, make a plan. If an older adult cannot decide, check your province's adult protection law.
Sources
Written from the CFPC Assessment Objectives and Canadian guidelines first. Checked by a Canadian family physician, MD, CCFP.
Last reviewed October 20, 2026For exam study. Not advice for a patient in front of you.
- Assessment Objectives for Certification in Family Medicine, 2nd editionCollege of Family Physicians of Canada · 2020