IMPORTANT NEWS Re: Allergy and Immunology OCC Recertification – The Pediatric and Adult Allergy and Immunology Conjoint Examination Committee will now offer the NBOME Longitudinal Assessment to Diplomates. For the 2024 examination year, Diplomates may choose to take the high stakes examination, or participate in Longitudinal Assessment (LA). The LA program for 2024 will launch in July and will be open to those Diplomates who hold certificates which will expire Dec. 31, 2024, and those who qualify under BOS policy.

Written Exam


The following eligibility requirements must be met for subspecialty board certification in Pediatric and Adult Allergy and Immunology:

  • Hold primary certification from either the American Osteopathic Board of Internal Medicine or the American Osteopathic Board of Pediatrics.
  • Senior Fellows must have completed 80% of program rotations to take the Allergy and Immunology Remote Exam.
  • Update your Fellowship training status with AOA Postdoctoral Education.
  • Hold an active medical license to practice medicine in one of the 50 states.
  • Conform to the standards of the AOA Code of Ethics.


Once training and eligibility requirements are met, candidates must submit:

  • A completed application
  • Payment of application fees
  • Verification of fellowship in Allergy and Immunology

Exam Fees

A fee of $1,700 must accompany your completed application. No application will be considered complete until all fees have been paid.

If you wish to cancel your participation in the exam, you must notify the examination committee in writing 15 full days prior to the exam date in order to receive a refund of your exam fee, less a $300 processing fee.

Exam Dates and Deadlines

The Written Exam for subspecialty certification in Pediatric and Adult Allergy and Immunology is held in spring. The application process opens in October and closes in March. Apply early to avoid late application fees.

Exam Content Outline

The Pediatric and Adult Allergy and Immunology Written Exam consists of 250 multiple choice questions.

Subspecialty Certification
    1. 1. Basic science
    2. 2. Primary and secondary immunodeficiencies
    3. 3. GI disorders
    4. 4. Autoimmunity and other immunological disorders
    5. 5. Pulmonary diseases
    6. 6. Hypersensitivity reactions and mast cell disorders
    7. 7. Allergic and non-allergic upper respiratory tract diseases
    8. 8. Skin disorders
  • 30%
  • 10%
  • 10%
  • 3%
  • 13%
  • 11%
  • 13%
  • 10%

Exam Scoring

Scoring Criteria

AOA reports candidates’ certification results using standardized scaled scores. Scaled scores are more valid and reliable compared to raw scores and make scores comparable across different forms of the exam. The AOA reports scores on a 200 to 800-point scale with a scaled score of 500 or higher required to pass.

  • A scaled score of 500 represents the minimum level of knowledge and skill necessary to pass the exam as established by AOA Certifying Boards.
  • The highest possible scaled score is 800.
  • The lowest possible scaled score is 200.
  • Overall scores are based on the total number of items answered correctly, regardless of content area.

Results by Content Area

  • When possible, a breakdown of exam scores by content area is provided to help you identify your areas of strength and areas that may need more development.
  • The number of items for each content area indicates the relative amount of test questions on the exam for that content area.
  • Content area scores are not weighted to calculate your overall score; each content area is scored separately after the overall analysis is complete.

Exam Failure

If you don’t pass your exam, you may apply for reexamination on the next available exam date. You’ll need to complete another application and submit the $1,400 exam fee. You will also need to submit CME hours based on the application guidelines in place at the time of your application.