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Written Exam


The following requirements must be met by physicians seeking certification in the subspecialty of Pain Management:

  • Graduate from a college of osteopathic medicine.
  • Hold an active license to practice medicine in a state or territory. A physician who has a restricted licence may petition AOBA to enter the certification process based on review of the reason for licensure restriction.
  • Demonstrate adherence to the AOA’s Code of Ethics.
  • Complete a residency training program in Anesthesiology.
  • Achieve primary certification through the AOBA.
  • Successfully complete at least a one-year training program in Pain Management. Training is not considered complete until all required documentation is approved by the AOA Council on Postdoctoral Training, AOA and AOBA.
  • Have practiced as a specialist in Pain Management for a minimum of one year prior to applying for subspecialty certification.
  • Pass a written subspecialty certification examination administered by the AOBA.


In order to take the Written Exam, you must:

  • Submit a completed application, required documentation and application fee prior to the application deadline of the year in which the examination is to be taken.
  • Provide two letters of endorsement submitted to the board on your behalf by diplomates of the AOBA who can vouch for your professional training and quality of service.
  • Be available for a personal interview upon request.
  • Demonstrate eligibility for examination in any other manner required by the board.

Exam Fees

An exam fee of $600 must be submitted with your completed application. No application will be considered complete until all fees have been paid.

After the published registration deadline, a late fee of $300 will be applied.

Exam candidates may elect to cancel their exam up to 60 days prior to the date of the exam. If cancelling, a reason for cancellation must be provided in writing to aoba@osteopathic.org. Exam cancellations received 60 days or more prior to the exam date will be refunded less a $100 cancellation fee. No refunds will be issued for cancellations received within 60 days of the exam date.

Exam Dates and Deadlines

The AOBA subspecialty certification exam is offered once in March and once in August. The application period opens at least 90 days prior to the exam date.

Exam Content Outline

The Written Exam for certification in the subspecialty of Pain Management is designed to test your knowledge and understanding of basic science and clinical knowledge, skills and principles. Effective Jan. 1, 2018, the examination is a 4-hour exam that consists of 200 multiple-choice questions, each with a single best answer. Questions will be categorized as follows:

Subspecialty Certification
  1. I. Anatomy & Physiology
  2. II. Diagnostic Testing
  3. III. Pain Assessment & Classification
  4. IV. Pharmacology
  5. V. Medical & Invasive Techniques
  6. VI. Pediatric, OB & Other Special Situations
  7. VII. Psychological Aspects
  8. VIII. Disability & Medicolegal
  9. IX. Osteopathic Principles & Methods
  • 8-12%
  • 5-9%
  • 3-7%
  • 21-25%
  • 23-27%
  • 6-10%
  • 1-5%
  • 11-15%
  • 1-5%

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

Candidates may attempt to pass the Written Exam up to three times during a three-year period, provided all requirements for examination are met. Following a third failure, the candidate must petition the board to re-enter the certification process. In this case, the board may request additional CME or training as a requirement for re-entry.