Cognitive Assessment (Component 3) – Pain Management – Anesthesiology: Cognitive Assessment


To meet the Cognitive Assessment (Component 3) requirements for Osteopathic Continuous Certification (OCC), in the subspecialty of Pain Management – Anesthesiology you must pass a psychometrically valid written cognitive assessment designed to evaluate your specialty medical knowledge and mastery of core competencies in the provision of health care. The AOBA sets forth the following requirements for Cognitive Assessment (Component 3).

Exam Fees

An exam fee of $750 must be submitted with your completed application. No application will be considered complete until all fees have been paid.

Applications submitted after the first deadline must include an additional 30% late fee ($225). Examination fees must be made by credit card within the application portal. No other forms of payment may be accepted.

Exam Cancellation Fees

  • 0 – 30 days before the exam: no refund
  • 31 days or more prior to the exam date: 50% refund
  • No refunds of late fees
  • Rejected Applications: 75% refund

Note: Prior to submitting your application, please be certain that you meet the criteria to apply

Exam Dates and Deadlines

The Pain Management – Anesthesiology OCC Certification Exam is offered annually via a remote proctored exam format. The application period opens six months prior to the exam.

The first application deadline will be 60 days prior to the first date of the exam administration window. The final deadline will be 30 days prior to the exam administration window.

All candidates requesting exam accommodations must submit their requests at the time of application and all information must be received at least 30 days prior to the exam administration date.

Exam Content Outline

The examination will consist of questions on clinical diagnosis and treatment, current knowledge, and clinical problems commonly encountered. The questions are designed to ensure appropriate evaluation of a candidate’s knowledge, intellectual abilities, judgment, and skills in the discipline of Pain Management – Anesthesiology. The examination is a 2-hour and 30-minute exam that consists of 100-120 multiple-choice questions, each with a single best answer. Questions will be categorized as follow:

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

Exam Scoring

AOA reports certification results using standardized scores. An adjusted score of 70% or greater is required to pass. The passing standard is determined by subject matter experts and osteopathic physicians who practice Pain Management Anesthesiology.

Candidates may attempt to pass the Pain Management – Anesthesiology OCC Certification Exam within three-years prior to expiration.

Pass and fail decisions are based solely on the content mastery displayed by the diplomate. Results will be reviewed by the AOBA Examination Committee and submitted for final approval. The AOA will notify candidates of exam results within 60 days of the exam.


Exam Failure

A physician may re-enter the process by completing any outstanding OCC requirements not fulfilled when the certification became inactive. The date of certification will be effective on the date that all requirements have been satisfied.

Physicians wishing to re-enter the certification process three (3) or more years following the expiration or inactivation of their certification must take and pass at a minimum the primary written certification examination or other applicable examination(s) as determined by the respective board and immediately begin the OCC process through participation in a Component 4 activity. Specialty certifying boards may also require additional examination and remedial activities such as training or CME.