Component 3: Cognitive Assessment


To complete Component 3 requirements for Osteopathic Continuous Certification in the primary specialty of Dermatology, a physician must pass a written examination once per 10-year OCC cycle.

Exam Process

The OCC exam is administered yearly in one two-hour session. Candidates are permitted to take the examination three years prior to the expiration date of their board certification. This allows the candidate sufficient time to pass the examination if necessary. For example, candidates with certifications expiring in 2021 may take the examination in 2018. If they pass, the new expiration date would still be 2031.

OCC is not required for physicians who hold non-time-limited (non-dated, non-expiring) certifications, although they may elect to participate voluntarily.

Dermatology OCC Exam

The OCC Cognitive Assessment is designed to thoroughly test the candidate’s knowledge of the clinical aspects of dermatology and related disciplines as they pertain to the routine practice of dermatology. The exam is psychometrically analyzed and updated yearly.

This examination utilizes high-resolution clinical images of dermatological conditions with associated multiple-choice questions, emphasizing clinical and laboratory dermatology, dermatopathology and surgery. The examination will focus on areas relevant to the practicing dermatologist.

The total test time is two hours, with approximately one hundred images and questions.

The core references used to construct the exam include standard texts and peer-reviewed journals on dermatology, dermatopathology and dermatological surgery. These texts will assist you in focusing your study efforts but do not guarantee that all examination questions will be taken from these references.

Mohs Micrographic Surgery OCC Exam

The exam consists of two parts: a written and practical exam. The proctored written exam questions are based on material published in standard dermatology and dermatologic surgery publications. It includes testing on several areas:

  • Tumor biology and cutaneous oncology
  • Indications for MMS
  • Surgical technique
  • Surgical anatomy
  • Local and regional anesthesia
  • Preoperative evaluation
  • Histological technique
  • Wound care and wound healing
  • Dermatopathology
  • Surgical complications
  • Instrumentation

The practical exam requires submission of three Mohs cases for evaluation. The cases must have been performed within the last two years and have at least two Mohs stages each, with one case being a tumor other than a basal cell carcinoma. Each case must include the pre-operative evaluation (indications), operative notes, post-operative notes, Mohs slides, and Mohs map. All cases must be brought to the examination site in cardboard slide trays and arranged by case. Photographs are not required but are highly encouraged.

Please note that to ensure HIPAA compliance, the AOBD will sign a Business Associate agreement with the candidate to protect the slide and patient information required for the exam.

Applications & Payment

The following are required to apply for the OCC Dermatology Cognitive Assessment:

  • The AOA will verify that you are a member in good standing.
  • One letter of recommendation from a board-certified dermatologist or dermatopathologist and one letter from your hospital chief of staff or another physician that has knowledge of your clinical practice. Letters must be dated within the same year of the exam. Please include your AOA ID on the letters.
  • Copy of your state license. License must be valid as of date of test.
  • One photo.
  • $1,800 non-refundable fee.

The following are required to apply for the OCC MMS Cognitive Assessment:

  • A copy of your medical license.
  • A copy of the appropriate CLIA laboratory registration certificate.
  • Documentation of a minimum of 15 hours of CME in Mohs Surgery, Cutaneous Oncology and associated reconstructive techniques in the two years prior to recertification.
  • Logs documenting a minimum of 100 cases of Mohs surgery performed in clinical practice during the last three years.
  • Non-refundable exam fee of $1,800.
  • All licenses, memberships and certificates must be valid as of the date of the test.

Applications must be complete by August 1 of the year of the exam.

OCC Certification
EXAM Type Fee
OCC Registration (once every three-year cycle) $300
OCC Cognitive Assessment Exam Fee $1,800
OCC Cognitive Assessment Re-examination Fee $1,800
OCC Late Registration Fee $150/year

Exam Results

AOA reports certification results using standardized scores. Examination results are reported on a scale of 200 to 800 and an overall scaled score of 500 or greater is required to pass. The passing standard is determined by subject matter expert osteopathic physicians who practice in the field of the specialty. The passing standard is approved by the respective board.

Content area scores are provided as informative feedback when possible. No minimal requirement is set for performance outcomes for the content area scores. Content area scores are not used to compute your total test score or to determine your performance outcome.

Exam results will be communicated through via letters following the exam. Exam results are reviewed by the board before being released.

Exam Failure

For physicians holding time-dated certification, failure to successfully complete the OCC process will result in the loss of certification when their current certification expires. Passing candidates will receive exam results in writing within 60-90 day of taking their exam. Candidates who pass their exams will be forwarded to the AOA Bureau of Osteopathic Specialists, which makes the final determination for diplomate status. Once approved, diplomates will receive a letter from the AOA; your certificate will be mailed within 6-10 weeks.

Compliance With Federal Regulations

The Board supports the intent of the Americans with Disabilities Act (ADA) for candidates who meet ADA eligibility. The board will make a reasonable effort to provide qualified board candidates who have documented disabilities the necessary auxiliary aids and services that do not fundamentally alter the measurement of the skills or knowledge the board assessment process is intended to test or result in an undue burden.

The Board supports the intent of the Health Insurance Portability and Accountability Act (HIPAA) for all patients or patient records that may be used as part of any part of the AOBD board certification process.