Clinical Exam


Note: Most candidates aren’t required to complete the Emergency Medicine Clinical Exam. The Clinical Exam is only required for candidates who were approved to sit for the Emergency Medicine Written (Part I) Exam before Sept. 1, 2013. As of Sept. 1, 2013, initial applicants for primary board certification in emergency medicine through the AOBEM do not need to complete the Emergency Medicine Clinical Exam. Please contact aobem@osteopathic.org with any questions about the clinical exam.

DOs who do need to complete the Clinical Exam must submit de-identified medical records for emergency medicine patients they’ve managed. The following training requirements must be completed before a candidate submits materials for the Emergency Medicine Clinical Exam:

  • Have completed an AOA-recognized emergency medicine residency program.
  • Continue the practice of emergency medicine, or continue completing the final year of emergency medicine residency, while completing the certification exam process.
  • Adhere to the AOA Code of Ethics.
  • Demonstrate eligibility for examination in any other manner required by the board.


Once training requirements for eligibility are met, candidates must submit the following:

  • A completed application.
  • Required fees.
  • A copy of your current medical license in the state for which you are submitting de-identified patient charts.
  • Letter from your hospital’s medical staff office verifying that you have full privileges to practice emergency medicine and are in good standing. The verification should be on official hospital stationery.
  • A copy of your current AOA CME activity report and records any additional CME activity not included on your AOA report. For every full year after you finish residency training, you must show that you’ve completed 50 hours of emergency medicine CME. If you’ve been in practice less than one year, the CME requirement is waived. Eligible CME activities are listed below.
  • A copy of your emergency department attending physician schedule for the last 6 months, for emergency department(s) attended by you.

Eligible CME Activities

The AOBEM defines accepted emergency medicine CME as follows:

  • Osteopathic or allopathic CME programs in the specialty of Emergency Medicine
  • State osteopathic CME programs
  • Osteopathic or allopathic medical teaching in the specialty of Emergency Medicine
  • Standardized life support courses
  • Osteopathic manipulative medicine CME courses
  • Bioterrorism and/or disaster medicine CME courses
  • Home study/journal reading/online CME in the specialty of Emergency Medicine. Note that this category is limited to a maximum of 50% of required CME hours.
  • Faculty development programs in the specialty of Emergency Medicine.
  • Emergency Medical Services courses/CME
  • Risk management courses/CME in the specialty of emergency medicine
  • Osteopathic or allopathic CME programs that are not within the specialty of Emergency Medicine may be submitted with course content/lectures for possible full or partial credit hours at the discretion of AOBEM.

Examination Fees

An exam fee of $650 must be submitted with your completed application. Applicants can pay online or by check.

Exam Dates and Deadlines

Submission deadlines for each grading cycle are March 31, June 30, Sept. 30, and Dec. 31. Clinical Exam materials should be sent to:

American Osteopathic Association
142 E. Ontario St.
Chicago, IL 60611-2864

Exam Process

Candidates must submit two sets of 20 de-identified cases to the AOBEM, one original set and one duplicate. These records must represent emergency medicine patients treated on at least five separate dates within the last 12 calendar months from the date of submission. A copy of the patient emergency department record must accompany dictated charts. At least 8 of the submitted charts must involve patients who were admitted (an appropriate transfer to another institution shall be considered as an “admission”).

Each set of cases should be submitted in a binder, in a securely bound format to allow easy review, and should be clearly indexed and tabbed. All patient records must have identifying information removed, including the patient’s name, birth date, and social security number; hospital name; and case medical records number. Each case submitted must include:

  • Physician chart
  • Physician orders
  • Age and sex of patient
  • Nurse’s notes
  • Results of laboratory testing
  • EKGs
  • Official radiologist interpretations of imaging studies
  • Discharge instructions / receipt to patients

Cases which are incomplete will not be graded until all materials are submitted, thus delaying the certification process.

No more than two charts will be accepted from any one of the following categories, and no charts with the same diagnosis and/or procedure may be submitted:

  • Abdominal and Gastrointestinal Disorders
  • Cardiovascular Disorders
  • Cutaneous Disorders
  • Endocrine, Metabolic and Nutritional Disorders
  • Environmental Disorders
  • Head, Ear, Eye, Nose, Throat Disorders
  • Hematologic Disorders/Immune System Disorders
  • Systemic Infectious Disorders
  • Musculoskeletal Disorders (Non-traumatic)
  • Nervous System Disorders
  • Obstetrics and Disorders of Pregnancy/Gynecology
  • Pediatric Disorders
  • Psychobehavioral Disorders
  • Renal Disorders/Urogenital Disorders
  • Thoracic/Respiratory Disorders
  • Toxicology and Clinical Pharmacology
  • Traumatic Disorders
  • Administrative Aspects of Emergency Medicine
  • Disaster Medicine
  • Procedures/Skills

Examination Scoring

Charts submitted as part of the Emergency Medicine Clinical Exam are reviewed based on the following:

  • History
  • Physical
  • Testing
  • Treatment
  • Diagnosis
  • Disposition / Discharge
  • Overall
  • Critical Errors

Rescoring of Examinations

Candidates who are required to complete the Clinical Exam submit two identical binders for scoring. If an examination needs to be rescored, the second binder is given to another examiner for grading.