OCC Cognitive Assessment Examination

If your certification expired in 2020 or before, you are required to complete the OCC Cognitive Assessment Examination process outlined below. If your AOBEM certification expires in 2021 or beyond, you are eligible to participate in the CORE examination process.


Physicians holding AOBEM certificates that expired during or before 2020 are required to complete the traditional written OCC exam. Upon passing the exam and completing any other outstanding OCC requirements, your credentials will be submitted for reactivation of certification. At that point, you will be eligible to register for CORE (Continuous Osteopathic Recertification Examination).

Exam Content

The Emergency Medicine Written Exam tests the knowledge and understanding of basic science and clinical knowledge, skills and principles critical to the practice of Emergency Medicine.  The exam is offered in the spring and fall through a remote proctored platform. This online platform allows each candidate to take the exam online from the convenience of your home or office with a remote proctor. The exam is in a multiple-choice format, with most questions directing diplomates to choose the one best answer among five possible answers. The exam consists of 150 questions, broken into three sections of 50 items.  Candidates will have 60 minutes to complete each section. There is an optional, 10-minute break after each section. Once you choose to move away from the section, your answers to the questions will become permanent and you will not be allowed to go back to the section

  • During breaks: Candidate may not access electronics or study materials.

Exam topics include:

OCC Cognitive Exam
  1. 1. Abdominal and gastrointestinal disorders
  2. 2. Cardiovascular disorders
  3. 3. Cutaneous disorders
  4. 4. Endocrine, metabolic and nutritional disorders
  5. 5. Environmental disorders
  6. 6. Head, ear, eye, nose and throat disorders
  7. 7. Hematologic and immune system disorders
  8. 8. Systemic infectious disorders
  9. 9. Musculoskeletal disorders (nontraumatic)
  10. 10. Nervous system disorders
  11. 11. Obstetrics and gynecology disorders
  12. 12. Psychobehavioral disorders
  13. 13. Renal and urogenital disorders
  14. 14. Thoracic respiratory disorders
  15. 15. Toxicological disorders/Clinical pharmacy
  16. 16. Traumatic disorders and disaster medicine
  17. 17. Administrative aspects of emergency medicine/EMS
  18. 18. Procedures/skills
    • 7-9%
    • 8-10%
    • 2-4%
    • 4-6%
    • 2-4%
    • 4-6%
    • 3-5%
    • 5-7%
    • 4-6%
    • 4-6%
    • 1-4%
    • 3-5%
    • 4-6%
    • 7-9%
    • 2-4%
    • 10-12%
    • 2-4%
    • 7-9%

Applications & Payment

Diplomates must submit an exam application, copy of their current medical license, and fees by the application deadline. The application deadline will be set 15 days before the exam administration.

Exam Fees

An exam fee of $800 must be submitted with your completed application. No application will be considered complete until all fees have been paid. The final application deadline will be set 15 days before the exam administration.

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.

Compliance with Federal Regulations

The AOBEM complies with all applicable federal and state regulations, including:

  • Americans with Disabilities Act (ADA): The AOBEM complies with requirements prohibiting discrimination and ensuring equal opportunity for persons with disabilities in employment, state and local government services, public accommodations, commercial facilities, and transportation, as well as regulations for Title II and Title III (and all subsequent regulations) as printed in the federal register. All candidates must submit their requests at the time of application and this must be done prior to 45 days from the exam date.
  • Health Insurance Portability and Accountability Act (HIPAA): In compliance with the HIPAA Act of 1996 and any subsequent modifications, the AOBEM ensures that individuals’ health information is properly protected, while allowing the flow of health information to provide and promote high quality health care. All medical records submitted for review by candidates for AOBEM certification will be de-identified by the candidate prior to submission, such that the remaining information cannot be used to identify an individual patient

Right to Appeal

If a candidate feels that actions of the AOBEM with regard to any part of the certification process constitute unequal application of the Bylaws or Policies and Procedures, unwarranted discrimination, prejudice, unfairness or improper conduct of the examination, he or she has the right to appeal to the board. Appeals to the board must be made in writing and should include any supporting document for proper review of the case. You must submit the completed appeal request form to the AOBEM within 24 hours of completing the exam. The board will not consider appeals based on examination content, sufficiency or accuracy of answers to exam questions, scoring of the exam, and/or determination of the minimum passing score. If an appeal is denied by the AOBEM, the candidate retains the right to appeal to the AOA Bureau of Osteopathic Specialists (BOS).