Component 3: Cognitive Assessment


To complete Component 3 requirements for Osteopathic Continuous Certification in the primary specialty of Emergency Medicine, a physician must pass a written examination. You can view your status for all components of Osteopathic Continuous Certification by logging in to the AOA Physician Portal.

Exam Process

The Emergency Medicine OCC exam is a three-hour computer-based exam made up of “choose the one best answer” multiple choice questions. The AOBEM Cognitive Assessment Examination has 150 multiple-choice questions. You will have three hours to complete all the questions in the exam.

  • Within the exam you can answer questions, mark questions so you can go back to them later, skip questions, go back to review previously marked or answered questions, and change answers.
  • At the end of the content section you will be notified on screen if you have any questions that are marked or unanswered. Please review these items before leaving the 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.

This exam does not have a scheduled break. You have two optional, 10-minute breaks between sections 1 and 2 and sections 2 and 3.

  • During 10-minute breaks: Candidate may not access electronics or study materials. Candidate may access locker for food, drink, and medicine only. Candidate may not leave center except to use restroom if located outside the site.

If you wish to take a break during the exam, signal the proctor before leaving the testing room. At the time you re-enter the testing room, you must show a valid ID. Please note that the content timer will continue to run while you’re out of the room. Diplomates may begin taking the exam three years prior to the expiration date of their certification. AOBEM exams are evaluated using an absolute standard (pass/fail).

OCC Cognitive Exam Content

There are 150 items on the Emergency Medicine OCC exam and 150 items on the subspecialty OCC exam. The majority of questions require you to choose one correct answer from five choices. The exam will cover all areas of emergency medicine as thoroughly as possible, including:

OCC Cognitive Exam
  1. 1. Abdominal and gatrointestinal 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 and 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

If a diplomate passes the OCC Written Exam in a year prior to the year in which the certificate expires, the passing grade will be held and reported to the AOA when all OCC requirements have been met, the new certificate will be valid for 10 years from the date of the expiring certificate. In accordance with the AOBEM Standards Review Committee, the Written Exam is reviewed by a psychometrician to verify adherence to rule of practice established in the APA/AERA National Standards for Education and Psychological Testing. Pass and fail decisions are based solely on the content mastery displayed by the diplomate. All exam results are reviewed and approved by the board. Diplomates will be notified no later than 8 weeks from the close of the testing window.

Exam Failure

Candidates who do not pass the OCC Written Exam may apply for reexamination and will be required to follow the OCC process in its entirety.

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).

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.