Early Entry Initial Certification Written Exam
Overview
The AOBFP Early Entry Initial Certification (EEIC) program allows physicians to seek specialty board certification while still completing their residency. Candidates may opt for board certification in Family Medicine and OMT (OMT Performance Examination required) or Family Medicine.
Eligibility
You are eligible to sit for the Early Entry Initial Certification Written Exam if you meet one of the following criteria:
- You are a DO/MD in a Family Medicine residency.
- You must be in your final year of residency at the time of the examination.
The following criteria must also be met:
- You have completed two osteopathic in-service exams produced and administered by ACOFP.
The chart below indicates timing for the first class of residents to be eligible for early entry.
| Eligibility Timeline | ||||
|---|---|---|---|---|
| CLASS | PGY 1 | PGY 2 | PGY 3 | EARLY ENTRY |
| 2024-25 | In-service exams: October 2022 |
In-service exams: October 2023 |
In-service exams: October 2024 |
Eligible for EEIC: 1Q 2025 |
| 2025-26 | In-service exams: October 2023 |
In-service exams: October 2024 |
In-service exams: October 2025 |
Eligible for EEIC: 1Q 2026 |
| 2026-27 | In-service exams: October 2024 |
In-service exams: October 2025 |
In-service exams: October 2026 |
Eligible for EEIC: 1Q 2027 |
Requirements
Once eligibility criteria is met, applicants must submit the following:
- A completed application
- Required fees
- Verification that you completed two AOBFP In-Service Exams during your residency
- A Statement of Understanding for Issuance Certification form
Exam Fees
An exam fee of $400 must be submitted with your completed application.
Exam Dates and Deadlines
The Early Entry Initial Certification Written (Cognitive) Exam will be administered via remote proctored platform between Jan. 12-14, 2027.
Application period opens: Aug. 12, 2026
First deadline: On or before Nov. 12, 2026 (no late fees)
Final deadline: Dec. 12, 2026 (late fees will apply
Exam Content
The Early Entry Initial Certification exam is designed to measure the competency and knowledge, skills, abilities and judgments of qualified osteopathic family practice physicians.
The American Osteopathic Board of Family Physicians (AOBFP) is committed to ensuring a fair, valid and high-quality certification process. As part of our continuous improvement efforts, AOBFP will introduce a modest update to exam content beginning in 2027.
What is changing?
Starting with the 2027 exam administrations:
- The Early Entry Initial Certification (EEIC) Examination will include 200 total questions.
- The Initial Certification Examination will include 300 total questions.
This update includes the addition of 25 pretest items on each exam.
What are pretest items?
Pretest items are unscored questions embedded within the exam. They are not identified during testing and do not affect your score.
Why are pretest items important?
Pretesting is best practice in high-quality assessment programs. It allows AOBFP to:
- Evaluate new questions under real testing conditions
- Ensure questions are fair and reliable
- Maintain the overall quality and integrity of the examination
Only questions that meet rigorous statistical standards are used as scored items on subsequent exams. This process helps ensure that every scored question on the exam meets AOBFP’s standards.
Exam timing and structure
The addition of pretest items results in minor adjustments to total testing time and section length.
2027 EEIC Examination: 200 items (including 25 pre-test items)
Two 105-minute sections with 100 items per section
Total test time: 210 minutes (3.5 hours), plus break time
| Early Entry Certification: Family Medicine | |
|---|---|
| CATEGORY | PERCENT |
| Allergy, Immunology, & Rheumatology | 5% |
| Cardiology & Pulmonology | 10% |
| Dermatology | 6% |
| EENT | 4% |
| Emergency Medicine | 2% |
| Endocrinology | 4% |
| Gastroenterology | 8% |
| General Surgery | 2% |
| Hematology | 4% |
| Infectious Disease Medicine | 6% |
| Nephrology & Urology | 6% |
| Neurology | 4% |
| Orthopedic, Musculoskeletal, & Sports Medicine | 6% |
| Osteopathic Principles and Practice | 10% |
| Population Health & Practice Management | 6% |
| Preventive Medicine | 3% |
| Psychiatry | 5% |
| Reproductive Medicine | 2% |
| Substance Use Disorders | 4% |
| Women’s Health (OB/GYN) | 3% |
| Total | 100% |
*These percentages represent the minimum amount of content from each of the stated areas. Many items may address multiple areas listed above while other items will also assess other knowledge bases, such as pediatrics, adolescent medicine and geriatrics.
Exam Scoring
Scoring Criteria
AOA reports candidates’ certification results using standardized scaled scores. Scaled scores are more valid and reliable compared to raw scores and make scores comparable across different forms of the exam. The AOA reports scores on a 200 to 800-point scale with a scaled score of 500 or higher required to pass.
- A scaled score of 500 represents the minimum level of knowledge and skill necessary to pass the exam as established by AOA Certifying Boards.
- The highest possible scaled score is 800.
- The lowest possible scaled score is 200.
- Overall scores are based on the total number of items answered correctly, regardless of content area.
Results by Content Area
- When possible, a breakdown of exam scores by content area is provided to help you identify your areas of strength and areas that may need more development.
- The number of items for each content area indicates the relative amount of test questions on the exam for that content area.
- Content area scores are not weighted to calculate your overall score; each content area is scored separately after the overall analysis is complete.
Exam Failure
Candidates who do not pass the certification examination and take the traditional Initial Certification Examination may apply for reexamination at the next administration unless additional requirements apply. The reexamination fee is $500 and requires the submission of an online application.