OSTEOPATHIC BOARD CERTIFICATION

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Family Medicine Early Entry Initial Certification Process

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.

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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

Apply now

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
  1. Allergy, immunology & rheumatology
    1. Autoimmune
    2. Arthritis
    3. Allergies
    4. Allergic rhinitis
    5. Anaphylaxis
    6. Crystal arthropathies
    7. Sarcodidosis
    8. Immune deficiency and compromise
    9. Connective tissue diseases
 5%
  1. Cardiology
    1. Hypertension
    2. Hyperlipidemia
    3. Heart failure
    4. Arrythmia
    5. Myocarditis
    6. Endocarditis
    7. Cardiomyopathy
    8. Vascular conditions
    9. Congenital heart disease
 5%
  1. Dermatology
    1. Skin cancer
    2. Systemic manifestations of disease
    3. Rosacea
    4. Venous stasis dermatitis
    5. Fungal skin infections
    6. Viral skin infections
    7. Bacterial skin infections
    8. Pigmentation disorders
    9. Dermatitis
    10. Autoimmune
    11. Parasitic
 5%
  1. ENT
    1. Deafness and hard of hearing
    2. Oral cavity disorders
    3. Ear conditions
    4. Nasal conditions
    5. ENT Infection
    6. Throat conditions
    7. Hoarseness and voice disorders
    8. Vertigo
 4%
  1. Emergency medicine
    1. Chest pain
    2. Metabolic disorders
    3. Poisoning
    4. Drug overdose
    5. Injury/trauma
    6. Respiratory distress
    7. Neurologic emergencies
    8. Airway, breathing and circulation
    9. Shock
    10. Environmental exposures
    11. Acute sepsis
    12. Polypharmacy and drug interactions
    13. Non-accidental injuries
    14. Human trafficking
 4%
  1. Endocrinology
    1. Diabetes
    2. Thyroid disorder
    3. Obesity
    4. Calcium and bone metabolism
    5. Aldosteronism
    6. Parathyroid disorders
    7. Metabolic syndrome
    8. Pituitary disorders
    9. Reproductive endocrinology
    10. Clinical guidance on hormonal therapy and/or replacement
    11. Gender affirming care
 5%
  1. Gastroenterology
    1. Colorectal pathology
    2. Gastroesophageal pathology
    3. Gastrointestinal bleed
    4. Hepatology
    5. Gastritis
    6. Esophageal cancer
    7. Small bowel obstruction
    8. Neuro gastroenterology and motility
    9. Inflammatory bowel disease
    10. Malabsorption disorders
    11. Pancreatic disorders
 5%
  1. General surgery
    1. Pre-operative work-up
    2. Cholecystitis
    3. Masses
    4. Ileus/bowel obstruction
    5. Appendicitis
    6. Wound management
    7. Plastic surgery
    8. Hernias
    9. Colorectal
    10. Transplant
    11. Pancreatic
    12. Hepatobilliary
    13. Surgical oncology
 3%
  1. Hematology
    1. Anemia
    2. Disorders of coagulation
    3. Venous thromboembolism
    4. Benign hematology
    5. Genetic disorders
 3%
  1. Infectious disease medicine
    1. Communicable respiratory viral illness
    2. Sexually transmitted infections
    3. Skin and tissue infections
    4. Fever of unknown origin
    5. Bacteremia/systemic inflammatory response syndrome/sepsis
    6. Osteomyelitis
    7. HIV/AIDS and related conditions
    8. Clostridium difficile
    9. Travel induced infection
    10. Other viral illness
    11. Meningitis
    12. Vector borne illness
    13. Antibiotic stewardship
 6%
  1. Nephrology
    1. Electrolyte imbalance
    2. Acute and chronic kidney disease
    3. Rhabdomyolysis
 4%
  1. Neurology
    1. Headache
    2. Dizziness
    3. Cerebrovascular accident/transient ischemic attack
    4. Neuro cognitive impairment
    5. Peripheral neuropathy
    6. Seizures/epilepsy
    7. Neurodegenerative disorders
    8. Neurologic autoimmune disorders
    9. Movement disorder
    10. Neuropathic pain
    11. Neurologic trauma
    12. Neuro inflammatory disorders
 5%
  1. Oncology
    1. Lung cancer
    2. Breast cancer
    3. Prostate cancer
    4. Colon cancer
    5. Skin cancer
    6. Cervical/uterine cancer
    7. Thyroid cancer
    8. Other malignancy
    9. Complications from chemotherapy, immunotherapy or radiation
    10. Oncologic emergencies
    11. Renal cancer
 4%
  1. Ophthalmology
    1. Eye infection/inflammation
    2. Eye injuries and emergencies
    3. Eye diseases
    4. Neuro-ophthalmological conditions
 2%
  1. Orthopedic, musculoskeletal & sports medicine
    1. Back pain
    2. Neck pain
    3. Spinal pathology
    4. Hip/iliosacral pain
    5. Traumatic injuries
    6. Concussion
    7. Arthropathies
    8. Compartment syndrome
    9. Overuse/occupational injury
    10. Sciatica piriformis/psoas
    11. Congenital and acquired bone pathology
 6%
  1. Osteopathic principles & practice (OPP)
    1. Diagnosis of somatic dysfunction
    2. Treatment of somatic dysfunction
    3. Application of osteopathic tenets
    4. Billing and coding
 5%
  1. Population health & practice management
    1. Health policy and medical jurisprudence
    2. Social determinants of health
    3. Epidemiology
    4. Healthcare equity
    5. Interdisciplinary teams
    6. Physician burnout
    7. Practice management
    8. Biostatistics
    9. Regulatory programs
    10. Telemedicine
    11. Remote patient monitoring
 6%
  1. Preventive medicine
    1. Primary prevention
    2. Secondary prevention
    3. Tertiary prevention
 4%
  1. Psychiatry
    1. Eating disorders
    2. Mood disorders
    3. Neurodevelopmental disorders
    4. Anxiety disorders
    5. Dual diagnosis
 5%
  1. Pulmonology
    1. Pulmonary infections
    2. Pulmonary fibrosis
    3. Restrictive lung diseases
    4. Obstructive lung diseases
    5. Obstructive sleep apnea
    6. Cough
 4%
  1. Substance use disorders
    1. Overdose
    2. Substance use disorder
    3. Tolerance, dependence and withdrawal
    4. Treatment and recovery
 2%
  1. Urology
    1. Urinary tract infections
    2. Incontinence/urgency
    3. Renal and ureteral calculi
    4. Urologic cancer
    5. Bladder cancer
    6. Prostate disease
    7. Erectile dysfunction
 4%
  1. Women’s health (OB-GYN)
    1. Cervical and uterine disorders
    2. Menopausal and peri-menopausal treatment
    3. Menstrual disorders
    4. Ovarian pathology
    5. Prenatal, perinatal and postnatal care
    6. Breast health
    7. Vulvovaginal conditions
    8. Pregnancy complications
    9. Pregnancy management
    10. Family planning
    11. Uterine pathologies
    12. Endometriosis
 4%

*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.

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