Written (Cognitive) Exam


The following requirements are in effect for exam eligibility:

  • Candidate completed an AOA-approved family medicine residency within the past six years OR the candidate may apply for examination during their final year of an AOA or ACGME approved training and sit for the examination up to six (6) months prior to completion of their residency training program.
  • Candidate must adhere to the AOA Code of Ethics.
  • Candidate must demonstrate eligibility for examination in any other manner required by the Board.


Once eligibility requirements are met, applicant must submit the following:

  • A completed application.
  • Required fees.
  • Copy of residency certificate if training completed or Verification of Residency training form listing start and completion dates or copy of residency certificate if program is complete.
  • Signed and dated Statement of Understanding for Issuance of Certification.

Note that although documentation of an active unrestricted state medical license is not a requirement for eligibility to sit for the certification exam, a copy of your state medical license showing an expiration date will be required to obtain certification.

Exam Fees

An exam fee of $550 must be submitted with your completed application. No application will be considered complete until all fees have been paid. Non-refundable late fees must be submitted with application based on published submission deadlines.

Cancellations must be submitted in writing and a cancellation processing fee will be assessed.

Exam Dates and Deadlines

The Family Medicine Cognitive Exam is offered twice yearly via remote proctored platform. Candidates will take the exam from the convenience of their home or office with the security of a remote proctor. The application period opens 6-8 months prior to the exam administration date. A letter confirming eligibility, the exam schedule with further deadlines (test date selection, cancellation, other requests) with instructions on selecting an appointment is provided to the applicant via email upon full processing of the application within four weeks. Applicants with deficient applications are notified of deficiencies.

Exam Content Outline

There are 275 single-answer, multiple-choice questions on the Family Medicine Cognitive Exam. This is an approximately 5.5 hour exam with breaks between sections. The breakdown of the exam is listed below.

Non-disclosure agreement – 2 minutes
Tutorial – 10 minutes
Section 1 – 92 questions for 98 minutes
10 minute optional break
Section 2 – 92 questions for 98 minutes
10 minute optional break
Section 3 – 91 questions for 98 minutes
Survey – 3 minutes

Total exam length: 329 minutes

Primary Certification: Family Medicine
Allergy, Immunology, & Rheumatology 5%
Cardiology & Pulmonology 10%
Dermatology 6%
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 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.