Component 3: Cognitive Assessment

Launch of Longitudinal Assessment on CATALYST

The American Osteopathic Board of Family Physicians (AOBFP) will no longer administer the traditional high-stakes exam taken by its diplomates at least once every 7 to 9 years to fulfill the Component 3 requirement of Osteopathic Continuous Certification (OCC). Diplomates will now be required to participate in the AOBFP Longitudinal Assessment (LA) to fulfill the Component 3 requirement of OCC.

Please note that once you register for the Longitudinal Assessment, it will take up to seven business days to review your application and activate your account in CATALYST. Candidates are encouraged to register at least two weeks before the end of the quarter to be able to participate in the assessment. Candidates will have access to all incorrect or unanswered items during the remediation period. View all exams and applications.

10 helpful tips for successful participation (PDF)

Certification Expiration Date Start Longitudinal Assessment
Dec. 31, 2023 January 2023
Dec. 31, 2024 January 2024
Dec. 31, 2025 January 2025
Dec. 31, 2026 January 2026
Dec. 31, 2027 January 2022
Dec. 31, 2028 January 2022
Dec. 31, 2029 January 2022
Dec. 31, 2030 January 2023
Dec. 31, 2031 January 2024

2024 Longitudinal Assessment References

The following references are provided as a preparation tool for the 2024 Longitudinal Assessment. The AOBFP longitudinal assessment is an “open book” assessment. If an article is free and accessible electronically, you will have the opportunity to read it via the direct links. In most situations, even if an article is not free, the Diplomate and/or their organization may be a subscriber to the publishing company and will not have any difficulty accessing the content. For some of the articles, a cited reference reading list is made available and posted on the AOBFP website. The Diplomate is responsible for obtaining these articles. While not mandatory, we do encourage you to read the articles in advance to prepare. Direct links to referenced articles are provided by the AOBFP, in addition to cited references.

The assessment is configured so that you have two attempts at the questions and are given the rationale for the correct answer upon responding. If there is an article that is hard for you to obtain, you may use the testing process to gain insight into the question and answer.


To complete Component 3 requirements for OCC in the primary specialty of Family Medicine, a physician must pass a cognitive assessment examination.

Only diplomates whose certification expired in 2021 will need to take the OCC exam. Diplomates have until Dec. 31, 2024 to pass this exam or will need to apply as OCC/Reentry and take the Initial Certification exam. Diplomates who have been in expired status since 2019 or prior (3+ years) must apply as OCC/Reentry and take the Initial Certification Exam.

Family Medicine OCC Cognitive Exam

The OCC exam for the primary specialty of Family Medicine is a three and a half-hour exam comprised of 200 single answer multiple-choice questions. There is an optional, 10-minute break halfway through the exam. Diplomates may begin taking the exam two years prior to the expiration date of their certification. These exams are offered twice yearly in the spring and fall. The exam is administered via Pearson VUE’s remote proctored platform, OnVUE. Candidates will take the exam from the convenience of their home or office. The breakdown of the exam is listed below:

Non-disclosure agreement – 2 minutes

Tutorial – 10 minutes

Section 1 – 100 items for 105 minutes

10-minute optional break

Section 2 – 100 items for 105 minutes

Survey – 3 minutes

Total exam length – 235 minutes

For physicians holding time-dated certification, failure to successfully complete the OCC process will result in the loss of certification when their current certification expires.

For physicians with non-time-limited (non-dated, non-expiring) certifications, OCC participation is not required, although they may elect to do so voluntarily. Failure to complete the OCC process will not result in the loss of primary certification.

OCC Cognitive Exam: Family Medicine
Addiction Medicine 4%
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%
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.

Family Medicine OMT Performance OCC Exam

The OMT performance exam requires the candidate to diagnose and demonstrate an appropriate technique for each of three cases representing the areas of spine, extremities, and systemic diseases. Candidates will be scored on diagnosis, identification of landmarks appropriate to the technique, implementation and demonstration of appropriate technique, ability to discuss each technique, and professionalism. You must obtain a passing score on two of the three cases.


Beginning on Jan. 1, 2020, the Osteopathic Manipulative Treatment (OMT) performance examination is no longer required for Diplomates whose certification expires Dec. 31, 2020, through Dec. 31, 2026. If your certification expires before 2026, you are not required to fulfill the OCC requirement to maintain your OMT certificate, and it will remain active through your current expiration date. Once you receive your new 9-year certificate, you must satisfy the requirements to maintain the OMT Certification. To view your specific activities and verify that you are on track to recertify, please login to the AOA Physician Portal. If you have any questions or need assistance, please contact our office at aobfp@osteopathic.org.

Diplomates holding certificates with expiration dates of Dec. 31, 2019, or earlier must still take the OMT performance examination as part of their OCC process to remain certified in Family Medicine or OMT.

Eligibility Requirements

Exam Fees

You must submit an exam fee of $500 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. A cancellation processing fee will be assessed once an application has been submitted. All cancellations must be submitted in writing.

Exam Failure

An opportunity to retake is offered during the same exam administration either later in the day or another consecutive day of testing. In the event of a failure on the second exam attempt within that session, the candidate will be required to document completion of a CME review course in osteopathic principles and techniques before retaking the OMT performance exam at a future date.

Geriatric Medicine OCC Exam

The 200-item single answer multiple-choice examination will cover the broad aspects of geriatric family medicine that physicians caring for the elderly are expected to know. Clinical situations involving diagnosis, etiology, prognosis and natural history of disease and management will be stressed. The breakdown of the exam is listed below.

Non-disclosure agreement – 2 minutes

Tutorial – 10 minutes

Section 1: 100 items for 105 minutes

10 minute optional break

Section 2: 100 items for 105 minutes

Survey – 3 minutes

Total exam length: 235 minutes

Specific areas of emphasis will include:

OCC Cognitive Exam: Geriatrics
Allergy, Immunology, & Rheumatology 5%
Cardiology & Pulmonology 12%
Dermatology 8%
Emergency Medicine 4%
Endocrinology 4%
Gastroenterology 6%
Hematology & Oncology 5%
Infectious Disease 7%
Nephrology & Urology 8%
Neurology 7%
Orthopedic & Musculoskeletal Medicine 7%
Osteopathic Principles and Practice 5%
Palliative Care 5%
Population Health 3%
Psychiatry 5%
Women’s Health 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 general surgery.

2024 Longitudinal Assessment References

The following references are provided as a preparation tool for the 2024 Longitudinal Assessment. View resources.

Conjoint OCC Exams

If you hold subspecialty/CAQ board certification through one of the conjoint committees in which the AOBFP participates, please visit the conjoint website for info on OCC Component 3 requirements.

Addiction Medicine

Hospice and Palliative Medicine

Pain Medicine

Sleep Medicine

Sports Medicine

Undersea and Hyperbaric Medicine

Exam Fees

Diplomates must submit an exam application, copy of their current medical license and fees no later than the published postmark deadline dates. Non-refundable late fees apply as determined for each exam administration. No applications will be accepted after the final deadline. Fees are subject to change.

Primary Certification
EXAM Type Fee
OCC Cognitive Exam fee $400
OCC Cognitive Exam non-refundable late fee $75
OCC Cognitive Exam re-examination fee $400
OCC Performance Exam fee $400
OCC Performance Exam non-refundable late fee $75
OCC Performance Exam re-examination fee $400

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.

Candidates are informed of results by email within 8 weeks.

Exam Failure

Candidates who do not pass the OCC cognitive examination may apply for reexamination at the next administration unless additional requirements apply. The reexamination fee is $400 and requires the submission of an online application.

Right to Appeal

If a candidate feels that actions of the AOBFP 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 can be made by emailing the request to AOBFP@osteopathic.org, along with any supporting documents necessary for proper review of the case. The appeal request must be submitted within 30 days of receiving exam results.

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.

ADA and HIPAA Policies

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

  • Americans with Disabilities Act (ADA): The AOBFP complies with all applicable federal and state regulations, including the Americans with Disabilities Act (ADA). The Board 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. To request an ADA accommodation from the AOBFP, you can submit an ADA Accommodation Application.
  • Health Insurance Portability and Accountability Act (HIPAA): In compliance with the HIPAA Act of 1996 and any subsequent modifications, the AOBFP 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 AOBFP certification will be de-identified by the candidate prior to submission, such that the remaining information cannot be used to identify an individual patient.