Written Exam


The following requirements must be completed before you may sit for the Written Exam for subspecialty certification in Hospice and Palliative Medicine:

  • General certification from a primary AOA certification board that is active and in good standing.
  • Successful completion of a one-year AOA-approved fellowship in hospice and palliative medicine, completed after July 1, 2009.
  • Hold a valid and active license to practice medicine in a U.S. state.


At the time of application, you must submit the following to the board:

  • A completed application.
  • All required fees.
  • Substantiation of your expertise in hospice and palliative medicine from the program director in the Hospice and Palliative Medicine fellowship.

Exam Fees

An application fee of $1,200 must be submitted with your completed application. Exam applications submitted after June 16 will incur a $360 non-refundable late fee. All fees must be submitted at time of application.

No applications will be accepted after July 16. All cancellations must be made in writing. No exam fees are refunded unless the candidate withdraws from the examination process, which will result in a loss of board eligibility. Refunds will be administered as follows:

  • On or before July 16: 50% refund
  • After July 16: No refund

Exam Dates and Deadlines

The Hospice and Palliative Care subspecialty certification exam is offered in August. The application period opens Feb. 16, 2024, and closes end of day July 16, 2024.

Exam Content Outline

The Hospice and Palliative Medicine exam is a 4.5-hour written examination consisting of 200 multiple-choice, single-answer questions. Questions are taken from current literature, including journals, monographs, recent publication, and recognized texts.

Topics include the following:

Subspecialty Certification
Approach to care 7-12%
Psycho-social and spiritual considerations 8-12%
Impending death 6-10%
Grief and bereavement 4-8%
Medical management 40-46%
Communication and teamwork 4-9%
Ethical and legal decision making 6-10%
Prognostication and natural history of serious history 6-10%

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.