Written Exam


The following training requirements must be completed before a candidate may sit for the Written Exam for subspecialty certification in Nephrology:

  • Have completed two years of training in an AOA-recognized fellowship program in Nephrology. You must have completed the required training by Aug. 15 of the year you plan to sit the exam.
  • Adhere to the AOA Code of Ethics.


Once training requirements for eligibility are met, candidates must submit the following:

  • A completed application.
  • Required fees.
  • Proof of an active medical license.
  • Initial applicants and applicants who have not completed their training must submit a Program Director report by July 18 verifying clinical competence and the completion date of an AOA-recognized fellowship training program.
  • If you completed your training in an ACGME fellowship program, submit a letter from the AOA stating that the ACGME fellowship training has been AOA-recognized.

Exam Fees

An exam fee of $800 must be submitted with your completed application. No application will be considered complete until all fees have been paid. Exam applications submitted after June 16 will incur a $240 non-refundable late fee. 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 Nephrology Written Exam is offered in August. The application period opens Feb. 16, 2024, and closes end of day July 16, 2024.

Exam Content Outline

The Nephrology Written Exam tests the knowledge and understanding of basic science and clinical knowledge, skills and principles critical to the practice of Nephrology. The seven-hour exam consists of 300 multiple choice questions in the following areas:

Subspecialty Certification
  1. 1. Fluid, acid-base, electrolyte physiology/renal function testing
  2. 2. Mineral metabolism/disorders (PO4, Ca, Mg)
  3. 3. Hypo/Hypernatremia
  4. 4. Hypo/Hyperkalemia
  5. 5. Acid-base disorders/Renal tubular disorders
  6. 6. Acute kidney injury
  7. 7. Pregnancy and the kidney
  8. 8. Overdose/Toxic nephropathy/Intoxication
  9. 9. Primary glomerular disease
  10. 10. Secondary glomerular disease
  11. 11. Diabetic nephropathy
  12. 12. Hypertension
  13. 13. Chronic kidney disease
  14. 14. Peritoneal dialysis
  15. 15. Hemodialysis
  16. 16. Renal transplantation
  17. 17. Vasculitis/Vascular disorders of kidney
  18. 18. Tubulointerstitial disease
  19. 19. Urolithiasis
  20. 20. Obstructive uropathy
  21. 21. Urinary tract infections/Pyelonephritis
  22. 22. Cystic disease/UT Anomalies
  23. 23. Familial disorders of kidney
  • 2-6%
  • 2-6%
  • 2-6%
  • 1-5%
  • 8-12%
  • 7-11%
  • 1-3%
  • 1-5%
  • 5-9%
  • 4-8%
  • 2-6%
  • 3-7%
  • 3-7%
  • 3-7%
  • 6-10%
  • 3-7%
  • 1-5%
  • 1-5%
  • 1-3%
  • 1-3%
  • 1-4%
  • 2-6%
  • 1-5%

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.