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Component 4: Practice Performance Assessment & Improvement


Component 4 requires physicians to engage in continuous quality improvement through comparison of personal practice performance measured against national standards for their medical specialty. You can view your status for all components of Osteopathic Continuous Certification by visiting the AOA Physician Portal.

For current certificates ending on or before Dec. 31, 2024, AOBOG requires a physician to complete two Practice Performance Assessment (PPA) modules and/or Quality Improvement (QI) activity attestations in a six-year OCC cycle. The deadline to complete Component 4 is Sept. 15 of the year of certification expiration.

Beginning in 2025 for the 2025-2027 certification CME cycle, the requirement will become one Practice Performance Assessment (PPA) module and/or Quality Improvement (QI) activity attestation each three-year certification CME cycle. This will apply to all diplomates regardless of certification expiration date. The deadline to complete Component 4 for the 2025-2027 cycle is Sept. 15, 2027.

PPA modules are available in a variety of ways:

  • Quality Improvement Activity Attestations. Physicians participating in Quality Improvement (QI) activities may attest to their participation for Component 4 credit using the online submission form in the AOA Physician Portal. Common activities received from OB/GYN physicians include patient satisfaction/feedback surveys, postpartum hemorrhage or neonatal safety drills (or other delivery room/operation room safety drills), condition screening (i.e. postpartum depression, diabetes, hypertension, etc.), Meaningful Use through EMR, participation on a patient-care-focused hospital committee, participation in a state or national data registry (i.e., prescription drug monitoring programs), service as a residency or fellowship program director or associate program director, etc. The Physician Portal also contains more information on what kinds of activities may qualify for the QI activity attestation. (Physicians who would like to request credit for more than one QI activity should submit the attestation form once for each activity requested.)
  • The Office of Minority Health’s “A Physician’s Practical Guide to Culturally Competent Care.” Physicians must complete all three themes (Fundamentals of Culturally Competent Care; Provide Language Access Services; and Structuring Culturally Competent Care) for credit for 1 PPA module. You must email or fax (312-202-8482) a copy of the CME certificate to the AOBOG office for credit. AOBOG will report CME credits on your behalf. (Please note: The Office of Minority Health allows physicians to complete this activity more than once {maximum of once per year}. The AOBOG will accept it for credit once per OCC cycle.)

For diplomates who are also in fellowship, one PPA module will be waived for each year both certified and in fellowship.