Written Exam


To be eligible for certification in the subspecialty of Hand Surgery, candidates must:

  • Have attained certification in Orthopedic Surgery through the AOBOS or in General Surgery or Plastic Surgery through the American Osteopathic Board of Surgery (AOBS).
  • Have completed a post-residency Hand Fellowship of one year.
  • Have a caseload of which at least 50% is in operative hand surgery and must have been in the active practice of hand surgery for at least two years.
  • Hold full operating privileges in a hospital or surgery center.
  • Hold a valid, active license to practice medicine in a U.S. state, commonwealth, District of Columbia or U.S. territory.
  • Adhere to the AOA Code of Ethics.


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

  • A completed surgical log meeting all requirements outlined by the AOBOS. This log must include a minimum of 125 major surgical cases in a consecutive 12-month period in the last three years.
  • Verification of fellowship program status as program complete.

Exam Fees

An exam fee of $3,000 must accompany your completed application. No application will be considered complete until all fees have been paid. Additional fees may apply for applications received after the first application deadline.

Exam Dates and Deadlines

The Hand Surgery Subspecialty Written Exam is offered once per year, generally in the fall. The application period opens in April/May, and applications are due in August.

Exam Content Outline

The written exam consists of 100 “type A” (one best answer) multiple-choice questions. It is given in one part, and candidates have two hours to complete the exam.

Subspecialty Certification
Amputation 3-5%
Arthritis 13-15%
Infection 11-13%
Joint 10-12%
Microsurgery 6-8%
Nerve 12-14%
Osseous 9-11%
Pediatrics 3-5%
Soft Tissue 1-3%
Tendon 8-10%
Tumor 7-9%
Vascular 5-7%

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.