Clinical Exam


The 2025 Winter Clinical Examination application has closed early due to reaching maximum testing capacity. The 2025 Summer Cycle Clinical application will open on Nov. 5, 2024, at 8:00 a.m. CT.

Objective of the Clinical Examination

The objective of the Clinical Examination is to evaluate a Candidate’s surgical practice by review of their medical records and oral defense of a subset of cases. To accomplish this goal, two board-certified orthopedic surgeons will review the medical record with particular emphasis on presurgical evaluation and preparation, postoperative management, surgical judgment and overall patient care. Twelve cases will be reviewed in detail, and from these five cases will be chosen for case defense.


To be eligible for the Clinical Exam, Candidates must meet the criteria below:

Please note that all Candidates who were or became Board Eligible in 2020 have been granted an additional year of eligibility due to the pandemic. Rather than six years of eligibility, those Candidates now have seven years. For example, if you completed your residency on June 30, 2019, you are Board Eligible until Dec. 31, 2026.


The following must be included with your application* by the first application deadline:

  • Surgical Log
    • The Surgical Log must include all major cases where the candidate was the primary surgeon in a six-month period. The minimum number of cases is 100, but ALL major cases in the six-month period must be reported.
    • The Surgical Log template provided in the application portal and on the AOBOS site must be used.
    • Included in the Surgical Log template is a Hospital Location Sheet (HLS) to report the hospitals where the candidate performs surgery.
    • The Clinical Examination Handbook should be read in full before candidates begin their surgical log collection. Candidates should understand the requirements for compiling a case for examination before beginning their collection period.
  • Mortalities within 30 days of surgery must be indicated in the Surgical Log and a Mortality Report must be completed.

*Please note that you may apply and pay the examination fee to hold your spot in the cohort. You must add your required documents before the published first deadline date to complete your application.

Examination Fees

The Clinical examination fee is $2,250.

A late fee of $250 will be added after the first deadline. No application will be considered complete until all exam fees are paid. If the application is not approved for the Clinical exam, 90% of the fee will be returned.

Exam Dates and Deadlines

The Clinical Exam is offered in two cycles annually: Winter and Summer.

Please note: The pandemic caused an abrupt halt to in-person examinations at the Candidate site. A new virtual process was conceptualized and implemented. This took time resulted in only one cycle being offered during 2020. As a result, there is an increased number of Candidates needing to examine, causing high competition for available positions within each cohort.

  • Candidates should plan to apply immediately when the application opens.
  • Applications and payment are required to secure a position in the cohort.
  • Required documents MUST be added by the first application deadline.
  • The application will be closed when maximum testing capacity is reached.

Surgical Log Guidelines

The Surgical Log must be added to your application before the first application deadline.

  • Candidates must collect all major cases where they are the primary surgeon for a minimum of six consecutive months.
    • The oldest eligible cases for inclusion are those occurring up to one year before the exam application opening date
    • The most recent eligible cases for inclusion are those occurring on the day of the first application deadline
  • The log must include equal to or greater than 100 cases. If a candidate does not reach or exceed 100 cases in the six-month collection period, they may continue to collect for up to 18 months or until they reach the 100-case minimum.

Clinical Cycle Testing Timeline

  • Examiner case selection and communication to candidate: ~13 days
    • During this time, the Senior Examiner reviews the Candidate’s Surgical Log and selects cases for examination.
  • Candidate chart preparation and upload: 30-35 days
    • During this time, Candidates compile case material and upload it to the secure file sharing system.
  • Candidate material upload deadline: 1 day
    • AOBOS staff convert file share links from to read-only and send the material to the Examiners.
  • Examiner review of Candidate materials: ~55 days
    • During this time, Examiners evaluate chart materials, submit chart scoring; conduct case defense interview and submit related scoring.
  • Examiner final grade submission deadline
    • Candidate results are posted within 12 weeks of the posted Examiner final grade submission deadline.