Written Exam


To be eligible for certification in Orthopedic Surgery, candidates must meet the criteria below:

  • Be a graduate of a COCA-accredited college of osteopathic medicine or an LCME accredited medical school in the US or Canada.
  • Have graduated from, or be in the fourth or fifth year of, an AOA-approved or ACGME accredited residency in orthopedic surgery.
  • Adhere to the AOA Code of Ethics.


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

  • Completed application and fees.
  • Check the pre-populated demographic information and make any necessary corrections.
    • Provide a personal email not your residency email
    • Provide a mobile number
  • Please read the pre-populated residency information.  If there are corrections needed, use the checkbox to indicate them. The AOA GME Department will verify the changes with your program and make the corrections. The changes will not be immediately recorded on the PDF copy of your application that is emailed to you

Exam Fees

An exam fee of $1,000 must accompany your completed application. No application will be considered complete until all fees have been paid.

Exam Dates and Deadlines

The Orthopedic Surgery Written Exam is offered once per year, the second week of May. The application period opens in November, and the first deadline is the first business day in March. Late fees will apply after the first deadline. The final application deadline is the first business day in April.

The written exam is administered by remote proctor and can be taken in the private space of your choosing. After your application is accepted, you will receive instructions for scheduling your exam appointment. For more information on what to expect on exam day, please visit our Remote Proctored Examination information page.

Exam Content Outline

The written exam consists of 250 multiple-choice questions. It is given in three 110-minute sections of approximately 80 questions each, with optional breaks between each section.

Primary Certification
Foot/Ankle 10-11%
Hand/Upper Extremity 10-12%
Joint 11-14%
Pediatrics 9-11%
Sports Medicine 11-13%
Spine 9-11%
Trauma 11-14%
Tumor 4-6%
Infection 5-6%
Basic Science 12-16%

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.