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.
  • Satisfactorily complete five years of AOA or ACGME-approved training in orthopedic surgery for training started after July 2008.
    • Candidates may apply during the fifth year of training if all application requirements are received by January 15 of the fifth year.
  • Hold an unrestricted license to practice in a state or territory.
    • Applicants for initial certification with a restricted license may petition the AOBOS for the ability to enter the certification process based upon review of the reason for licensure restriction.
  • Adhere to the AOA Code of Ethics.


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

  • Copy of your osteopathic diploma.
  • Copy of your current state medical license.

Exam Fees

An exam fee of $1,650 must accompany your completed application. No application will be considered complete until all fees have been paid.

The examination fee is non-refundable, and no cancellations will be accepted once an application has been submitted.

Exam Dates and Deadlines

The Orthopedic Surgery Written Exam is offered once per year, generally every May. The application period opens in October, and applications are due in January.

The written exam is administered by computer at Prometric test centers. After your application is accepted, you will receive additional information regarding instructions on scheduling your exam appointment.

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.