Written Exam


Fellowship Pathway

To be eligible for certification in Pain Medicine through the Fellowship Pathway, candidates must meet the criteria below:

  • Hold an active AOA primary board certification.
  • Satisfactorily complete a one-year AOA- or ACGME-approved fellowship training in pain medicine, as evidenced by a copy of a pain medicine certificate and letter of recommendation from the program director. You will be eligible for certification examination for six years beginning on the date you complete fellowship training.
  • Hold an unrestricted license to practice in a state or territory.
  • Adhere to the AOA Code of Ethics.

Exam Fees

An application fee of $1,300 must be submitted with your completed application. A late fee of $390 will be added to any application received after the initial deadline. No applications will be accepted after the final deadline.

Exam Cancellation Policy

Cancellation Policy
Up to 31 days before the start of the testing window 50%
0-30 days before the start of the testing window No refunds will be issued

Exam Accommodations

All candidates must submit requests for exam accommodations at the time of application. This must be at least 45 days prior to the exam administration date (prior to first application deadline).

Exam Dates and Deadlines

The Pain Medicine Written Exam is offered once a year, generally in the fall.

Exam Content Outline

The Pain Medicine Written Exam consists of 200 scored items and up to 25 non-scored items. Non-scored items are inserted throughout the examination to obtain data relating to the performance of the items. The items may be selected for use as scored items in future examinations.

Subspecialty Certification
Comprehensive Osteopathic Assessment of Pain 23-27%
Osteopathic Manipulation 3-7%
Therapeutic Measures /Modalities 28-32%
Regional Pain 20-24%
Diffuse Pain Syndromes 5-9%
Special Populations 9-13%

You can download the complete exam table of specifications below.

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.