Written Exam


The following training requirements must be completed before a candidate may sit for the Written Exam for primary certification in Pediatrics:

  • Complete a three-year, AOA-approved or ACGME-accredited pediatric residency training program. If your internship year was a pediatric specialty track, two years of AOA-approved or ACGME-accredited residency training are required.
  • Third-year residents may apply to take the exam prior to completing residency, but you must have completed at least 30 months of residency or 80% of the total program rotations by the exam date.
  • Adhere to the AOA Code of Ethics.


Once training requirements for eligibility are met, candidates must submit the following:

  • A completed application.
  • Required fees.
  • Verification of residency training, as follows:
    • If you’re in your third year of residency and have completed 30 months of training or 80% of the total program rotations, please submit a letter from your residency program director stating that you’re qualified to take the Pediatrics Written Exam.
    • If you’ve already completed residency, please submit a copy of your residency certificate. If it’s not available, please provide a letter from your residency program director indicating you completed the residency satisfactorily. ACGME-trained physicians can submit their letter from the AOA indicating their residency training is AOA-recognized.

If you take the Pediatrics Written Exam as third-year resident, you’ll receive your exam scores after you’ve completed the residency program, submitted all required documentation and received approval from all involved parties.

Exam Fees

An exam fee of $1,700 must be submitted with your completed application. No application will be considered complete until all fees have been paid.

Applications for spring exams must be submitted by March 2 in order to avoid incurring a late fee. If you submit your application less than 30 days before the exam date, the late fee increases to $800. No applications will be accepted two weeks before the exam date.

All cancellations must be made in writing at least 15 full days before the examination date. Diplomates who cancel an exam will have the examination fee refunded, less a $300 processing fee.

Exam Dates and Deadlines

The Pediatrics Written Exam is offered each spring, and is a remotely-proctored examination. The exam application period opens in the fall.

Exam Content Outline

The Pediatrics Written Exam tests the knowledge and understanding of basic science and clinical knowledge, skills and principles critical to the practice of Pediatrics. The exam is a written, multiple choice type exam and many items utilize visual images. The exam consists of eight sessions of 50 questions (approximately 400 items). Each section is timed for 60 minutes each for a total of 480 minutes (8 hours). It is required that candidates spend no more than one hour on each session to complete each individual session. After the second, fourth, and sixth sections there will be an optional 10 minute break.

8 sections

  • Confirmation/Intro/Instruction
  • Section 1 – 60 minutes
  • Section 2 – 60 minutes
  • Break – 10 minutes (optional)
  • Section 3 – 60 minutes
  • Section 4 – 60 minutes
  • Break – 40 minutes (optional)
  • Section 5 – 60 minutes
  • Section 6 – 60 minutes
  • Break – 10 minutes (optional)
  • Section 7 – 60 minutes
  • Section 8 – 60 minutes


Exam topics are listed below. The following percentages are to be used as a guideline only. Many items may reflect content from multiple categories.

Primary Certification
Pediatric Health Maintenance and Preventative Care 11%
Infectious Diseases 8%
Laboratory, Procedural, and Diagnostic Performance and Interpretation 7%
Neonatal Medicine and Newborn Care 6%
Emergency Medicine and Critical Care 4%
Gastroenterology and Nutrition 4%
Mental Health 4%
Nephrology/Urology 4%
Neurology 4%
Otolaryngology 4%
Sports Medicine and Orthopedics 4%
Adolescent Medicine 3%
Allergy and Immunology 3%
Developmental and Behavioral Health 3%
Hematology and Oncology 3%
Osteopathic Principles and Practice 3%
Pulmonology 3%
Social Determinants of Health 2%
Cardiology 2%
Child Abuse and Neglect 2%
Dermatology 2%
Endocrinology 2%
Epidemiology and Public Health 2%
Genetics and Metabolic Disorders 2%
Ophthalmology 2%
Rheumatology 2%
Research Methodology and Quality Improvement 2%
Ethics and Medical Jurisprudence 1%
Pain and Fluid Management and Other Pharmacology 1%

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.


Third-Year Residents

Third-year residents who take the Pediatrics Written Exam will receive exam scores after they’ve completed their residency program, submitted all required documentation and received approval from all involved parties.

Rescoring of Examinations

Candidates may request that the AOBP psychometrician manually review the computer scoring of the exam. Requests for review of the written exam must be submitted in writing to AOBP at aobp@osteopathic.org within 30 days of receiving exam results. If the request is for an oral exam, the appeals must be submitted within two hours from the completion of the oral exam process.

Exam Failure

Candidates who do not pass any certifying examination may apply for reexamination and must take the exam on the next available date. The reexamination fee is identical to the examination fee. The certification exam can be taken yearly until board eligibility expires. Candidates who do not succeed in becoming certified by the end of the first re-entry into the certification process must petition the AOBP in order to enter the final certification pathway.

BOS Handbook