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Longitudinal Assessment Purpose Statement

The American Osteopathic Board of Surgery (AOBS) has transitioned from the 10-year recertification examination to a longitudinal assessment model for primary certification. The AOBS longitudinal assessment aligns with the three-year Osteopathic Continuous Certification (OCC) cycle to fulfill the Component 3 requirement. Our goal is to provide flexible, effective learning opportunities for our Diplomates and promote current knowledge of optimal surgical practice.

AOBS Longitudinal Assessment Design and Structure
  • An open book assessment with the ability to save and return to at your convenience.
  • Remote platform that is available online 24/7 and can be accessed from the convenience of your home or office.
  • The assessment questions are untimed and can be completed during one or multiple sittings during the assessment cycle.
  • Three attempts to pass the assessment questions during the assessment cycle.
  • Immediate scoring upon final completion of the assessment.
Once I’m registered, how long do I have to start the longitudinal assessment?

Once you are registered and have access to the CATALYST assessment platform, you may begin the assessment at any time. It is important to know that your start time is not the time of registration; however, it is when you begin the assessment on CATALYST. Once you log on and answer any of the available questions, the assessment must be completed within that quarter of the calendar year.

What are the quarters of the calendar year?

The assessment will be available once each quarter, or four times a year:

  • Quarter 1: January – March
  • Quarter 2: April – June
  • Quarter 3: July – September
  • Quarter 4: October – December
How many attempts do I have to pass the assessment?

For the 2022-2024 cycle, you will have a total of three attempts to pass the assessment. You will have the ability to decide which quarter is best for you to complete the reattempt(s). Changes will take place for the 2025 cycle, which will be annually with less attempts.

Are the questions timed?

No, the questions are not timed. You will have unlimited time to answer each question, but please plan accordingly, as each article may take approximately 5-15 minutes to review in its entirety.

Are we allowed three tries per question before it is marked incorrect?

You will have three attempts to pass the 2022-2024 assessment with an 80% passing rate needed. In reality, yes, you would then have three attempts at the incorrect questions but not within the same sitting. Once you select an answer for an individual question and receive an incorrect score, you will not immediately be able to retake that question, but rather on the second attempt of your assessment. The CATALYST platform allows for Diplomates to review questions scored incorrectly and encourages you to review the article links again. Any attempt to answer the incorrectly scored questions will be provided during a reattempt of the assessment.

Will the articles be available to read during the assessment?

The AOBS longitudinal assessment is an “open book” assessment. If an article is free and accessible electronically, you will have the opportunity to read it via the direct links. In most situations, even if an article is not free, the Diplomate and/or the organization is already a subscriber to the publishing company and will not have any difficulty accessing the content. For some of the articles, a cited reference reading list is made available and posted on the AOBS website. The Diplomate is responsible for obtaining these articles. While not mandatory, we do encourage you to read the articles in advance to prepare. Direct links to referenced articles are provided by the AOBS, in addition to cited references. Please also visit the AOBS website for more information.

I am on my second attempt of the assessment and have concerns regarding the confidence level questions.

After you select an answer for each question, you will click the submit button. Prior to NBOME logging your answer, must complete a question that asks about your confidence level. There are four options to choose from, which are not at all confident, somewhat confident, confident or highly confident. These responses from the Diplomates allow us to gauge whether or not Diplomates are truly reading the articles prior to selecting an answer, and helps AOBS determine whether or not content needs to be further reviewed.

What if I start my assessment in the first quarter of the year, but don’t finish all the questions?

The assessment must be successfully completed by the end of the quarter in which you start.   Because the assessment questions are untimed, once you begin, the assessment questions can be completed during one or multiple sittings throughout the quarter.

Completing the assessment is dependent upon your personal schedule and commitment. The assessment will resume where you previously left off. We recommend that you don’t wait until quarters three or four within the final year of the OCC cycle, as you could potentially forfeit one or more re-attempts if needed.

How is the longitudinal assessment administered?

The AOBS longitudinal assessment for General Surgery and Surgical Critical Care will be administered through the National Board of Osteopathic Medical Examiners’ (NBOME) CATALYST learning assessment platform. In addition to the learning opportunities that the CATALYST platform offers, assessments delivered on CATALYST provide both performance feedback and additional support.

You will have access to CATALYST 24/7 and can be accessed via laptop computer, tablet, smartphone or through the CATALYST app.

What is the fee for the AOBS longitudinal assessment?

The fee for general surgery is $675 total per cycle ($225 per year). The fee for surgical critical care is $375 total per cycle ($125 per year). The assessment fee for the cycle is due at the time of registration.

How do I know when my certification was issued or expires?

Visit the AOA physician portal (login required) to view your certification information and to check the OCC status.

If my recertification is due to expire in 2024, do I have until the end of 2024 to complete the assessment, or will my certificate become inactive?

All Diplomates in General Surgery and Surgical Critical Care with a time-limited certificate expiring on or after Jan. 1, 2022, have been transferred to the new process in the OCC cycle in which the expiration date of their current time-limited certificate falls (i.e., if your certificate expires in 2026, you will start the longitudinal assessment during the 2025 annual assessment).

Once registered and you began participating in the longitudinal assessment, your certificate will remain active through the end of the OCC cycle (Dec. 31, 2024).

If my certificate is set to expire in 2023 or 2024, when do I start the registration process and assessment?

All Diplomates with certificates that expired in 2022 or 2023, or will expire in 2024, have access to the assessment which started in January 2022. Because Diplomates are given three attempts to pass the 2022-2024 assessment, those whose certification expired in 2023 or 2024 have had the same amount of time (three years) as those whose certification expired in 2022. This provides all Diplomates with equal opportunities during the assessment cycle. While you are encouraged to start the Longitudinal Assessment early, it is up to the individual Diplomate to decide what assessment time frame works for them. If you prefer to wait until the year your certification will expire to begin the longitudinal assessment, you will have less time in the cycle to complete retakes if necessary.

What if I just passed my oral qualifying exam and received certification to become a Diplomate. When does longitudinal assessment start?

For Diplomates who received their certification in 2022, you may begin the 2022-2024 longitudinal assessment cycle at any time. However, it must be completed by the end of year. For Diplomates that receive their certification in 2023, you will be placed in the annual assessment beginning in 2025. The AOA believes the start time is fair to Diplomates, as there was only one scheduled oral exam in 2023, which was later in the year. Thus, Diplomates who passed in late 2023 had less time to complete the assessment.

Is there a fee for second attempts or retakes if I fail my assessment?

No. Two additional attempts on each question during the assessment are provided to assist you with passing the assessment. No additional out-of-pocket expenses are required (unless you fail all three attempts). The annual fee paid at the time of registration covers the full cost of the assessment.

How do I prepare for the longitudinal assessment?

Links to all articles for the 2022-2024 assessment are available now for effective preparation. You are encouraged to visit the below links at your convenience, in addition to downloading and saving any articles you wish to reread in preparation.

What types of questions can be expected on the longitudinal assessment?

The content includes assessing a Diplomate’s knowledge and practice of the surgical professional so that continuing education expectations of the osteopathic profession are withheld. A total of 60 questions are administered for General Surgery in the 2022-2024 cycle, and a total of 30 questions are administered for Surgical Critical Care in the 2022-2024 cycle. After reading the provided article links, you should prepare for the topics on the following page.

General Surgery


Number of Items

Cancer/Tumor Biology














Nutrition, Metabolism






Skin/Soft Tissue




Surgical Critical Care




Wounds, Burns



Surgical Critical Care


Number of Items



Initial Resuscitation 






Thermal Injury





Is there a late fee for registration?

No. At this time a late fee will not be assessed.

Who developed the content of the AOBS longitudinal assessment?

The AOBS longitudinal assessment was developed by AOA board certified osteopathic surgeons who represent the AOBS Division of Examiners. These physicians are also known as subject matter experts (SME).

Each SME has a wealth of knowledge in content appropriate for ongoing osteopathic certification, including being trained in professional item writing. All questions administered during the longitudinal assessment were written with the assistance of medical editors and psychometric staff of the AOA Certifying Board Services department and the NBOME. Questions are submitted and vetted by the AOBS Division of Examiners as appropriate, debated and voted upon for acceptance.

Is longitudinal assessment available for AOBS subspecialty or conjoint certifications?

Yes, longitudinal assessment is available for AOBS subspecialty certificate holders. Longitudinal assessment for specialties is required on an annual basis. Beginning in 2025, General Surgery and Surgical Critical Care will also be on an annual basis. Please refer to the Frequently Asked Questions Document for Specialties which will provide you with further information.

Will I receive CME credits for successfully completing the AOBS longitudinal assessment?

Yes. A total of 15.0 AOA Category 1-B credits will be awarded at the end of the calendar year upon successful completion of the assessment (for the 2022-2024 cycle). Credits will not be awarded should a Diplomate fail the assessment. In 2025, when General Surgery and Surgical Critical Care move to an annual assessment, 5.0 AOA Category 1-B credits will be awarded.

What is required to pass the assessment?

The passing score has been set at 80% for the assessment, across all AOBS assessments.

Will I receive a new certificate once I complete the longitudinal assessment?

If your certificate was granted to you prior to 2018, it currently has an issuant date and an expiration date. After 2018, the AOA discontinued putting expiration dates on certificates to enhance the nature of continuous learning. You will only receive a new certificate if your current certificate has an expiration date, and all other OCC components have been met. For those who will not receive a new certificate, you will receive a formal letter from the AOA confirming successful completion of OCC component 3. Should you ever need a new certificate, remember that you can order one through the AOA Physician’s Profile.

What if I fail my longitudinal assessment?

Again, you receive three attempts on the 2022-2024 assessment. Remember that the assessment will provide you with the correct answers. If a Diplomate truly fails the assessment three times, this is of great concern to the AOBS Board. The Bureau of Osteopathic Specialists (BOS) is currently further discussing remediation and we anticipate changes to be announced later in 2024 which may determine an inactive status. However, at the present time, Diplomates will remain active, but know that you must complete the assessment you failed and successfully pass before moving to the next cycle. You also can simultaneously work on the year you failed, in addition to the current assessment. You will be provided with access to the assessment on the AOA’s Learning Management System to do so.

How will the assessment be provided to repeat diplomates or those who have not participated?

If you have failed the assessment three times, or have not participated at all, you must successfully complete the assessment you failed or didn’t participate in. If you have failed the 2022-2024 assessment, you must again register to take the assessment for that cycle and again pay the $675 fee for General Surgery, or $225 for Surgical Critical Care.

Will the remediation assessment be hosted on NBOME/CATALYST?

The remediation assessment will not be on the NBOME Catalyst platform, but rather available on the AOA’s Learning Management System. Each Diplomate will be provided with instructions and a secure log-in.

When will I have access to the AOA’s Learning Management System assessment if I am in remediation?

Diplomates will be provided access to the assessment if in remediation, starting in February of the current year.

How many attempts do I have to pass the assessment if I am in remediation?

Like the first 2022-2024 assessment, you will be given three opportunities to pass the assessment and you must re-answer all questions for the assessment you are repeating. That is, 60 questions for General Surgery, and/or 30 questions for Surgical Critical Care.

What if I again fail both attempts in the remediation assessment?

Should you fail all three attempts, you must again pay the registration fee and will be granted three additional attempts. Diplomates will continuously be charged the same fee with the same number of attempts until they pass the cycle. You must pass this assessment.

If my certification was due to expire at the end 2022 and I did not participate in longitudinal assessment in 2023 (rolled over), what is my status?

At the present time, you must register and complete all outstanding assessments. Without a paid registration, you are currently inactive. For those reasons, we encourage you to register as quickly as possible. Remember that this is only one component of the OCC Process, Component 3. You must also complete OCC Components 1, 2 and 4.

Should I experience issues accessing the platform, who should I contact?

If you have any questions or concerns regarding features and functionality of the CATALYST platform, contact NBOME Client Services at clientservices@nbome.org or (866) 479-6828. If you are in remediation and are attempting to pass the assessment on the AOA’s Learning Management System, please call (312) 202-8078. For general questions, please email us at aobs@osteopathic.org.

Reading links and works cited

Reading Links

General Surgery Works Cited

Article 15: Pieracci, Fredric M., et. al. “A Multicenter, Prospective, Controlled Clinical Trial of Surgical Stabilization of Rib Fractures in Patients with Severe, Nonflail Fracture Patterns (Chest Wall Injury Society NONFLAIL).” Journal of Trauma and Acute Care Surgery, vol. 88, no. 2, Feb. 2020, pp. 249–57, https://doi.org/10.1097/TA.0000000000002559.

Article 17: Gingrich, Alicia A., et. al. “Neoadjuvant Radiotherapy Is Associated with R0 Resection and Improved Survival for Patients with Extremity Soft Tissue Sarcoma Undergoing Surgery: A National Cancer Database Analysis.” Annals of Surgical Oncology, vol. 24, Oct. 2017, pp. 3252–63, https://doi.org/10.1245/s10434-017-6019-8.

Article 20: Clementson, Martin, et. al. “Acute Scaphoid Fractures: Guidelines for Diagnosis and Treatment.” EFFORT Open Reviews, vol. 5, no. 201, Feb. 2020, https://doi.org/10.1302/2058-5241.5.190025.

Article 21: Melchiors, Jacob, et. al. “Cricothyroidotomy – The Emergency Surgical Airway.” Journal of the Sciences and Specialties of The Head and Neck, vol. 38, no. 7, July 2016, pp. 1129–31, https://doi.org/10.1002/hed.24392.

Article 40: O׳Keeffe, Michael, et. al. “Imaging Protocols for Trauma Patients: Trauma Series, Extended Focused Assessment With Sonography for Trauma, and Selective and Whole-Body Computed Tomography.” Seminars in Roentgenology, vol. 51, no. 3, July 2016, pp. 130–42, https://doi.org/10.1053/j.ro.2016.02.007.