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Component 3: Cognitive Assessment

Transition to Longitudinal Assessment Begins Jan. 1, 2022

Sept. 8, 2021: The American Osteopathic Board of Surgery (AOBS) has announced, under the guidance of the AOA, that the process by which AOA board-certified surgeons maintain certification will be changing. Beginning in January 2022, the board will begin the transition to a longitudinal assessment model that will replace the high-stakes written examination previously required for Component 3 of Osteopathic Continuous Certification (OCC).

The new Component 3 requirements will take effect when the new OCC cycle begins on Jan. 1, 2022, starting with implementation of longitudinal assessment for diplomates certified in General Surgery and Surgical Critical Care. All other AOBS primary specialties, including General Vascular Surgery, Cardiothoracic Surgery, Neurological Surgery, Plastic & Reconstructive Surgery and Urological Surgery, will transition to longitudinal assessment at a later date. Additional details on the timeline will be forthcoming.

The transition away from the high-stakes examination to a longitudinal assessment model will enable AOBS to provide high-quality evaluation of diplomates while allowing greater flexibility, accessibility and convenience. The new model will afford diplomates the freedom to access and select content that is relevant to their specialty, while maintaining the true spirit of “continuous learning” that longitudinal assessment delivers.

Please continue to consult this website for further details and information regarding transition timeframes.


To complete Component 3 requirements for Osteopathic Continuous Certification (OCC) for the board of Surgery, a physician must pass a written examination.

Exam Process

The OCC Written Exam is generally offered in May and October via a remote proctoring platform. Diplomates may begin taking the exam three years prior to the expiration date of their certification and will have up to six opportunities to pass the exam.

Exam Content Outline

The AOBS Osteopathic Continuous Certification (OCC) exams in Cardiothoracic Surgery, General Surgery, Neurological Surgery, Plastic and Reconstructive Surgery, Surgical Critical Care, Urological Surgery, and Vascular Surgery consist of  100 multiple-choice questions that tests the knowledge and understanding of basic science and clinical knowledge, skills and principles critical to each respective specialty. The examinations are subjected to conventional psychometric analysis using accepted modern methods of key validation and item scoring. The total examination time for respective exam is 2 hours and 15 minutes and is administered via a remote proctoring platform.

Applications and Payment

Diplomates must submit an exam application and fees prior to taking the OCC Written Exam.

OCC Primary (Clinical Pathway)
EXAM Type Fee
OCC $2,225

Exam Results

If a diplomate passes the written exam in a year prior to the year in which the certificate expires, the passing grade will be held and reported to the AOA when all OCC requirements have been met, The new certificate will be valid for 10 years from the date of the expiring certificate.

AOA reports certification results using standardized scores. Examination results are reported on a scale of 200 to 800 and an overall scaled score of 500 or greater is required to pass. The passing standard is determined by subject matter expert osteopathic physicians who practice in the field of the specialty. The passing standard is approved by the respective board.

Content area scores are provided as informative feedback when possible. No minimal requirement is set for performance outcomes for the content area scores. Content area scores are not used to compute your total test score or to determine your performance outcome.

Pass and fail decisions are based solely on the content mastery displayed by the diplomate. Results will be reviewed by the AOBS Examination Committee and submitted for final approval. The AOA will notify candidates of exam results within 90 days of the exam.

Exam Failure

Upon failing an administration of the OCC Written Exam, diplomates may retake the exam provided that certain conditions are met, including the following “current CME” requirements. “Current CME” denotes credits earned since the most recent failure and prior to re-examination.

  • First failure: 15 hours of current CME in the discipline.
  • Second failure: 20 hour of current CME in the discipline.
  • Third failure: 25 hours of current CME in the discipline.
  • Fourth failure: 30 hours of current CME in the discipline.
  • Fifth failure: 35 hours of current CME in the discipline.
  • Sixth failure: AOA will be notified and the certification will be inactivated.

Exam Policies

Rescoring of Examinations

Candidates have the right to request a rescore and audit process of their examination scores. Requests for the rescoring and audit must be submitted to the Board in writing via formal letter or email within one month of the Board’s release of the exam results. The fee for rescoring and audit is $200. The Board will commence the rescoring and audit process following receipt of the candidate’s request and payment. This process is limited to rescoring and audit of the candidate’s exam. Candidates are not allowed to review specific items on the examination. The Board will not reevaluate or reset the “cut” score for passing the exam. The electronic examination data of candidates will be destroyed 24 months after the administration of the examination.

Right to Appeal

If a candidate feels that actions of the AOBS with regard to any part of the certification process constitute unequal application of the Bylaws or Policies and Procedures, unwarranted discrimination, prejudice, unfairness or improper conduct of the examination, he or she has the right to appeal to the board. Appeals to the board can be made by submitting an Appeal Request Form along with any supporting documentary material necessary for proper review of the case. The Appeal Request Form must be submitted within seven days after completion of the exam. The board will not consider appeals based on examination content, sufficiency or accuracy of answers to exam questions, scoring of the exam, and/or determination of the minimum passing score. Candidates will be advised by certified mail within 30 days of final action of the board.

Compliance With Federal Regulations

The AOBS complies with all applicable federal and state regulations, including:

  • Americans with Disabilities Act (ADA): The AOBS complies with requirements prohibiting discrimination and ensuring equal opportunity for persons with disabilities in employment, state and local government services, public accommodations, commercial facilities, and transportation, as well as regulations for Title II and Title III (and all subsequent regulations) as printed in the federal register.
  • Health Insurance Portability and Accountability Act (HIPAA): In compliance with the HIPAA Act of 1996 and any subsequent modifications, the AOBS ensures that individuals’ health information is properly protected, while allowing the flow of health information to provide and promote high quality health care. All medical records submitted for review by candidates for AOBS certification will be de-identified by the candidate prior to submission, such that the remaining information cannot be used to identify an individual patient.