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Medical Education  |   February 2006
Board Certification of Osteopathic Physicians
Author Notes
  • From the Division of Certification, Department of Education, American Osteopathic Association, Chicago, Ill. 
  • Address correspondence to Armando F. Ramirez, Department of Education, American Osteopathic Association, 142 E. Ontario St, Chicago, IL 60611-2864. E-mail: aramirez@osteopathic.org 
Article Information
Medical Education / Preventive Medicine / Professional Issues
Medical Education   |   February 2006
Board Certification of Osteopathic Physicians
The Journal of the American Osteopathic Association, February 2006, Vol. 106, 77-84. doi:10.7556/jaoa.2006.106.2.77
The Journal of the American Osteopathic Association, February 2006, Vol. 106, 77-84. doi:10.7556/jaoa.2006.106.2.77
As managed care's role in the healthcare industry has grown in recent years, the importance of board certification in the professional lives of physicians has also grown. Most managed care organizations require board certification for physicians participating in their plans. Increasingly, hospitals are also making board certification a prerequisite to obtain staff privileges. Many physicians, of course, continue to become certified to obtain the professional recognition that accompanies completing the intensive requirements of board certification and to establish and legitimize areas of expertise. These are all compelling factors propelling more and more physicians to begin the process of certification. 
The public's perspective of board certification continues to play a role in certification's importance. As patients become more knowledgeable and sophisticated about their treatment options, they increasingly view board certification as a sign of physician quality and competence. The educated consumer of healthcare prefers to be treated by board-certified physicians. Thus, board certification, though a voluntary process, has become an indispensable designation for many physicians. 
The AOA Certification Program
The American Osteopathic Association's (AOA) board certification program began in 1939. The official AOA certifying body, the Bureau of Osteopathic Specialists (BOS), through its 18 approved specialty boards, has been the primary certification provider for osteopathic physicians and has issued more than 28,100 General, Special Qualifications, and Added Qualifications certifications (Figure 1). 
As of the end of December 2005, a total of 19,837 osteopathic physicians were actively certified by the AOA, holding a combined total of 23,016 active certificates. In 2005, a total of 1002 certificates were awarded in specialty and subspecialty areas (Table 1). Also in 2005, 35 certificates of added qualifications were awarded (Table 2). 
Table 1
American Osteopathic Association Certification Awarded January 1999 Through December 2005 *

Specialty

1999

2000

2001

2002

2003

2004

2005
□ Allergy and Immunology0010100
□ Anatomic Pathology 0 2 1 0 0 0 0
□ Anatomic Pathology and Laboratory Medicine0101000
□ Anesthesiology 20 31 18 11 15 8 20
□ Cardiology11913911264
□ Child Neurology 0 0 0 1 0 0 0
□ Child Psychiatry0000304
□ Dermatology 8 14 8 16 10 14 18
□ Diagnostic Radiology26292117172819
□ Emergency Medicine 106 110 87 103 120 104 120
□ Endocrinology1120101
□ Facial Plastic Surgery 0 0 0 0 0 0 0
□ Family Practice and Osteopathic Manipulative Treatment934546596686435445343
□ Forensic Pathology 0 0 1 0 0 0 0
□ Gastroenterology7028693
□ General Vascular Surgery 12 7 2 7 0 8 7
□ Gynecologic Oncology0000111
□ Hematology 1 0 0 0 0 2 0
□ Infectious Diseases3044530
□ Internal Medicine 118 145 146 143 157 118 155
□ Laboratory Medicine0110000
□ Maternal and Fetal Medicine 1 1 0 1 2 0 0
□ Neonatology0001100
□ Nephrology 1 11 4 2 9 7 3
□ Neurological Surgery4316143
□ Neurology9811124101
□ Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine 16 20 24 23 35 28 62
□ Nuclear Medicine0001000
□ Obstetrics and Gynecology 43 80 27 61 53 36 50
□ Oncology2211745
□ Ophthalmology 12 10 8 10 12 10 10
□ Orthopedic Surgery75143945447255
□ Otolaryngology 0 2 1 2 1 1 1
□ Otolaryngology and Facial Plastic Surgery1110131111927
□ Pediatrics 5 21 17 18 18 17 18
□ Physical Medicine and Rehabilitation Medicine§1011170000
□ Plastic and Reconstructive Surgery 6 2 1 3 0 2 2
□ Preventive Medicine and Aerospace Medicine2122401
□ Preventive Medicine and Public Health 0 2 3 3 1 2 0
□ Preventive Medicine (Occupational and Environmental)53104515
□ Proctology 4 0 0 0 1 1 0
□ Psychiatry1021161313611
□ Pulmonary Diseases 4 10 3 7 4 6 5
□ Radiation Oncology0111001
□ Radiology 0 0 0 0 0 0 0
□ Reproductive Endocrinology1002002
□ Rheumatology 1 2 1 2 5 3 0
□ Surgery (General)51461148143939
□ Thoracic Cardiovascular Surgery 2 4 1 1 0 2 1
□ Urological Surgery 9
4
2
6
3
2
5
Total
1531
1187
1118
1294
1030
1028
1002
 *Totals are calculated by date of final approval by the Bureau of Osteopathic Specialists.
 Before July 1993, certificates were issued as General Practice. Since April 15, 2000, all new family physicians have been recommended for certification in Family Practice and Osteopathic Manipulative Treatment.
 In 2000, the American Osteopathic Board of Neuromusculoskeletal Medicine certificates in Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine ([OMM]; formerly known as the American Osteopathic Board of Special Proficiency in OMM) began issuing certificates in Neuromusculoskeletal Medicine and OMM.
 §Formerly named the American Osteopathic Board of Rehabilitation Medicine.
Table 1
American Osteopathic Association Certification Awarded January 1999 Through December 2005 *

Specialty

1999

2000

2001

2002

2003

2004

2005
□ Allergy and Immunology0010100
□ Anatomic Pathology 0 2 1 0 0 0 0
□ Anatomic Pathology and Laboratory Medicine0101000
□ Anesthesiology 20 31 18 11 15 8 20
□ Cardiology11913911264
□ Child Neurology 0 0 0 1 0 0 0
□ Child Psychiatry0000304
□ Dermatology 8 14 8 16 10 14 18
□ Diagnostic Radiology26292117172819
□ Emergency Medicine 106 110 87 103 120 104 120
□ Endocrinology1120101
□ Facial Plastic Surgery 0 0 0 0 0 0 0
□ Family Practice and Osteopathic Manipulative Treatment934546596686435445343
□ Forensic Pathology 0 0 1 0 0 0 0
□ Gastroenterology7028693
□ General Vascular Surgery 12 7 2 7 0 8 7
□ Gynecologic Oncology0000111
□ Hematology 1 0 0 0 0 2 0
□ Infectious Diseases3044530
□ Internal Medicine 118 145 146 143 157 118 155
□ Laboratory Medicine0110000
□ Maternal and Fetal Medicine 1 1 0 1 2 0 0
□ Neonatology0001100
□ Nephrology 1 11 4 2 9 7 3
□ Neurological Surgery4316143
□ Neurology9811124101
□ Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine 16 20 24 23 35 28 62
□ Nuclear Medicine0001000
□ Obstetrics and Gynecology 43 80 27 61 53 36 50
□ Oncology2211745
□ Ophthalmology 12 10 8 10 12 10 10
□ Orthopedic Surgery75143945447255
□ Otolaryngology 0 2 1 2 1 1 1
□ Otolaryngology and Facial Plastic Surgery1110131111927
□ Pediatrics 5 21 17 18 18 17 18
□ Physical Medicine and Rehabilitation Medicine§1011170000
□ Plastic and Reconstructive Surgery 6 2 1 3 0 2 2
□ Preventive Medicine and Aerospace Medicine2122401
□ Preventive Medicine and Public Health 0 2 3 3 1 2 0
□ Preventive Medicine (Occupational and Environmental)53104515
□ Proctology 4 0 0 0 1 1 0
□ Psychiatry1021161313611
□ Pulmonary Diseases 4 10 3 7 4 6 5
□ Radiation Oncology0111001
□ Radiology 0 0 0 0 0 0 0
□ Reproductive Endocrinology1002002
□ Rheumatology 1 2 1 2 5 3 0
□ Surgery (General)51461148143939
□ Thoracic Cardiovascular Surgery 2 4 1 1 0 2 1
□ Urological Surgery 9
4
2
6
3
2
5
Total
1531
1187
1118
1294
1030
1028
1002
 *Totals are calculated by date of final approval by the Bureau of Osteopathic Specialists.
 Before July 1993, certificates were issued as General Practice. Since April 15, 2000, all new family physicians have been recommended for certification in Family Practice and Osteopathic Manipulative Treatment.
 In 2000, the American Osteopathic Board of Neuromusculoskeletal Medicine certificates in Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine ([OMM]; formerly known as the American Osteopathic Board of Special Proficiency in OMM) began issuing certificates in Neuromusculoskeletal Medicine and OMM.
 §Formerly named the American Osteopathic Board of Rehabilitation Medicine.
×
Table 2
American Osteopathic Association Certification of Added Qualifications 2001 Through 2005 by Specialty Board *

Specialty Board and Certification of Added Qualifications

2001

2002

2003

2004

2005
Anesthesiology
□ Critical Care00000
□ Pain Management31110
Dermatology
□ Dermatopathology 0 0 0 0 0
□ Mohs Micrographic Surgery 0 3 1 0 0
Emergency Medicine
□ Emergency Medical Services01010
□ Medical Toxicology20000
□ Sports Medicine01000
Family Physicians
□ Addiction Medicine 1 0 0 0 0
□ Adolescent Medicine 0 0 0 0 0
□ Geriatrics 37 61 1 2 6
□ Sports Medicine 4 17 0 13 1
Internal Medicine
□ Addiction Medicine00000
□ Cardiac Electrophysiology00010
□ Critical Care605010
□ Geriatrics06040
□ Interventional Cardiology0016122
□ Sports Medicine00000
Neurology and Psychiatry
□ Addiction Medicine 2 0 0 1 0
Ophthalmology and Otolaryngology
□ Otolaryngic Allergy03003
Orthopedic Surgery
□ Hand Surgery 21 0 6 0 2
Pathology
□ Dermatopathology00000
Physical Medicine and Rehabilitation Medicine
□ Sports Medicine 0 0 0 0 1
□ Sports Medicine—Special Proficiency in Osteopathic Manipulative Medicine 0 1 0 0 0
Preventive Medicine
□ Occupational Medicine103463
□ Sports Medicine00000
Radiology
□ Body Imaging 3 0 0 0 0
□ Neuroradiology 8 3 0 2 4
□ Nuclear Radiology 2 0 0 0 0
□ Pediatric Radiology 1 0 0 0 0
□ Vascular Interventional Radiology 1 1 0 4 2
Surgery
□ Critical Care—Surgery 6
1
0
3
1
Total
107
102
34
50
35
 *Totals are calculated by date of final approval by the Bureau of Osteopathic Specialists.
 Previously called Angiography and Interventional Radiology.
Table 2
American Osteopathic Association Certification of Added Qualifications 2001 Through 2005 by Specialty Board *

Specialty Board and Certification of Added Qualifications

2001

2002

2003

2004

2005
Anesthesiology
□ Critical Care00000
□ Pain Management31110
Dermatology
□ Dermatopathology 0 0 0 0 0
□ Mohs Micrographic Surgery 0 3 1 0 0
Emergency Medicine
□ Emergency Medical Services01010
□ Medical Toxicology20000
□ Sports Medicine01000
Family Physicians
□ Addiction Medicine 1 0 0 0 0
□ Adolescent Medicine 0 0 0 0 0
□ Geriatrics 37 61 1 2 6
□ Sports Medicine 4 17 0 13 1
Internal Medicine
□ Addiction Medicine00000
□ Cardiac Electrophysiology00010
□ Critical Care605010
□ Geriatrics06040
□ Interventional Cardiology0016122
□ Sports Medicine00000
Neurology and Psychiatry
□ Addiction Medicine 2 0 0 1 0
Ophthalmology and Otolaryngology
□ Otolaryngic Allergy03003
Orthopedic Surgery
□ Hand Surgery 21 0 6 0 2
Pathology
□ Dermatopathology00000
Physical Medicine and Rehabilitation Medicine
□ Sports Medicine 0 0 0 0 1
□ Sports Medicine—Special Proficiency in Osteopathic Manipulative Medicine 0 1 0 0 0
Preventive Medicine
□ Occupational Medicine103463
□ Sports Medicine00000
Radiology
□ Body Imaging 3 0 0 0 0
□ Neuroradiology 8 3 0 2 4
□ Nuclear Radiology 2 0 0 0 0
□ Pediatric Radiology 1 0 0 0 0
□ Vascular Interventional Radiology 1 1 0 4 2
Surgery
□ Critical Care—Surgery 6
1
0
3
1
Total
107
102
34
50
35
 *Totals are calculated by date of final approval by the Bureau of Osteopathic Specialists.
 Previously called Angiography and Interventional Radiology.
×
Reentry Into the Certification Process
In February 1994, the AOA Board of Trustees directed all certifying boards to establish a mechanism for re-entry into the certification process for those physicians whose board eligibility had expired. Such a re-entry process, which may differ from board to board, may include the completion of a specific amount and type of continuing medical education (CME) credit before physicians are allowed to sit for certification examination. This process does not re-establish board eligibility status, but it does allow physicians to meet the requirements for sitting for certification examinations. 
Conjoint Examinations
In July 1993, the AOA Board of Trustees directed the AOA executive director, in conjunction with the BOS, to study the issue of creating a mechanism for the formation of conjoint boards in areas of overlapping specialties. This action was prompted by an application for the formation of a conjoint board of sports medicine. 
In its discussions, the BOS noted that, over time, there likely will emerge new areas of overlapping jurisdiction in osteopathic medicine in addition to sports medicine, and that the formation of a new certifying board each time would not be practical. Instead, the BOS recommended that a mechanism be formed for creating conjoint examinations that would allow all appropriate specialty boards to participate. The Board of Trustees accepted this recommendation in February 1994 and approved the mechanism for creating conjoint examinations. 
The conjoint mechanism allows diplomates (those holding general certification) from participating boards to establish eligibility to sit for examinations. Currently, three conjoint examinations are offered (sports medicine, addiction medicine, and dermatopathology). 
Recertification Gains Momentum
Effective January 1, 1995, the AOA certifying boards were directed to offer a recertification mechanism to its diplomates. In conjunction with implementation of the recertification process, numerous boards have instituted time-limited certificates (that is, new certificates are issued with an expiration date.) By January 1, 2004, those AOA certifying boards that had not yet implemented a certificate time-dating policy were required to make all newly issued certificates time-limited to 10 years or less. Fifteen of the 18 AOA certifying boards had already time-limited their certificates before January 1, 2004. Certificates issued before the time-limit requirement are valid for life. All diplomates are eligible to sit for recertification examinations, even if they hold a lifetime certificate. Figure 2 summarizes the current status of time limits on the certificates issued by AOA certifying boards. 
Figure 1.
American Osteopathic Association certification terminology.
Figure 1.
American Osteopathic Association certification terminology.
American Osteopathic Association recertification rates continue to rise as many of the initial time-dated certifications expire (Table 3). In 2005, there was a 72% increase in the recertification rate compared with 2004. This increase was driven primarily by family practitioners recertifying through the American Osteopathic Board of Family Physicians, as well as by internal medicine specialists and subspecialists taking the various recertification examinations provided by the American Osteopathic Board of Internal Medicine. Certain other specialties, including orthopedic surgery, are also beginning to see rising recertification rates. It is expected that recertification activity through the certifying boards of the AOA will continue to increase as more of the time-dated certificates expire and as recertification becomes a more widespread requirement for managed care participation/credentialing and obtaining hospital privileges. 
Table 3
American Osteopathic Association Recertification Statistics January 2000 Through December 2005 *

Specialty

2000

2001

2002

2003

2004

2005
□ Allergy and Immunology000020
□ Anesthesiology 4 0 0 3 32 0
□ Cardiac Electrophysiology000003
□ Cardiology 0 0 0 8 8 23
□ Critical Care—Internal Medicine00011312
□ Dermatology 0 0 0 0 0 0
□ Diagnostic Radiology6423173
□ Diagnostic Roentgenology 0 0 1 0 0 0
□ Emergency Medicine101113202129
□ Endocrinology 0 0 0 0 3 3
□ Family Practice and Osteopathic Manipulative Medicine3117201741229
□ Gastroenterology 0 0 0 13 8 12
□ Geriatrics and Family Practice001002
□ Geriatrics and Internal Medicine 0 0 0 3 7 6
□ Hematology000310
□ Infectious Diseases 0 0 0 2 3 1
□ Internal Medicine000618371
□ Neonatology 0 0 0 2 2 0
□ Nephrology000204
□ Neurology and Psychiatry 0 0 0 0 0 0
□ Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine0000319
□ Neuroradiology 1 1 0 0 0 0
□ Nuclear Medicine000000
□ Obstetrics and Gynecology 0 0 0 0 0 0
□ Oncology000705
□ Ophthalmology/Otolaryngology 1 0 0 0 0 1
□ Orthopedic Surgery40303447
□ Osteopathic Manipulative Medicine 0 0 0 0 0 0
Pathology000000
□ Pediatrics 0 0 0 10 9 1
□ Physical Medicine and Rehabilitation Medicine000001
□ Preventive Environmental Medicine 0 1 5 1 0 4
□ Preventive Medicine and Aerospace Medicine111011
□ Preventive Medicine and Occupational Medicine 0 0 1 0 0 0
□ Preventive Medicine and Public Health011041
□ Proctology 0 4 0 0 2 1
□ Pulmonary Diseases000995
□ Rheumatology 0 0 0 3 3 2
□ Sports Medicine and Family Practice000005
□ Surgery 0 0 1 0 0 0
□ Urological Surgery 0
0
0
0
0
0
Total
58
40
70
176
286
491
 *Totals are calculated by date of final approval by the Bureau of Osteopathic Specialists.
Table 3
American Osteopathic Association Recertification Statistics January 2000 Through December 2005 *

Specialty

2000

2001

2002

2003

2004

2005
□ Allergy and Immunology000020
□ Anesthesiology 4 0 0 3 32 0
□ Cardiac Electrophysiology000003
□ Cardiology 0 0 0 8 8 23
□ Critical Care—Internal Medicine00011312
□ Dermatology 0 0 0 0 0 0
□ Diagnostic Radiology6423173
□ Diagnostic Roentgenology 0 0 1 0 0 0
□ Emergency Medicine101113202129
□ Endocrinology 0 0 0 0 3 3
□ Family Practice and Osteopathic Manipulative Medicine3117201741229
□ Gastroenterology 0 0 0 13 8 12
□ Geriatrics and Family Practice001002
□ Geriatrics and Internal Medicine 0 0 0 3 7 6
□ Hematology000310
□ Infectious Diseases 0 0 0 2 3 1
□ Internal Medicine000618371
□ Neonatology 0 0 0 2 2 0
□ Nephrology000204
□ Neurology and Psychiatry 0 0 0 0 0 0
□ Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine0000319
□ Neuroradiology 1 1 0 0 0 0
□ Nuclear Medicine000000
□ Obstetrics and Gynecology 0 0 0 0 0 0
□ Oncology000705
□ Ophthalmology/Otolaryngology 1 0 0 0 0 1
□ Orthopedic Surgery40303447
□ Osteopathic Manipulative Medicine 0 0 0 0 0 0
Pathology000000
□ Pediatrics 0 0 0 10 9 1
□ Physical Medicine and Rehabilitation Medicine000001
□ Preventive Environmental Medicine 0 1 5 1 0 4
□ Preventive Medicine and Aerospace Medicine111011
□ Preventive Medicine and Occupational Medicine 0 0 1 0 0 0
□ Preventive Medicine and Public Health011041
□ Proctology 0 4 0 0 2 1
□ Pulmonary Diseases000995
□ Rheumatology 0 0 0 3 3 2
□ Sports Medicine and Family Practice000005
□ Surgery 0 0 1 0 0 0
□ Urological Surgery 0
0
0
0
0
0
Total
58
40
70
176
286
491
 *Totals are calculated by date of final approval by the Bureau of Osteopathic Specialists.
×
Psychometric Assistance
Because certification is so consequential, the certification process must be legally justifiable and valid for credentialers to accept it. In January 1994, the AOA began providing psychometric services to assist osteopathic medical certifying boards in the validation of their certification examinations. The AOA provides consultation and data analysis services to certifying boards and assists them in creating, scoring, and analyzing their examinations. These services provide psychometric guidance to a board in all steps of the examination process, including written, oral, and practical examinations. 
Standards Review Committee
From the beginnings of the AOA's certification program, the AOA has been concerned with the quality and standardization of its certifications. In 1992, the AOA Board of Trustees established a policy on uniform standards for all AOA certifying boards for test construction, evaluation, and use. In 1995, the Board of Trustees resolved that the BOS provide for rigorous statistical validation of the examinations of all AOA certifying boards. In 1997, formal approval was granted to the Guidelines for AOA Certification Examination Standards, which describe the psychometric standards that all AOA examinations must meet. From this document, a plan for a formal evaluation process to assess the validity and reliability of each AOA certification examination was devised and, in June 2000, the first official reviews of three AOA certifying boards were conducted. This review process brings value to osteopathic certification and to those holding it. The process is in essence a continuous improvement mechanism that benefits not only the certifying board but the current and future diplomates as well. 
The format of the certifying board review is a self-study with completion of a report. These reports are then reviewed by the Standards Review Committee, which includes six elected members plus the BOS public member, two alternate members, and the AOA psychometrician (nonvoting). After the first cycle review, each board is reviewed again in 3 ½ years. After the second review, the time interval between reviews is 5 years. At each BOS meeting, three certifying boards are reviewed. Conjoint examinations are reviewed at the last meeting of the evaluation cycle. 
After review of the certifying board's self-study report, the Standards Review Committee may make recommendation of compliance to the BOS, or the committee may defer making any recommendation at that time. Within 30 days of the Standards Review Committee's evaluation, the certifying board will receive a written evaluation, and examination activities found not in compliance with the standards will be clearly described to the board. In the first evaluation cycle, if the certifying board was not approved by the BOS as compliant, the board has 120 days from the date of the written evaluation to respond in writing with its action plan, specifying how the activities not in compliance will be addressed. For the second and later review cycles, the submission of an action plan is not required. 
Figure 2.
Current time limits on certificates issued by American Osteopathic Association certifying boards.
Figure 2.
Current time limits on certificates issued by American Osteopathic Association certifying boards.
For the first review cycle, at the next meeting of the Standards Review Committee, the certifying board's action plan is studied, and any comments are forwarded to the board. In most cases, the board's action plan is formally accepted at this time, but in some cases, further information from the board may be requested. Within 1 year of the Standards Review Committee's appraisal of the action plan, the certifying board must submit an updated report to the committee with evidence that the board is in compliance with the standards. 
For the second and later review cycles, if any examination activities are found not in compliance with the standards, the certifying board must submit an updated report within 1 year of the review date, along with acceptable evidence showing that all the examination activities are in compliance with the standards. The board must submit its updated report at least 45 days in advance of the meeting in which the Standards Review Committee will study it. 
The Standards Review Committee will review the updated report and make a recommendation to the BOS for action. If the BOS finds the certifying board not in compliance, the BOS may impose a 1-year probation period and the practice affiliate will be notified of the board's probationary status. The failure of the certifying board to comply with the standards results in a BOS recommendation to the Board of Trustees that the certifying board's directors and/or members may be replaced and that certification activities may be suspended until the board demonstrates compliance with the standards. At the end of the probation period, the board must demonstrate compliance with the standards. 
The Standards Review Committee began meeting in conjunction with the BOS meetings (held in January and June) in June 2000. The second review cycle began in January 2004. Subsequent review cycles start in January 2009 and will occur every 5 years after that. The schedule for the first and second review cycles is shown in Figure 3. 
Evolution of the Osteopathic Recertification Process
Ensuring the validity of the BOS board examinations through its standards review process is only one initiative that the BOS has taken to better assess the competence of board-certified physicians. In January 2005, the BOS adopted a resolution mandating that each specialty include the seven core competencies (interpersonal and communication skills; medical knowledge; osteopathic philosophy and osteopathic manipulative medicine; patient care; practice-based learning and improvement; professionalism; and system-based practice) in its board examination process. These are the same competencies that have previously been adopted at the training level in osteopathic residency programs. The process to test core competencies, under the guidance and support of the BOS, will vary according to the specific needs of each specialty board. 
Figure 3.
Schedule for the first and second Standards Review Committee evaluation cycles.
Figure 3.
Schedule for the first and second Standards Review Committee evaluation cycles.
In addition to testing core competencies, the BOS continues to evaluate the concept of continuous assessment of physician competence. The BOS has reviewed the allopathic model of maintenance of certification (MOC) and considers it to be one of several possible models to maintain the high competency levels of osteopathic physicians. The BOS is also considering its own continuous assessment model as a way to better fit the needs of the osteopathic medical profession and as a response to public and government calls for improved patient care. It should be noted that many of the elements of MOC, including professional standing, required CME, and cognitive examination, are part of the osteopathic recertification process currently in place. The method by which continuous assessments will be made will be decided in the near future. 
The commitment of the BOS to assess continued competence of board-certified physicians is clear. It is this commitment that is guiding the BOS to create an assessment process that fulfills its function to protect the public and promote the continued competence of board-certified osteopathic physicians to deliver quality care. 
Board of Trustees Establishes Task Force on Certification
In October 2002, the AOA Board of Trustees created a Task Force on Certification to review the overall operational structure of the AOA's certification program and to study future trends that may impact or change the certification process and demand. The Task Force on Certification worked closely with the BOS on determining future steps to safeguard and promote AOA certification. The task force transferred its functions to the newly created BOS Committee on Financial and Administrative Board Matters, which will monitor existing and upcoming certification trends in the osteopathic medical profession. 
New Certification Pathway for ACGME-Trained/ABMS Board-Certified Osteopathic Physicians
In July 2004, the AOA Board of Trustees approved a new certification pathway that provides a more streamlined and facilitative process for osteopathic physicians trained by the Accreditation Council for Graduate Medical Education (ACGME) and certified by the American Board of Medical Specialties (ABMS) to enter into the AOA certification process. To be eligible, candidates must have completed an ACGME-accredited residency program at least 5 years before application and hold ABMS certification in a primary specialty. The pathway is for AOA certification only and does not confer approval of the first year of training as equivalent to an osteopathic internship (provided through Resolution 42 [A/2000]). For complete requirements and eligibility information, and to determine whether a particular specialty participates in this new pathway, inquiries can be referred to the AOA Division of Certification at (800) 621-1773, extension 8266 or 8105. 
Board Certification: Dynamic and Ever-Changing
As the needs of the healthcare environment continue to change rapidly, the AOA and its specialty boards will keep adapting to meet the needs of osteopathic physicians and protect the interests of the public. Board certification no doubt will continue to play a key role in the professional lives of osteopathic physicians well into the future. 
Figure 1.
American Osteopathic Association certification terminology.
Figure 1.
American Osteopathic Association certification terminology.
Figure 2.
Current time limits on certificates issued by American Osteopathic Association certifying boards.
Figure 2.
Current time limits on certificates issued by American Osteopathic Association certifying boards.
Figure 3.
Schedule for the first and second Standards Review Committee evaluation cycles.
Figure 3.
Schedule for the first and second Standards Review Committee evaluation cycles.
Table 1
American Osteopathic Association Certification Awarded January 1999 Through December 2005 *

Specialty

1999

2000

2001

2002

2003

2004

2005
□ Allergy and Immunology0010100
□ Anatomic Pathology 0 2 1 0 0 0 0
□ Anatomic Pathology and Laboratory Medicine0101000
□ Anesthesiology 20 31 18 11 15 8 20
□ Cardiology11913911264
□ Child Neurology 0 0 0 1 0 0 0
□ Child Psychiatry0000304
□ Dermatology 8 14 8 16 10 14 18
□ Diagnostic Radiology26292117172819
□ Emergency Medicine 106 110 87 103 120 104 120
□ Endocrinology1120101
□ Facial Plastic Surgery 0 0 0 0 0 0 0
□ Family Practice and Osteopathic Manipulative Treatment934546596686435445343
□ Forensic Pathology 0 0 1 0 0 0 0
□ Gastroenterology7028693
□ General Vascular Surgery 12 7 2 7 0 8 7
□ Gynecologic Oncology0000111
□ Hematology 1 0 0 0 0 2 0
□ Infectious Diseases3044530
□ Internal Medicine 118 145 146 143 157 118 155
□ Laboratory Medicine0110000
□ Maternal and Fetal Medicine 1 1 0 1 2 0 0
□ Neonatology0001100
□ Nephrology 1 11 4 2 9 7 3
□ Neurological Surgery4316143
□ Neurology9811124101
□ Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine 16 20 24 23 35 28 62
□ Nuclear Medicine0001000
□ Obstetrics and Gynecology 43 80 27 61 53 36 50
□ Oncology2211745
□ Ophthalmology 12 10 8 10 12 10 10
□ Orthopedic Surgery75143945447255
□ Otolaryngology 0 2 1 2 1 1 1
□ Otolaryngology and Facial Plastic Surgery1110131111927
□ Pediatrics 5 21 17 18 18 17 18
□ Physical Medicine and Rehabilitation Medicine§1011170000
□ Plastic and Reconstructive Surgery 6 2 1 3 0 2 2
□ Preventive Medicine and Aerospace Medicine2122401
□ Preventive Medicine and Public Health 0 2 3 3 1 2 0
□ Preventive Medicine (Occupational and Environmental)53104515
□ Proctology 4 0 0 0 1 1 0
□ Psychiatry1021161313611
□ Pulmonary Diseases 4 10 3 7 4 6 5
□ Radiation Oncology0111001
□ Radiology 0 0 0 0 0 0 0
□ Reproductive Endocrinology1002002
□ Rheumatology 1 2 1 2 5 3 0
□ Surgery (General)51461148143939
□ Thoracic Cardiovascular Surgery 2 4 1 1 0 2 1
□ Urological Surgery 9
4
2
6
3
2
5
Total
1531
1187
1118
1294
1030
1028
1002
 *Totals are calculated by date of final approval by the Bureau of Osteopathic Specialists.
 Before July 1993, certificates were issued as General Practice. Since April 15, 2000, all new family physicians have been recommended for certification in Family Practice and Osteopathic Manipulative Treatment.
 In 2000, the American Osteopathic Board of Neuromusculoskeletal Medicine certificates in Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine ([OMM]; formerly known as the American Osteopathic Board of Special Proficiency in OMM) began issuing certificates in Neuromusculoskeletal Medicine and OMM.
 §Formerly named the American Osteopathic Board of Rehabilitation Medicine.
Table 1
American Osteopathic Association Certification Awarded January 1999 Through December 2005 *

Specialty

1999

2000

2001

2002

2003

2004

2005
□ Allergy and Immunology0010100
□ Anatomic Pathology 0 2 1 0 0 0 0
□ Anatomic Pathology and Laboratory Medicine0101000
□ Anesthesiology 20 31 18 11 15 8 20
□ Cardiology11913911264
□ Child Neurology 0 0 0 1 0 0 0
□ Child Psychiatry0000304
□ Dermatology 8 14 8 16 10 14 18
□ Diagnostic Radiology26292117172819
□ Emergency Medicine 106 110 87 103 120 104 120
□ Endocrinology1120101
□ Facial Plastic Surgery 0 0 0 0 0 0 0
□ Family Practice and Osteopathic Manipulative Treatment934546596686435445343
□ Forensic Pathology 0 0 1 0 0 0 0
□ Gastroenterology7028693
□ General Vascular Surgery 12 7 2 7 0 8 7
□ Gynecologic Oncology0000111
□ Hematology 1 0 0 0 0 2 0
□ Infectious Diseases3044530
□ Internal Medicine 118 145 146 143 157 118 155
□ Laboratory Medicine0110000
□ Maternal and Fetal Medicine 1 1 0 1 2 0 0
□ Neonatology0001100
□ Nephrology 1 11 4 2 9 7 3
□ Neurological Surgery4316143
□ Neurology9811124101
□ Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine 16 20 24 23 35 28 62
□ Nuclear Medicine0001000
□ Obstetrics and Gynecology 43 80 27 61 53 36 50
□ Oncology2211745
□ Ophthalmology 12 10 8 10 12 10 10
□ Orthopedic Surgery75143945447255
□ Otolaryngology 0 2 1 2 1 1 1
□ Otolaryngology and Facial Plastic Surgery1110131111927
□ Pediatrics 5 21 17 18 18 17 18
□ Physical Medicine and Rehabilitation Medicine§1011170000
□ Plastic and Reconstructive Surgery 6 2 1 3 0 2 2
□ Preventive Medicine and Aerospace Medicine2122401
□ Preventive Medicine and Public Health 0 2 3 3 1 2 0
□ Preventive Medicine (Occupational and Environmental)53104515
□ Proctology 4 0 0 0 1 1 0
□ Psychiatry1021161313611
□ Pulmonary Diseases 4 10 3 7 4 6 5
□ Radiation Oncology0111001
□ Radiology 0 0 0 0 0 0 0
□ Reproductive Endocrinology1002002
□ Rheumatology 1 2 1 2 5 3 0
□ Surgery (General)51461148143939
□ Thoracic Cardiovascular Surgery 2 4 1 1 0 2 1
□ Urological Surgery 9
4
2
6
3
2
5
Total
1531
1187
1118
1294
1030
1028
1002
 *Totals are calculated by date of final approval by the Bureau of Osteopathic Specialists.
 Before July 1993, certificates were issued as General Practice. Since April 15, 2000, all new family physicians have been recommended for certification in Family Practice and Osteopathic Manipulative Treatment.
 In 2000, the American Osteopathic Board of Neuromusculoskeletal Medicine certificates in Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine ([OMM]; formerly known as the American Osteopathic Board of Special Proficiency in OMM) began issuing certificates in Neuromusculoskeletal Medicine and OMM.
 §Formerly named the American Osteopathic Board of Rehabilitation Medicine.
×
Table 2
American Osteopathic Association Certification of Added Qualifications 2001 Through 2005 by Specialty Board *

Specialty Board and Certification of Added Qualifications

2001

2002

2003

2004

2005
Anesthesiology
□ Critical Care00000
□ Pain Management31110
Dermatology
□ Dermatopathology 0 0 0 0 0
□ Mohs Micrographic Surgery 0 3 1 0 0
Emergency Medicine
□ Emergency Medical Services01010
□ Medical Toxicology20000
□ Sports Medicine01000
Family Physicians
□ Addiction Medicine 1 0 0 0 0
□ Adolescent Medicine 0 0 0 0 0
□ Geriatrics 37 61 1 2 6
□ Sports Medicine 4 17 0 13 1
Internal Medicine
□ Addiction Medicine00000
□ Cardiac Electrophysiology00010
□ Critical Care605010
□ Geriatrics06040
□ Interventional Cardiology0016122
□ Sports Medicine00000
Neurology and Psychiatry
□ Addiction Medicine 2 0 0 1 0
Ophthalmology and Otolaryngology
□ Otolaryngic Allergy03003
Orthopedic Surgery
□ Hand Surgery 21 0 6 0 2
Pathology
□ Dermatopathology00000
Physical Medicine and Rehabilitation Medicine
□ Sports Medicine 0 0 0 0 1
□ Sports Medicine—Special Proficiency in Osteopathic Manipulative Medicine 0 1 0 0 0
Preventive Medicine
□ Occupational Medicine103463
□ Sports Medicine00000
Radiology
□ Body Imaging 3 0 0 0 0
□ Neuroradiology 8 3 0 2 4
□ Nuclear Radiology 2 0 0 0 0
□ Pediatric Radiology 1 0 0 0 0
□ Vascular Interventional Radiology 1 1 0 4 2
Surgery
□ Critical Care—Surgery 6
1
0
3
1
Total
107
102
34
50
35
 *Totals are calculated by date of final approval by the Bureau of Osteopathic Specialists.
 Previously called Angiography and Interventional Radiology.
Table 2
American Osteopathic Association Certification of Added Qualifications 2001 Through 2005 by Specialty Board *

Specialty Board and Certification of Added Qualifications

2001

2002

2003

2004

2005
Anesthesiology
□ Critical Care00000
□ Pain Management31110
Dermatology
□ Dermatopathology 0 0 0 0 0
□ Mohs Micrographic Surgery 0 3 1 0 0
Emergency Medicine
□ Emergency Medical Services01010
□ Medical Toxicology20000
□ Sports Medicine01000
Family Physicians
□ Addiction Medicine 1 0 0 0 0
□ Adolescent Medicine 0 0 0 0 0
□ Geriatrics 37 61 1 2 6
□ Sports Medicine 4 17 0 13 1
Internal Medicine
□ Addiction Medicine00000
□ Cardiac Electrophysiology00010
□ Critical Care605010
□ Geriatrics06040
□ Interventional Cardiology0016122
□ Sports Medicine00000
Neurology and Psychiatry
□ Addiction Medicine 2 0 0 1 0
Ophthalmology and Otolaryngology
□ Otolaryngic Allergy03003
Orthopedic Surgery
□ Hand Surgery 21 0 6 0 2
Pathology
□ Dermatopathology00000
Physical Medicine and Rehabilitation Medicine
□ Sports Medicine 0 0 0 0 1
□ Sports Medicine—Special Proficiency in Osteopathic Manipulative Medicine 0 1 0 0 0
Preventive Medicine
□ Occupational Medicine103463
□ Sports Medicine00000
Radiology
□ Body Imaging 3 0 0 0 0
□ Neuroradiology 8 3 0 2 4
□ Nuclear Radiology 2 0 0 0 0
□ Pediatric Radiology 1 0 0 0 0
□ Vascular Interventional Radiology 1 1 0 4 2
Surgery
□ Critical Care—Surgery 6
1
0
3
1
Total
107
102
34
50
35
 *Totals are calculated by date of final approval by the Bureau of Osteopathic Specialists.
 Previously called Angiography and Interventional Radiology.
×
Table 3
American Osteopathic Association Recertification Statistics January 2000 Through December 2005 *

Specialty

2000

2001

2002

2003

2004

2005
□ Allergy and Immunology000020
□ Anesthesiology 4 0 0 3 32 0
□ Cardiac Electrophysiology000003
□ Cardiology 0 0 0 8 8 23
□ Critical Care—Internal Medicine00011312
□ Dermatology 0 0 0 0 0 0
□ Diagnostic Radiology6423173
□ Diagnostic Roentgenology 0 0 1 0 0 0
□ Emergency Medicine101113202129
□ Endocrinology 0 0 0 0 3 3
□ Family Practice and Osteopathic Manipulative Medicine3117201741229
□ Gastroenterology 0 0 0 13 8 12
□ Geriatrics and Family Practice001002
□ Geriatrics and Internal Medicine 0 0 0 3 7 6
□ Hematology000310
□ Infectious Diseases 0 0 0 2 3 1
□ Internal Medicine000618371
□ Neonatology 0 0 0 2 2 0
□ Nephrology000204
□ Neurology and Psychiatry 0 0 0 0 0 0
□ Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine0000319
□ Neuroradiology 1 1 0 0 0 0
□ Nuclear Medicine000000
□ Obstetrics and Gynecology 0 0 0 0 0 0
□ Oncology000705
□ Ophthalmology/Otolaryngology 1 0 0 0 0 1
□ Orthopedic Surgery40303447
□ Osteopathic Manipulative Medicine 0 0 0 0 0 0
Pathology000000
□ Pediatrics 0 0 0 10 9 1
□ Physical Medicine and Rehabilitation Medicine000001
□ Preventive Environmental Medicine 0 1 5 1 0 4
□ Preventive Medicine and Aerospace Medicine111011
□ Preventive Medicine and Occupational Medicine 0 0 1 0 0 0
□ Preventive Medicine and Public Health011041
□ Proctology 0 4 0 0 2 1
□ Pulmonary Diseases000995
□ Rheumatology 0 0 0 3 3 2
□ Sports Medicine and Family Practice000005
□ Surgery 0 0 1 0 0 0
□ Urological Surgery 0
0
0
0
0
0
Total
58
40
70
176
286
491
 *Totals are calculated by date of final approval by the Bureau of Osteopathic Specialists.
Table 3
American Osteopathic Association Recertification Statistics January 2000 Through December 2005 *

Specialty

2000

2001

2002

2003

2004

2005
□ Allergy and Immunology000020
□ Anesthesiology 4 0 0 3 32 0
□ Cardiac Electrophysiology000003
□ Cardiology 0 0 0 8 8 23
□ Critical Care—Internal Medicine00011312
□ Dermatology 0 0 0 0 0 0
□ Diagnostic Radiology6423173
□ Diagnostic Roentgenology 0 0 1 0 0 0
□ Emergency Medicine101113202129
□ Endocrinology 0 0 0 0 3 3
□ Family Practice and Osteopathic Manipulative Medicine3117201741229
□ Gastroenterology 0 0 0 13 8 12
□ Geriatrics and Family Practice001002
□ Geriatrics and Internal Medicine 0 0 0 3 7 6
□ Hematology000310
□ Infectious Diseases 0 0 0 2 3 1
□ Internal Medicine000618371
□ Neonatology 0 0 0 2 2 0
□ Nephrology000204
□ Neurology and Psychiatry 0 0 0 0 0 0
□ Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine0000319
□ Neuroradiology 1 1 0 0 0 0
□ Nuclear Medicine000000
□ Obstetrics and Gynecology 0 0 0 0 0 0
□ Oncology000705
□ Ophthalmology/Otolaryngology 1 0 0 0 0 1
□ Orthopedic Surgery40303447
□ Osteopathic Manipulative Medicine 0 0 0 0 0 0
Pathology000000
□ Pediatrics 0 0 0 10 9 1
□ Physical Medicine and Rehabilitation Medicine000001
□ Preventive Environmental Medicine 0 1 5 1 0 4
□ Preventive Medicine and Aerospace Medicine111011
□ Preventive Medicine and Occupational Medicine 0 0 1 0 0 0
□ Preventive Medicine and Public Health011041
□ Proctology 0 4 0 0 2 1
□ Pulmonary Diseases000995
□ Rheumatology 0 0 0 3 3 2
□ Sports Medicine and Family Practice000005
□ Surgery 0 0 1 0 0 0
□ Urological Surgery 0
0
0
0
0
0
Total
58
40
70
176
286
491
 *Totals are calculated by date of final approval by the Bureau of Osteopathic Specialists.
×