General Information from AOA

What is OCC?

Osteopathic Continuous Certification (OCC) is a process in which board certified DOs can maintain currency and demonstrate competency in their specialty area. The goals for OCC are to provide certified physicians with a process to continually assess and improve their skills and to assure patients and the public that certified physicians are being assessed through reliable and valid measures.

Who is required to participate in OCC?

All time-limited certificate holders will be required to participate in OCC.

If I have a time-limited certificate can I remain certified if I don’t participate in OCC?

No. By choosing not to participate in OCC you are voluntarily suspending the rights to your board certification.

Who has the option of participating?

If you have a non-time-limited certification, you will not be required to participate in OCC at this time. We strongly encourage your participation. The Federation of State Medical Boards (FSMB) has agreed to accept OCC for Maintenance of Licensure (MOL). If you do not participate in OCC, you may have additional requirements for MOL as prescribed by the state(s) where you are licensed. Remember that "non-expiring" is not a lifetime certification. You are required to maintain your license to practice and to maintain AOA membership, which also includes meeting all CME requirements for your specialty.

How can I track my progress on the continuous certification requirements?

The AOA is developing an online platform that will be accessed through in order to track the progress of an OCC cycle.

I have a restricted license. What happens to my AOA board certification?

A committee underneath the supervision of the Bureau of Osteopathic Specialists has been created what will monitor license suspensions on a case by case basis alongside the certifying boards.

AOBEM Frequently Asked Questions

Do all diplomats need to participate in the Continuous Certification process?

All diplomats who received their certification after January 1, 1994 have time-limited certificates that require subsequent recertification at 10 year intervals. All of these diplomats are required to participate in the Osteopathic Continuous Certification Process.

When can I recertify?

Diplomats can take the FRCE (Formal Recertification Exam) as early as 2 years prior to the expiration of their certification status. There is a maximum of 2 years after their certification expires to successfully complete the FRCE. However, upon expiration of the certificate, the diplomate is considered NOT board certified.

What happens if I fail to complete the FRCE (Formal Recertification Exam) 2 years after my certification expires?

You must then apply to re-enter the certification process in its entirety (Part I, Part II, and Part III).

What is the FRCE Exam?

The Formal Recertification Exam is a combined computer-based test and oral examination. It is offered once a year. The computer-based exam covers the breath of the clinical practice of Emergency Medicine, and consists of approximately 125 questions. The Table of Specificity serves as the basis for the content of the exam. The oral exam includes four clinical cases. You must pass both the computer-based and oral portions of the examination to achieve recertification.

Where do I find the Table of Specificity?

It is on the website:

What is the oral portion of the Formal Re-certification Exam?

The oral exams are composed of two clinical stations. Each clinical testing station consists of two patient encounters. The candidate is given 30 minutes to complete the two cases. Each clinical encounter is designed to give candidates a clear and consistent set of conditions under which they are expected to evaluate and treat the simulated patient. Testing materials for each case include a narrative description, and accompanying 12-lead EKGs, monitor strips, lab test results, and medical images which are projected on a monitor for the candidate’s viewing. Candidates should "work through" these cases much as they do in daily practice, and be prepared to do so in a timely manner. Candidates are graded on their ability to perform a history and physical examination, order and interpret appropriate diagnostic studies, arrive at a differential diagnosis, treat as necessary, and determine disposition. Candidates are also graded on their demonstration of interpersonal skills, appropriateness of actions, and professional behavior.

How long is the computer based FRCE exam?

You are given 2 hours and thirty minutes to complete approximately 125 questions.

Are the COLA questions included on the written portion of the FRCE?

A COLA question may appear on the FRCE exam if it is considered general knowledge and can be referenced in one of the major Emergency Medicine texts. No question that is solely based on a specific article will be used.

My certification has expired. Can I still take the FRCE?

If you have fulfilled the COLA, Practice Performance, and Patient Communication and Satisfaction requirements then you are permitted to take the FRCE up to two years after your certification has expired. If you do not pass the FRCE or take the required number of COLA modules, then you must re-enter the certification process (i.e., Part I, Part II, and Part III).

Am I still board certified after my certificate has expired?


Can I recertify by just passing the COLA (Continuous Osteopathic Learning Assessment) or by just taking the FRCE exam?

No. You need to take and pass the correct number of COLA (Continuous Osteopathic Learning Assessment) modules, as well as pass the Formal Recertification Exam. You must also meet the Practice Performance and Patient Communication and Satisfaction requirements.

What happens if I did not take and pass the required number of COLA exams to sit for the FRCE?

You will not be permitted to sit for the FRCE exam if you have not passed the necessary number of COLA modules. NO EXCEPTIONS! You must re-enter the certification process (i.e. Part I, Part II and Part III).

How long are the COLA modules available on line?

Each COLA module is available on line for 3 years. Once the COLA module is taken off, there is no way to access the exam and complete it.

What score do I need to pass a COLA? How will I know if I pass?

If you are graded 75% or above, you have passed the COLA. You will receive a certificate from ACOEP. ACOEP will report this information to the AOA for your CME report.

What if I fail and score less than 75%?

You are permitted three attempts to pass a COLA. If you fail a COLA Module three times then you are permitted to submit a new application and payment and are permitted another three attempts.

When do I need to start to participate in the COLA process?

All diplomats with time-dated certification must participate NOW. The Continuous Certification process began in January 2004.

What is the purpose of the COLA modules?

Board certification should be a continuous rather than an episodic process. The COLA modules are designed to assist physicians in remaining current with the practice of Emergency Medicine.

Can I recommend readings to be used for the COLA modules?

Yes. The Board encourages all diplomats and ACOEP committees to recommend articles for inclusion in the COLA modules. Each COLA module covers the core content area for that year. The core content areas can be found on the AOBEM website under CCEM.

How do I submit an article?

You may e-mail the reference to AOBEM at or send it in a letter to the Board office. Please include the name of the journal, title, author and date. Include the reason for selection of this article.

How does the Board select articles for the COLA?

A committee is appointed each year to select articles and formulate the COLA test. The goal of the articles is to promote continuous learning. The articles are selected using the core content guideline listed on the AOBEM website. These articles are supplemented by others that are felt to be excellent review articles or new developments/treatments in the field of Emergency Medicine.

Why are copies of the articles not provided?

The articles are copyrighted; the cost to re-produce them is exorbitant. AOBEM makes every attempt to select articles from major journals available in most hospital libraries. Some articles can be found on-line at no cost. Most publishers also provide on-line downloads for a fee.

Are we permitted to review and discuss the COLA modules as a group?

Yes. ACOEP sponsors sessions at their conferences where members get together as a group to take the COLA modules.

The COLA module is an on-line test. Is there anything special I need to do?

Read the instructions on the website BEFORE starting the exam. If you are going to stop in the middle of the exam, you must click on the “Save Exam” button to save your answers. To score the test, your computer must allow pop-ups.

What happens to the COLA process when I pass the FRCE?

It starts all over again. You enter a new 10 year cycle during which you must take 8 COLA modules in order to be eligible for your next re-certification exam.

What happened to the term "lifetime certificate"?

The AOA now refers to this as non-expiring certificates.

Do physicians with a non-expiring certificate need to take the COLA modules or the recertification exam?

No. They are encouraged to enter the process to demonstrate their continued learning and knowledge, but are not obligated to do so.

If I have a non-expiring certificate, can I take the COLA modules without taking the recertification exam?


How do I enter the recertification process if I have a non-expiring certificate?

You may register to take the FRCE at any time. No COLA modules are required for those diplomats with a non-expiring certificate, taking the re-certification exam for the first time.

I have a non-expiring certificate—what happens to it, if I recertify?

You will still have a non-expiring certificate. In addition, you will have a timed certificate for 10 years. Remember that "non-expiring" is not a lifetime certification. You are required to maintain your license to practice and to maintain AOA membership, which also includes meeting all CME requirements for your specialty

If I have a non-expiring certificate and recertify, do I have to take the COLA modules?

You will always have the non-expiring certificate. No COLA modules are required for your first re-certification exam. However, if you plan on recertifying again in 10 years, then you will follow the same process as those with timed certificates (i.e., you will need to take 8 COLA modules, 2 Practice Performance modules, and one Patient Communication and Satisfaction module over the succeeding 10 years, in order to be eligible for re-certification again).

I hold a non-expiring certificate in emergency medicine. Am I required to re-certify every ten years in order to be a core faculty member or program director in an AOA sponsored emergency medicine residency program?

Yes. While your non-expiring certificate will always remain valid, recertification every ten years is a requirement for holding those academic positions. Additionally, recertification is required in order to be an AOBEM Board member, and is required by some private insurance carriers.