- The initial AOBOS Orthopedic Sports Medicine exam has 200 questions in two 100-question, 120-minute sections.
- Passing requires a scaled score of at least 500 on the AOA's 200-800 scale.
- The initial examination fee is $3,000; the 2026 exam date is September 25.
- Knee carries the highest ceiling of any domain at up to 21% of the exam.
Quick-Reference Snapshot
If you need the entire Certification in Orthopedic Sports Medicine picture on one page, here it is. This credential is awarded by the American Osteopathic Board of Orthopedic Surgery (AOBOS) under the American Osteopathic Association, and it is distinct from primary AOBOS Part I certification, annual OCC, and the primary-care sports medicine CAQ. Keep that distinction firmly in mind - this cheat sheet covers only the AOBOS orthopedic sports medicine subspecialty pathway.
| Element | Detail |
|---|---|
| Certifying Body | American Osteopathic Board of Orthopedic Surgery (AOBOS) |
| Total Questions | 200 multiple-choice, in two 100-question sections |
| Time Allowed | 120 minutes per section (4 hours total, plus optional 10-minute break) |
| Passing Score | Scaled score of at least 500 (200-800 scale) |
| Initial Exam Fee | $3,000 |
| 2026 Exam Date | September 25 |
| 2026 Application Window | March 25 - August 25 |
For a deeper breakdown of how these numbers translate into a study strategy, see the full Orthopedic Sports Medicine Study Guide, and for a granular look at what "passing" actually means, review the Orthopedic Sports Medicine Passing Score guide.
Eligibility & Certification Requirements
The AOBOS pathway separates exam admission from full certification award, and candidates often conflate the two. Keep them separate in your prep plan.
To Sit for the Initial Written Examination
- Completion of a minimum one-year ACGME-accredited sports medicine fellowship, with completion verification
- Active U.S. medical licensure
- Adherence to the AOA Code of Ethics
To Receive the Full Certification Award
- Primary AOBOS orthopedic surgery certification already held
- At least two years of active orthopedic sports medicine practice
- Full operating privileges
- A consecutive 12-month case log containing at least 115 operative cases, including at least 75 with arthroscopy, plus 10 nonoperative cases
Key Takeaway
You can sit for the written exam right after a qualifying one-year fellowship, but you cannot receive the certification award until you also hold primary AOBOS certification and have logged two years of qualifying practice and case volume.
There is also a limited pathway for the 2026, 2027, and 2028 examinations. It admits qualifying active AOBOS diplomates who fall outside the ordinary eligibility windows but who completed an ACGME-accredited or AOA-approved sports medicine fellowship. If this describes your situation, confirm your standing early - this is a time-boxed accommodation, not a permanent route. For a complete breakdown of every eligibility path, including this limited pathway, see the dedicated Orthopedic Sports Medicine Requirements guide.
The Seven Domains and Their Weights
The initial examination blueprint has seven official content categories. Percentages are published as ranges, not fixed allocations or midpoints, so treat them as directional weighting rather than an exact question count per section. The current outline was reviewed September 22, 2026.
| Domain | Weight Range |
|---|---|
| Lower Extremity: Hip | 10-14% |
| Lower Extremity: Knee | 15-21% |
| Lower Extremity: Foot and Ankle | 11-17% |
| Upper Extremity: Shoulder | 12-18% |
| Upper Extremity: Elbow | 10-16% |
| Upper Extremity: Wrist and Hand | 12-14% |
| Non-Operative | 11-17% |
Lower Extremity: Knee
Knee has the highest upper bound of any domain at 21%, making it the single most consequential category to master cold.
- Ligamentous injury patterns and reconstruction principles
- Meniscal pathology and repair versus meniscectomy decision-making
- Patellofemoral disorders and cartilage restoration options
Non-Operative
This category spans conservative management, rehabilitation principles, and return-to-play decision-making across every joint region rather than one anatomic area - candidates sometimes underestimate its breadth because it isn't tied to a single body part.
- Concussion and medical sideline coverage principles
- Injection and bracing indications
- Rehabilitation progression and activity modification
Because the seven domains span both anatomic regions and a cross-cutting non-operative category, mapping your weak areas against the exact weight ranges matters more than generic review. The Orthopedic Sports Medicine Exam Domains Guide walks through each of the seven categories in far more depth, including likely question styles within each.
Exam Day, Format, and Remote Testing Rules
The exam is delivered as 200 multiple-choice questions split into two 100-question sections, each with a 120-minute time limit. That's 4 hours of pure answering time, with an optional 10-minute scheduled break between sections, for a total seat time of 4 hours 10 minutes if you take the break.
Remote Proctoring Specifics
Remote testing follows the AOA MonitorEDU/PARADIGM arrangement. If you plan to test remotely, you'll need:
- A private, enclosed testing space
- Valid identification
- Secure-browser preparation completed in advance
- A supported computer meeting technical requirements
- Acceptance of mobile device monitoring during the session
Because the two sections run independently at 120 minutes each, pacing math is simple: roughly 72 seconds per question if you want a buffer for flagged items. Practicing under that exact split - not a generic timed quiz - is one of the best ways to internalize the real pressure of test day. If you're still calibrating how tough this exam actually feels relative to your current knowledge base, the How Hard Is the Orthopedic Sports Medicine Exam guide breaks down the difficulty factors in detail, and our practice test platform lets you rehearse the two-section, 120-minute format directly.
2026 Dates and Application Window
Mark these dates now if you're targeting the 2026 administration:
- Application window: March 25 - August 25
- Examination date: September 25
That leaves roughly one month between the application deadline and test day - a tight runway if you haven't started reviewing yet. Because the limited pathway for late-eligible diplomates also applies to the 2026, 2027, and 2028 cycles, candidates using that route should apply as early in the window as possible to leave time for any documentation review. For a full multi-year calendar and guidance on when to start preparing relative to each deadline, see Orthopedic Sports Medicine Exam Dates 2026.
Key Takeaway
Apply as early in the March 25-August 25 window as your case log and fellowship verification allow - the September 25 exam date doesn't move, but your readiness window shrinks the longer you wait to submit.
Maintaining Certification: OCC, CME, and Longitudinal Assessment
Passing the initial exam is not the end of the obligation. Continued certification runs through AOBOS's Osteopathic Continuous Certification (OCC) program, which requires active licensure and documented practice-performance improvement.
CME Requirements
For the 2025-2027 cycle, time-limited and voluntary-OCC diplomates must complete 60 CME credits over three years, including at least 15 Category 1-A credits.
Sports Subspecialty Longitudinal Assessment
Rather than participating in primary orthopedic surgery longitudinal assessment, sports medicine subspecialty diplomates complete a separate track:
- 20 annual questions, untimed and open-book, based on assigned articles
- 80% passing criterion each year
- $270 annual fee
New subspecialty diplomates certified after January 1, 2024 get one full calendar year before they must begin longitudinal-assessment participation - a useful grace period to settle into practice before the annual assessment cycle starts.
Before committing time and the $3,000 exam fee plus ongoing OCC costs, many candidates want the full financial picture. The Orthopedic Sports Medicine Certification Cost breakdown lays out every fee across the initial exam and maintenance cycle, and the Is It Worth It analysis weighs those costs against career impact.
One-Week Domain Review Plan
With seven domains and a 120-minute-per-section format, the most efficient last-mile review allocates days by weight, not by alphabetical order. Here's a compressed seven-day pass suited to candidates in their final stretch before the September 25 exam date.
Knee (15-21%)
- Ligament and meniscal decision trees
- Cartilage restoration indications
- Timed practice blocks matching the 120-minute section format
Shoulder (12-18%) and Foot/Ankle (11-17%)
- Instability and rotator cuff pathology
- Ankle instability and tendon disorders
Non-Operative (11-17%)
- Concussion protocols and sideline coverage
- Rehabilitation and return-to-play criteria
Elbow (10-16%), Wrist/Hand (12-14%), Hip (10-14%)
- Overuse injury patterns in throwing athletes
- Hand and wrist fracture management
Full Timed Simulation
- Two 100-question, 120-minute sections back to back
- Practice the optional 10-minute break to calibrate energy management
This isn't a generic spaced-repetition template - it's built around the exact weight ranges and section structure of this specific exam. For a longer runway plan spanning several months rather than one week, the full Orthopedic Sports Medicine Study Guide covers pacing across an entire fellowship-to-exam timeline, and you can rehearse the two-section format directly using our practice tests.
Frequently Asked Questions
The exam has 200 multiple-choice questions, split into two 100-question sections, each with a 120-minute time limit.
You need a scaled score of at least 500 on the AOA's 200-800 scale. See the Passing Score guide for more detail on how scaling works.
Lower Extremity: Knee has the highest published upper bound at 21%, making it the single highest-leverage domain to master, though every domain contributes a meaningful share to the total score.
Yes. Exam admission only requires completion of a minimum one-year ACGME-accredited sports medicine fellowship, active U.S. licensure, and adherence to the AOA Code of Ethics. Full certification award requires additional steps, including primary AOBOS certification and a qualifying case log.
Yes. Diplomates enter OCC, which includes CME (60 credits over the 2025-2027 cycle, including 15 Category 1-A) and a sports subspecialty longitudinal assessment of 20 annual open-book questions with an 80% passing criterion and a $270 annual fee.