American Osteopathic Association

Advancing the distinctive philosophy and practice of osteopathic medicine

Osteopathic Continuous Certification - FAQ

What is osteopathic continuous certification?

Osteopathic continuous certification (OCC) is a process in which board certified DOs can maintain currency and demonstrate competency in their specialty area.

Why is OCC being implemented?

There are three main points for the implementation of OCC:

1. The single certification/recertification examination model at given intervals is no longer the competitive standard in the health care industry, or the standard demanded by the public. 

2. Federal and state governments as well as health plans are now tying reimbursement to performance measures.  

3. External factors in the past decade have also made it apparent that the osteopathic medical profession needed to consider performance evaluation as part of the certification process. Some of these factors include:

  • Institute of Medicine reports calling for improvements in the quality of medical care.

  • Allopathic requirements for Maintenance of Certification - more than half of ABMS Boards have implemented these new industry standards, with many more follow.

  • Federation of State Medical Boards recommendations for Maintenance of Licensure requirements that call for continuous professional development for license renewal.

The AOA's role is to ensure that the profession remains a viable force in the delivery of health care. As a result, the AOA held various meetings with the above organizations, as well as with osteopathic affiliates - divisional societies, specialty colleges and certifying boards -  to ensure that DOs would continue to be viewed as an important part of the nation's health care delivery system.

How will OCC affect me? Will I have to do anything differently?

Component 4 "Practice Performance Assessment" is the only new component rounding out the osteopathic continuous certification process. All other components are already a part of the current osteopathic recertification process. While each specialty board will have specific requirements and procedures for the Practice Performance Assessment, in general, this component will require you to assess your current practice performance against established benchmarks.  

I have a subspecialty (Certification of Added Qualifications), which requires me to maintain my primary certification. What do I need to do?

You will need to maintain the requirements for OCC with the following considerations:

  1. For OCC Component 2, your CME requirement will take your subspecialty into account; at least 13 credits must be in your subspecialty area. Those credits will also count toward your primary certification.

  2. The Component 4 Practice Performance and Improvement activity you complete for your subspecialty will also be credited toward the completion of the Component 4 requirement for your primary specialty.

How much will this cost me in time, money and resources?

Detailed information regarding OCC requirements are posted on each specialty certifying board website. Every effort has been made to streamline the process so that resources are utilized efficiently, making the OCC process as painless as possible, while still ensuring that the standards demanded by the public and regulatory bodies are met.

Will OCC change requirements or the process of initial certification?

There are currently no planned changes to the initial certification process.

When did OCC go into effect?

OCC went into effect for all AOA specialty boards on Jan. 1, 2013.

What if I have a non-expiring certificate?

If you have a non-expiring 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.

What if I do not complete all of the modules in the time allotted? What if I am unsuccessful in the OCC process?

There will be a re-entry mechanism for all participating DOs.

Does the Centers for Medicare and Medicaid Services (CMS) still offer the Physician Quality Reporting System Maintenance of Certification (PQRS MOC) Program Incentive?

No. This program has been discontinued. The 2014 reporting year was the last year for the incentive.​

Whom should I contact with questions about my certification status or about OCC in general?

Questions regarding a physician’s certification status and general OCC information should be directed to the AOA Division of Certification at or (312) 202-8266. For verification of certification please visit