Pain Management
Critical Care
Info Booklet


Beginning on January 1, 2013 all Specialty Certifying Boards of the AOA must fully operational and compliant with all Osteopathic Continuous Certification (OCC). In conjunction with OCC, the Certifying Boards are required to incorporate assessment of seven (7) Core Competencies. This process will replace the process currently in place for recertification in anesthesiology, along with the CAQs in pain management and critical care medicine. A transition period, for those currently in the recertification process, can be found under the "Primary" tab above, at the bottom of the page.

The requirements for Osteopathic Continuous Certification and the Core Competencies are described below.

Osteopathic Continuous Certification Requirements

  • Professional Standing/Unrestricted Licensure
  • Lifelong Learning/Continuing Medical Education
  • Cognitive Assessment
  • Practice Performance Assessment
  • Continuous AOA Membership

Core Competencies

  • Osteopathic Philosophy and Osteopathic Manipulative Medicine. Physicians are expected to demonstrate and apply knowledge of accepted standards in Osteopathic Manipulative Treatment (OMT) appropriate to their specialty; and remain dedicated to life-long learning and to practice habits in osteopathic philosophy and manipulative medicine.

  • Medical Knowledge. Physicians are expected to demonstrate and apply knowledge of accepted standards of clinical medicine in their respective area, remain current with new developments in medicine, and participate in life-long activities, including research.

  • Patient Care. Physicians must demonstrate the ability to effectively treat patients, provide medical care that incorporates the osteopathic philosophy, patient empathy, awareness of behavioral issues, the incorporation of preventive medicine, and health promotion.

  • Interpersonal and Communication Skills. Physicians are expected to demonstrate interpersonal and communication skills that enable them to establish and maintain professional relationships with patients, families, and other members of health care teams.

  • Professionalism. Physicians are expected to uphold the Osteopathic Oath in the conduct of their professional activities that promotes advocacy of patient welfare, adherence to ethical principles, collaboration with health professionals, life-long learning, and sensitivity to a diverse patient population. Physicians should be cognizant of their own physical and mental health in order to effectively care for patients.

  • Practice-Based Learning and Improvement. Physicians must demonstrate the ability to critically evaluate their methods of clinical practice, integrate evidence-based medicine into patient care, show an understanding of research methods, and improve patient care practices.

  • Systems-Based Practice. Physicians are expected to demonstrate an understanding of health care delivery systems, provide effective and qualitative patient care within the system, and practice cost-effective medicine.


Non-Time Dated Certificates. These are certificates issues prior to 2000 and are awarded to an AOA-accredited anesthesiologist . These certificates have no time limit and do not expire.

Time-Dated Certificates. These are certificates awarded to an AOA-accredited anesthesiologist after 2000 and have a ten (10) year time limit. Those anesthesiologists with this type of certificate are required to complete the OCC process prior to the expiration date on their certificate. Anesthesiologists with an expiration date after 2013 will be phased into this process according to a timeline based on the date of expiration.

Recertification Certificates. Certificates awarded to an AOA-accredited anesthesiologist after successful completion of the recertification process. These certificates have a ten (10) year time limit. Those anesthesiologists with an expiration date after 2013 will be phased into the OCC process. This type of certificate will only apply to anesthesiologists with a non-time dated certificate who electively wish to recertify through the OCC process. The OCC process DOES NOT REPLACE the original non-time dated certificate, which remains valid.


The following requirements must be met for eligibility into the OCC process:

  • The diplomate must be a graduate of an AOA-accredited College of Osteopathic Medicine.
  • The diplomate must hold an active state license to practice medicine.
  • The diplomate must be able to show evidence of conformity to the standards set in the Code of Ethics of the American Osteopathic Association.
  • The diplomate must be a member in good standing of the American Osteopathic Association.
  • The diplomate must have been previously certified in anesthesiology.
  • The diplomate must currently practice the specialty of anesthesiology or one of its subspecialties.
  • The diplomate must complete the application for recertification and submit the appropriate application fees.

The official date of recertification will be when the American Osteopathic Board of Anesthesiology notifies the diplomate that he/she has successfully passed the examination and is being recommended to the American Osteopathic Association for recertification. Formal action by the Bureau of Osteopathic Specialists of the AOA is required to complete the process and the diplomate may not claim recertification until notified of this action in an official letter from the AOA.


Impaired Physicians
Diplomates who have a mental or physical impairment that could affect their ability to practice anesthesiology will not be eligible for OCC in anesthesiology unless they present medical evidence from appropriate physicians, treatment centers, and hospitals which satisfy the AOBA that the impairment does not compromise their ability to render safe and effective patient care. This documentation must accompany the application form.

Chemical Dependency
An diplomate for OCC in anesthesiology who has been diagnosed as chemically dependent, has been treated for drug or other substance abuse and/or has entered a rehabilitation center within three (3) years of his/her application must present evidence to the AOBA that he/she:

  • Has successfully completed the authorized rehabilitation program.
  • Is successfully enrolled in such a program.
  • Can present attestations from the responsible program administrators and physicians demonstrating to the satisfaction of the AOBA that the diplomate has been free of chemical dependency for a period sufficient to establish that the diplomate is not currently using illegal drugs or other substance abuse and does not have an ongoing problem.

Non-Clinical Physicians
Defined as a physician who has no direct patient contact or clinical care. To maintain certification or recertification under the OCC process, these physicians must complete all components with the exception of the Practice Performance Assessment requirements. Non-physician categories include:

  • Academic/Administrative/Research Anesthesiologists
  • Retired Anesthesiologists
  • Non-Operative Anesthesiologists


If it is determined that a diplomate has falsified information on the application form, has failed to provide material information, or has misrepresented his/her status with the AOBA to any 3rd party, the diplomate’s application will not be considered for the OCC process.

Examination diplomates should understand that the following may be sufficient cause to bar them from future examinations, to terminate participation in the examination, to invalidate the results of an examination, to withhold or revoke scores or certification, or to take other appropriate action:

  • The giving or receiving of aid in the examination, as evidenced either by observation or by statistical analysis of answers of one or more participants in the examination.
  • The unauthorized possession, reproduction, or disclosure of any materials, including, but not limited to, examination question or answers before, during or after the examination.
  • The offering of any benefit to any agent of the AOBA in return for any right, privilege, or benefit which is not usually granted by the AOBA to other similarly situated applicants or persons.
  • The engaging in irregular behavior in connection with the administration of the examination.

The following are examples of behavior considered to be irregular and which may be cause for invalidation of the examination or imposition of a penalty:

  • Referring to books, notes, or other devices at any time during the examination.
  • Any transfer of information or signals between applicants during the test, including bathroom breaks.
  • Any appearance of looking at the examination of another applicant during the examination.
  • Allowing another applicant to view one’s answers or otherwise assisting another applicant in the examination.
  • Taking any examination information, such as notes or diagrams, outside the examination room.

Diplomates should also understand that the AOBA may or may not require a diplomate to retake one or more portions of the examination if presented with sufficient evidence that the security of the examination has been compromised.


​Should a diplomate be unsuccessful in the OCC process, he/she may complete the process the following year and subsequent years as noted below. Certification is lost due to expiration but NOT as a result of failing the process. If an applicant fails the process, certification remains intact and uninterrupted until the expiration date on the certificate.

In order to regain your certification, the AOBA will move your 10-year OCC cycle forward one-year. Any activities not completed in the original cycle must be completed within this one (1) year. In addition, the diplomate must complete the requirements of the 1st year of the next OCC cycle.

Upon successful completion of the year 1 activities, and any other activities the diplomate did not complete in the first 10 year cycle, the AOBA will recommend to the AOA to issue the diplomate a certificate valid for 10 years from the date of completion of the program. The AOBA will move a OCC cycle forward, one year at a time, for up to three (3) years.

At the end of the three years, if the OCC requirements have not been completed, the diplomate will have to restart the primary certification process. Upon successful completion of the primary certification process, the diplomate will re-attain "diplomate" status and will be issued a new time-limited certificate.

For diplomates with a non-time dated certificate, unsuccessful completion of the above requirements will result in the loss of their recertification certificate and would have to re-enter the OCC process. Successful completion of all the requirements will result in the reissuance of a new time-limited recertification certificate from the date of completion of the OCC process. 
It is the diplomate's responsibility to make sure all information is correct and up-to-date.