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Information for the Subspecialty Certification Program in Hospice and Palliative Medicine

Please see exam information below. Click here to View/Save exam information.


The Hospice and Palliative Medicine(HPM) program for Certification of Added Qualifications is developed by a conjoint effort of the American Osteopathic Boards of Family Medicine, Internal Medicine, Neurology and Psychiatry, and Physical Medicine and Rehabilitation Medicine. This program is designed to recognize excellence among physicians who are specialists in HPM.

This information booklet has been prepared by the AOA/BOS Boards participating in the conjoint examination for its Diplomates who are applying for examination in HPM. The program will have two components:

  1. Satisfactory completion of training.

  2. Successful performance on a comprehensive, one-day examination.


Candidates must possess a valid certification certificate by the AOBIM in internal medicine or subspecialty and have completed a 12 month AOA approved fellowship in HPM which was completed after July 1, 2009.


The date of the HPM Examination will be on August 29, 2017. The completed application must be submitted in toto no later than April 1, 2017. Any applications postmarked after April 1, 2017, will be assessed a two hundred dollar ($200) late registration fee. No applications will be accepted after May 1, 2017. All candidates who have submitted their application prior to the deadline date will be notified whether or not they have been admitted to the examination prior to June 1, 2017.


The application/examination fee will be $1200, which must be submitted no later than April 1, 2017. There is a nonrefundable fee of $100 for withdrawals prior to April 1 and $400 for withdrawals between April 1, 2017 and May 1, 2017. No refund is granted for any withdrawal postmarked after May 1, 2017.

Instructions for Completing the Application Packet

Please read all of the website information on the dropdown “Directions and Information for Submitting the Application” carefully before completing the application form.


General Description:

This examination will be a computer-based 5-hour examination consisting of multiple-choice questions of the "one best answer" type. There will be a total of 200 items on the examination which will be administered at 300 Prometric testing sites and will begin at 8:00 am and end at 1:00 pm. The examination fee is $1200 and must be submitted no later than April 1, 2017. The HPM Examination will cover the broad aspects of HPM that specialists practicing in the field are expected to know. The examination will assess the candidate’s knowledge and clinical judgment in aspects of HPM required to perform at a high level of competence. The examination will include but will not be restricted to:

Approach to care including relief of symptoms, bereavement care, treating the family and the patient as a unit of care, standards of delivery of care, medical director’s role, hospice Medicare benefit, other reimbursement mechanisms and approach to specific populations such as children, elderly, substance abusers; cultural, spiritual, socio-economic and psychiatric considerations of the patient and the family; grief and bereavement including normal grief, abnormal grief, risk factors and therapeutic interventions; all aspects of the management of impending death including the physiological changes and complications; medical management of pain including assessment of pain, fundamentals and principles of analgesics, radiation, nerve block, acupuncture, hypnosis, barriers to pain relief, and pain management of special ricpopulations; non-pain symptom management including spinal cord compression, cachexia, dry mouth, diarrhea, dysphagia, pruritus, skin breakdown, agitated delirium, acute airway obstruction, palliative sedation, and discontinuation of technologic support, etc; communication and teamwork including family-centered approach, effective communication with co-workers, patients and families, physician leadership, and interdisciplinary care; ethical and legal decision-making including ethical principles, decision-making principles, patient rights, ethics of physician/patient relationship, professionalism, burnout, coma and controversies in terminal care; prognostication and the natural history of serious illness including reasonable patient prognostication, amyotrophic lateral sclerosis, cardiovascular complications, cancer, dementia, frailty, multi-organ dysfunction syndrome, pediatric medical issues, pediatric neurological conditions, perinatal and infant death, pulmonary disease, renal failure, stroke and unintentional injury and trauma.

The content areas covered and their relative proportions on the exam are as follows:

Medical Content Category Relative Percentage
Approach to care 9.5%
Psychosocial and spiritual considerations 10%
Impending death 8%
Grief and bereavement 6%
Medical management 44%
Communication and teamwork 6.5%
Ethical and legal decision making 8%
Prognostication and natural history of serious illness 8%

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