- What This Cheat Sheet Covers (and What It Doesn't)
- The Exam at a Glance
- The 26 Published Content Headings and Their Ranges
- High-Yield Clinical Topics by Heading
- Eligibility and Timing Snapshot
- Fees, Cancellations, Rescore and Retest Rules
- Written and Oral Exam-Day Logistics
- After You Pass: Maintenance Snapshot
- A Domain-Ordered Study Sequence
- Frequently Asked Questions
- The written exam is 200 multiple-choice questions in 4 hours 30 minutes, with a passing scaled score of 500 on a 200-800 scale.
- Base AOBS fees are $1,500 written plus $1,500 oral, $3,000 total for the usual two-exam route.
- The largest published range is Aneurysm, Arterial Disease, Emboli, Non-ASVD, Thrombosis at 12-16%, followed by Cerebrovascular at 10-14%.
- Full primary certification also requires an oral clinical-case exam; the oral page notes in-person testing in New Orleans and no virtual orals in 2026.
What This Cheat Sheet Covers (and What It Doesn't)
This page condenses the facts that matter most for Primary Certification in Vascular Surgery through the American Osteopathic Board of Surgery (AOBS), with certification approved through the American Osteopathic Association (AOA). Current issuer pages label the selected credential General Vascular Surgery. Everything below is drawn from published AOBS and AOA pages, and where those pages conflict or stay silent, this sheet says so rather than guessing.
Two cautions before you start. First, the published content headings are written-exam headings with percentage ranges, not fixed weights, and they are not an exhaustive blueprint of the combined written and oral process. Second, several details (scored versus unscored item split, open-book status of the initial written exam, adaptive delivery) were not verified, so treat any claim about them elsewhere with suspicion. For a deeper walk through study planning, see our Vascular Surgery Study Guide 2026: How to Pass on Your First Attempt.
The Exam at a Glance
Primary certification has two stages: a written examination and an oral clinical-case examination. The numbers below cover the written component only, because the oral page publishes no numeric cutoff, total case count or duration.
| Item | Written Exam | Oral Exam |
|---|---|---|
| Format | 200 multiple-choice questions | Clinical-case examination assessing diagnostic interpretation, management and judgment |
| Time | 4 hours 30 minutes | Duration not published on the reviewed page |
| Passing standard | Scaled score of 500 on a 200-800 scale (not a percent-correct mark) | Criterion referenced; no numeric cutoff published |
| Base fee | $1,500 | $1,500 |
| Delivery | Remote proctored via MonitorEDU Secure Browser | In person; the oral page notes New Orleans and no virtual orals in 2026 |
The 26 Published Content Headings and Their Ranges
The AOBS General Vascular Surgery written-exam content outline lists 26 headings with percentage ranges. Some headings overlap (for example, Dialysis appears both alone and inside a combined Diagnostics heading; Extra-Anatomic appears both alone and inside Basic Science), and they remain separate in the published outline. No midpoints or normalized percentages are invented here.
| Content Heading | Published Range |
|---|---|
| Aneurysm, Arterial Disease, Emboli, Non-ASVD, Thrombosis | 12-16% |
| Cerebrovascular | 10-14% |
| Basic Science, Anatomy/Physiology, Extra-Anatomic | 8-12% |
| Endovascular | 6-10% |
| Trauma | 6-10% |
| Venous | 4-8% |
| Lower Extremity | 4-6% |
| Aorta | 2-6% |
| Hematology | 2-6% |
| Thoracic | 2-6% |
| Critical Care | 1-5% |
| Diagnostics (incl. Doppler), Pharmacology, Dialysis | 1-5% |
| Graft | 1-5% |
| Non-ASVD | 1-5% |
| Portal | 1-5% |
| Renal | 1-5% |
| Visceral | 1-5% |
| Amputation | 1-4% |
| Dialysis | 1-4% |
| Lymphatic | 1-4% |
| Arterial | 1-3% |
| ASVD | 1-3% |
| Carotid | 1-3% |
| Complication | 1-3% |
| Extra-Anatomic | 1-3% |
| Pharmacology | 1-3% |
Read the table as a prioritization tool: the top five rows (Aneurysm/Arterial Disease/Emboli/Non-ASVD/Thrombosis, Cerebrovascular, Basic Science/Anatomy/Physiology/Extra-Anatomic, Endovascular and Trauma) carry the highest published ceilings, while many of the remaining headings are small individually but add up quickly. A full breakdown of each heading lives in Vascular Surgery Exam Domains 2026: Complete Guide to All 26 Content Areas.
High-Yield Clinical Topics by Heading
The outline publishes headings, not itemized topics, so the lists below are study prompts built from the heading names and standard vascular surgery knowledge. Use them to structure review, not as a claim about which specific questions appear.
Aneurysm, Arterial Disease, Emboli, Non-ASVD, Thrombosis (12-16%)
The largest single heading, so this is where breadth pays off.
- Aneurysm natural history, size thresholds for intervention and open versus endovascular decision-making
- Acute limb ischemia: embolus versus in-situ thrombosis, classification of severity, revascularization timing
- Non-atherosclerotic arterial disease: fibromuscular dysplasia, arteritides, popliteal entrapment, adventitial cystic disease
- Thrombosis and thromboembolism: sources, workup and anticoagulation versus intervention
Cerebrovascular (10-14%) and Carotid (1-3%)
Two separate headings; together they form a major block of the exam.
- Symptomatic versus asymptomatic carotid stenosis and the logic behind timing of intervention
- Carotid endarterectomy versus stenting: patient selection, technical pitfalls and perioperative stroke prevention
- Vertebrobasilar disease, carotid dissection and other less common cerebrovascular presentations
- Postoperative complications: cranial nerve injury, hyperperfusion, restenosis
Basic Science, Anatomy/Physiology, Extra-Anatomic (8-12%)
Foundational material that supports every clinical question.
- Vascular anatomy and common variants, including surgical exposures
- Hemodynamics, wound healing, and the biology of atherosclerosis and intimal hyperplasia
- Coagulation physiology and graft biology
- Extra-anatomic bypass concepts and when they are chosen over in-line reconstruction
Endovascular (6-10%) and Trauma (6-10%)
Both carry the same published range; neither should be left until the end.
- Endovascular: access complications, device selection logic, imaging guidance, contrast and radiation safety, and management of endoleaks and other device-related problems
- Trauma: vascular injury recognition, hard versus soft signs, damage-control approaches, shunting, fasciotomy, and extremity versus cervical versus truncal injuries
Venous (4-8%), Lymphatic (1-4%) and Lower Extremity (4-6%)
- Venous: DVT diagnosis and therapy, chronic venous insufficiency, varicose vein management, venous ulcers and thrombolysis considerations
- Lymphatic: lymphedema evaluation and management principles
- Lower extremity: claudication versus chronic limb-threatening ischemia, revascularization strategy and wound care context
Smaller Headings That Still Matter
Headings such as Hematology, Thoracic, Aorta, Renal, Visceral, Portal, Dialysis, Graft, Critical Care, Amputation and Pharmacology each carry modest ranges, but the exam draws from all of them. Practical anchors include heparin-induced thrombocytopenia and hypercoagulable workups, mesenteric ischemia (acute versus chronic), renovascular disease, dialysis access creation and complications, graft infection and surveillance, amputation level selection and perioperative anticoagulation and antiplatelet pharmacology. Because a handful of questions per heading can swing a result, give each at least one focused review pass.
Eligibility and Timing Snapshot
The specialty written page states the training pathway as five years of AOA-approved General Surgery training plus two years of AOA-approved General Vascular Surgery training, along with RPVI examination success, an application and fees. Applicants within 90 days of completing training need a program-director letter, and documents must be approved at least 14 days before testing. The oral stage requires program completion and board approval.
Ordinary board eligibility ends December 31 of the sixth year following training. Separately, an April 29, 2026 AOA announcement accepts a pass on the ABS Written Vascular Surgery Qualifying Exam (VSQE) as meeting the written requirement for AOBS oral application, though remaining AOBS requirements still apply and this route does not replace the AOBS written blueprint. The full checklist is in Vascular Surgery Requirements 2026: Eligibility, Prerequisites & How to Qualify.
Scheduling Caveat
The generic timeline says annual written testing occurs in May, while the written page says April. The board homepage lists the next Spring Qualifying Examination on May 1-3, 2027 and the oral examination on October 20, 2027 in Orlando. Because sources disagree, administration-specific notices should govern your scheduling. Use Vascular Surgery Exam Dates 2026: Testing Windows, Deadlines & Scheduling to track the latest windows.
Fees, Cancellations, Rescore and Retest Rules
| Item | Published Detail |
|---|---|
| Written exam fee | $1,500 |
| Oral exam fee | $1,500 |
| Base total (usual two-exam route) | $3,000; no member/nonmember tier published |
| Not included | Travel, review products and applicable late charges |
| Timely cancellation | $500 deduction; no later refund |
| Transfer | One board-approved transfer for extenuating circumstances to the next administration |
| Rescore/audit | $200, requested within one month of results; no access to individual items and no reconsideration of the passing cutoff |
| Retesting after failure | Retest within two years to keep the file active |
| Third failure | Oral page requires documented board-review-course remediation after a third written and/or oral failure |
Note that the oral page uses both "30 days or more" and "within 30 days" wording at the exact cancellation boundary, so do not rely on the last day of the window. Cancel well ahead. For the complete money picture including the cost of preparation, see Vascular Surgery Certification Cost 2026: Complete Pricing Breakdown.
Written and Oral Exam-Day Logistics
Written Exam (Remote Proctored)
- Delivered through the MonitorEDU Secure Browser with AOBS/AOA remote proctoring.
- You need a private room, a computer and a mobile device, plus a government photo ID that matches your AOA candidate ID.
- AOA recommends a personal computer with administrator access; work-managed laptops with restrictions can cause problems.
- Online lab values, a scratch pad and a calculator are supplied.
- PARADIGM provides generic platform practice, not a specialty-specific practice examination.
- Open-book permission and adaptive delivery were not verified for the initial written examination, so assume a standard closed-resource, fixed-form experience unless the candidate notice says otherwise.
Oral Exam (In Person)
- The oral page carries a dated September 30, 2026 notice for in-person testing in New Orleans and states explicitly that there are no virtual oral examinations in 2026.
- The AOBS Rules of Conduct for the In-Person Oral Exam require government-issued photo ID, prohibit notes and books in examination and sequestered areas, and prohibit electronic devices in the examination room.
- Cases assess diagnostic interpretation, management and judgment, so practice talking through a case aloud: state your differential, your imaging or test of choice, your operative or endovascular plan, and your plan for complications.
Key Takeaway
Do a full technology rehearsal at least a week before the written exam: ID match, room setup, secure browser launch, second device. Lost time to a technical problem is time you cannot recover in a 4 hour 30 minute window.
After You Pass: Maintenance Snapshot
The exact timeline describes active certification for one year after issue, conditional on OCC (Osteopathic Continuous Certification), rather than an unconditional ten-year term. The maintenance requirements are separate from initial certification and include:
- Component 1: annual unrestricted-license verification and ethics compliance.
- Component 2: 60 CME credits per three-year cycle for AOBS time-limited diplomates and non-time-limited diplomates voluntarily participating in OCC; 120 for non-time-limited diplomates outside OCC. No separate AOBS Category 1 or specialty-specific minimum is listed. Newly certified physicians' mid-cycle requirements are prorated.
- Component 3: an annual 15-question open-book longitudinal assessment, with 12 of 15 (80%) required to pass, delivered through the AOA LMS from 2026. The 2026 registration fee is $225 and covers two attempts. Annual participation begins in the certificate-expiration year, and certificates issued after 2018 omit printed expiration dates.
- Component 4: at least one QI/QA attestation every three years. Note that the component page retains legacy ten-year-cycle wording, and Component 2 retains an older proration table; neither overrides the current timeline or the verified 2025-27 CME document.
If you are weighing whether the credential justifies the effort, our analyses of whether the certification is worth it and the earnings landscape take a qualitative look at the career side.
A Domain-Ordered Study Sequence
Generic study advice is plentiful. The only part worth repeating here is how to order the published headings so your hours track the published ranges. This sample sequence assumes a multi-week runway; compress or expand as your timeline allows.
Foundations first
- Basic Science, Anatomy/Physiology, Extra-Anatomic, because every later heading builds on it
- Hematology and Pharmacology, since anticoagulation and antiplatelet logic recurs everywhere
- Diagnostics (incl. Doppler), so you can interpret duplex and imaging in later cases
The two heaviest clinical blocks
- Aneurysm, Arterial Disease, Emboli, Non-ASVD, Thrombosis (12-16%), plus Aorta, Thoracic and Lower Extremity
- Cerebrovascular and Carotid, with emphasis on intervention timing and complication management
Procedural and acute care
- Endovascular and Graft, including surveillance and complications
- Trauma, Critical Care and Amputation
Remaining headings and mixed review
- Venous, Lymphatic, Renal, Visceral, Portal, Dialysis
- Timed mixed sets and a full-length run-through of the 200-question, 4 hour 30 minute format
As you finish each block, test yourself with scenario-style questions rather than rereading. The Vascular Surgery practice test platform is built for that kind of retrieval practice, and you can use it to find which headings need a second pass. To calibrate expectations about difficulty, read How Hard Is the Vascular Surgery Exam? Complete Difficulty Guide 2026; for what is and is not known about outcomes, see Vascular Surgery Pass Rate 2026: What the Data Shows.
Frequently Asked Questions
The AOBS written component has 200 multiple-choice questions with 4 hours 30 minutes allotted. The scored versus unscored split is not specified.
A scaled score of 500 on a 200-800 scale. It is not a percent-correct mark, so you cannot translate it directly into a number of questions answered correctly.
The base AOBS fees are $1,500 for the written exam and $1,500 for the oral exam, for $3,000 total on the usual two-exam route. Travel, review products and any late charges are extra, and no member or nonmember pricing tier is published.
The oral page carries a dated September 30, 2026 notice for in-person testing in New Orleans and states there are no virtual oral examinations in 2026. Confirm location and format in your candidate notice for the administration you register for.
Aneurysm, Arterial Disease, Emboli, Non-ASVD, Thrombosis at 12-16%, followed by Cerebrovascular at 10-14%. These are published ranges rather than fixed weights, and overlapping headings remain separate in the outline.
For a broader orientation to the credential itself, you can also review Vascular Surgery Certification and the overview of what Vascular Surgery certification is, then return to this sheet as a quick-reference page in the final weeks before your exam.