Get Certified

Certification Information

The American Federation for Medical Accreditation (AFMA) offers certification in the following specialties:

The examination process is administered by The American Academy of Neurological and Orthopaedic Surgeons (AANOS). Only members of The American Academy of Neurological and Orthopaedic Surgeons qualify for AFMA board certifications.

Click HERE to submit your application using our online form.

Because board certification is a voluntary process, it is separate and distinct from the required licensure to practice medicine, which is a function regulated by the state government. A valid medical license is required to be board-certified, but board certification is not necessary for licensure.

Board certification is an important step in the process whereby physicians demonstrate that they have met specific standards, achieved certain levels of clinical training and education, and completed examinations that are developed by peers to assure the public that a physician is adequately knowledgeable and experienced to practice in a specialty area of medicine. Board certification is designed to establish physicians as recognized specialists in their fields.

For further inquiries, please call us at (312) 787-1608.

General Certification Requirements

The requirements below apply to all applicants regardless of where training was completed.

  1. All applicants for certification must first be members of the American Academy of Neurological and Orthopaedic Surgeons (AANOS). AANOS membership application may be submitted simultaneously.
  2. Applicants must be licensed to practice medicine in the country where certification will be used. Documentation is necessary and will be verified to the extent possible. To be eligible, you must have successfully completed the following education and training or its equivalent and supply supporting documentation:
    1. Medical School
    2. Internship
    3. One (1) year General Surgery residency
    4. Residency program in the specialty of the certification for which you are applying:
      1. For Neurosurgery, Orthopaedic Surgery, and Spinal Surgery, four (4) years of residency is required. Spinal Surgery also requires certification in either Neurosurgery or Orthopaedic Surgery.
      2. For Neurology, a three (3) year residency is required.
      3. For Critical Care, prior certification in Neurosurgery, Neurology, or Internal Medicine is required. In addition, an essay (cover letter) delineating interest/experience in neurocritical care must be provided.
  3. Documentation must be provided demonstrating the successful completion of residency training in the applicable specialty. The program director, not the applicant, must state in writing directly to the Credentials Committee that the applicant has satisfactorily completed the training program.
  4. Active practice for at least 18-24 months related to the specialty being certified in the country where certification will be used (after the successful completion of residency or equivalent* training).
  5. Applicants must furnish, for review, a minimum of 25 case reports where the applicant is the primary provider, or 25 Operative Reports and/or Surgical Cases performed as the primary surgeon in the US (cases must be from the surgical specialty being certified). An additional 25 case reports (50 total) will be required if residency training is not in the USA. Case reports may be used for oral exams.

* Equivalent training refers to training programs not accredited by the ACGME for certification to be used in the US. If residency training for any specialty is obtained outside the U.S. then requirements for active practice in the US and case reports from a US-based practice are automatically increased to the maximum (24 months and 50 cases).

Specific Neurological Surgery Requirements

For certifications to be used in the US, a minimum of 5 years of residency or equivalent training* is required for Neurological Surgery.

The following should be used as a guideline for residency training in Neurological Surgery:

  • First year post graduate from medical school is an internship, preferably in general surgery.
  • Second year is spent in the surgical disciplines including neurosurgery and at least 3 months in Neurology.
  • The remaining 4 years will be in clinical neurosurgery culminating in 12 months as Chief Resident (Senior Resident Surgeon) The various disciplines, i.e., neuropathology, neuroradiology, etc. will be completed during this 4 year period.
Specific Orthopaedic Surgery Requirements

Orthopaedic Surgery is a 4-year residency not including the first post graduate year (internship) or equivalent training.*

Specific Spinal Surgery Requirements

Spinal Surgery certification requires fellowship training (neurosurgery or orthopedic) or equivalent training* and/or experience. Applicants must be board certified in Neurological Surgery or Orthopedic Surgery prior to application to be certified in Spinal Surgery.

Specific Neurology Requirements

Neurology certification requires a 3-year residency program following the first post graduate year after medical school (internship).

Specific Clinical Neurological and Neurosurgical Critical Care Requirements

For Clinical Neurological and Neurosurgical Critical Care, prior certification in Neurosurgery, Neurology, or Internal Medicine is required. In addition, an essay (cover letter) delineating interest/experience in neurocritical care must be provided.

Application and Examination Instructions

A fully completed application and supporting documents (as outlined on the application form), along with the appropriate application and examination fee must be submitted and approved prior to scheduling the Written Examination.

There is a Written Examination for each certification, which is taken online. The written portion of the certification examinations can be taken in the convenience of your own home, office, or wherever Internet access is available. The exams can also be scheduled to fit your busy practice, even on weekends or holidays.

A cumulative passing score for the written and oral exams is 70%. In the event a second Written Examination is needed due to an inadequate score, a separate examination fee must be paid prior to retaking the Written Examination. A six-month waiting period is required prior to retaking the examination.

Your Oral Examination can be taken immediately after the successful completion of the Written Examination, preferably within two (2) months after the successful completion of the Written Examination.

In order to take the examinations online, the following system specifications are required:

  • High speed internet connection
  • Windows or Mac operating system
  • Internet browser that can access our testing system website (test link will be provided once the exam is scheduled)

You may take any of the board examinations after you pay the application fee and submit all required documents along with your application.

To complete this application, please have two letters of recommendation from colleagues in your specialty sent directly to the address below. The letters must be on their letterhead with verifiable contact information. The letters also must include dates of practice observation and signature. 

Please fill out this form completely and return it with all requested documents and fees to:

AFMA c/o Nick Rebel
1524 North Lake Shore Drive
Chicago, IL 60610

Please be sure all items are included in your application packet. Failure to include will delay processing.


All fees must be paid before application processing can begin. Application and Exam Fees are $1,850.00. Send a check payable to AANOS to the address above, or pay by Visa/Mastercard/AMEX by entering your credit card information on the printed application form. You may also pay using a credit card by visiting the following link at the website of the ICS-US Section, which handles administrative activities for the AANOS. 

Information for International Physicians

With a wealth of experience in accreditation, the AFMA and its Boards welcome international physicians and surgeons with appropriate training to apply for our certifications. We are dedicated to providing robust comparable examinations so that medical professionals with our certifications can excel within the American healthcare system.

Surgeons practicing in countries outside the U.S. have received certifications from AFMA Boards. These certifications are restricted to the countries in which the surgeon is practicing and licensed at the time of the certification. International certifications are not transferable to the U.S.

Your certificate will be issued for use in the country in which you are licensed and practicing at the time of issuance of certification. Only applicants who legally reside and practice in the US will receive certification valid in the US.

Your certificate will be issued for your practice in the country from which you are applying. Only applicants licensed in the United States will receive an unrestricted certification.

Please note: If residency training for any specialty is obtained outside the U.S. then requirements for active practice in the US and case reports from a US-based practice are automatically increased to the maximum (24 months and 50 cases).

Important Notices

  • Once the Written Examination has been scheduled, the application and exam can only be canceled (with the fee refunded) with 30 days prior written notice to the Board Chair and/or headquarters office.
  • You may apply to take any of the board examinations offered. If, however, we find your qualifications to be deficient (e.g., you do not meet residency requirements) and/or you do not send us the appropriate training certificates and CV, you will not be allowed to take the exam. Please verify that you are qualified before submitting this application and the required fees. Your payment may be forfeited if we determine that your qualifications are not adequate or cannot be verified. If we find any deficiencies in your application materials (i.e. residency training is not adequate) your application may not be accepted.
  • The AFMA and AANOS are not liable for any actions of individuals who have obtained a Board Certification authorized by the AFMA and administered by the AANOS. The AFMA and AANOS make no limitations and warranties, neither expressed nor implied. No guarantees are made as to a certified physician’s ability to use the board certifications in certain situations.
  • The credentialing body reserves the right to final judgment.
  • AFMA and AANOS are separate entities both Incorporated in Nevada.
  • No guarantees or warranties are made or implied by either organization pertaining to a physician’s actual abilities in certain situations.
  • AFMA certifications are widely accepted by many hospitals in the United States. AFMA does not guarantee that its certifications will be accepted by any particular hospital for privileges.
  • Please note that board certification is not a license to practice medicine or surgery.