In 1973, the Board of Trustees of the American Osteopathic Association approved the Rules and Regulations of the American Osteopathic Board of Internal Medicine for the subspecialty certification program in internal medicine. The written objective examination process was finalized and implemented in 1984. Since 1984, 354 candidates have entered the examination process, with the largest number in the subspecialty field of cardiology. Through 1992, 91% of the candidates entering the examination process have passed the certifying examination and become certified. The number of first-time certifying-examination takers moderately increased in the last 2 years studied. The pass rate for first-time takers has averaged 75%, whereas the pass rate for repeaters has been 72%.