2022 BOARD EXAMINATIONS APPLICATION

  • Application Number:RTW3Q-62YDJ-VLCQD-8LTAN-GZ8AN

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1. Exam Selection

$1750.00
Examination Date: October 1, 2022
Application Deadline: August 15, 2022
$250 application fee is non-refundable upon receipt.
Balance is non-refundable after September 1, 2022.
$1600.00
Examination Date: October 1, 2022
Application Deadline: August 15, 2022
$250 application fee is non-refundable upon receipt.
Balance is non-refundable after September 1, 2022.

2. Contact Information

All applicable fields are required.

3. Mailing Address

The address you enter must be a daytime address at which you can receive mail requesting a signature.  You may change your address at any time by informing us in writing.  If you are in residency, remember to advise ABPM of address and phone number changes after you complete your residency.

Address Line 1:
Address Line 2:
City:
State/Province:
ZIP/Postal Code:
Country:

4. Public Address

If you do not provide a second address, your mailing address will be used as your public address.  When you achieve either board qualified or board certified classification with ABPM, this address will be made available to the public.

Address Line 1:
Address Line 2:
City:
State/Province:
ZIP/Postal Code:
Country:

5. Education

Enter your 4-digit graduation year beside each school you have attended.

6. Postgraduate Experience

For each program you have completed, enter the date of completion and submit a copy of your residency certificate or, if currently in residency, provide a letter from your Residency Director confirming your program type, year, and expected date of completion. 

Add a Program

7. Minimum Activity Volume (MAV)

8. Licenses

List all states in which you hold a podiatry license.  Upload a copy of each current license.

Add a License

Please note: in order to be granted board qualified status, you must have an active license and you must send a copy to headquarters once obtained.

9. Test Accommodations

ABPM is committed to providing access for all individuals with disabilities.  At the request of ABPM, Pearson VUE provides reasonable test accommodations for candidates with specific needs who provide timely and adequate documentation on a case-by-case basis.  It is essential for applicants requesting special accommodations to submit supporting documentation at the time of application submission.  That will assist, but not guarantee, the candidate obtaining accommodation at a test center proximate to their point of origin.

Special Accommodations Request.docx

Add a Supporting Document

ABPM will notify candidate via e-mail once accommodation is approved and advise them on how to schedule their appointment.

10. Ethics

1) Have any diciplinary actions been initiated and/or are any pending against you by any state licensure board?
2) Has your license to practice medicine in any state been denied, limited, suspended, revoked, placed on probation or involuntarily relinquished?
3) Have you been suspended, sanctioned or otherwise restricted from participating in any private, federal or state health insurance program (e.g. Medicare/Medicaid)?
4) Have you been the subject of any investigation by any private, federal or state agency including Professional Review Organizations, concerning you participation in any private, federal or state health insurance program?
5) Has your Federal DEA State Control Substance Certificate been denied, limited, suspended, revoked or involuntarily relinquished?
6) Have you ever been convicted of a felony or misdemeanor other than minor traffic violations?

If you answered Yes to any of the above questions, please explain:

11. Solicitation by Other Organizations

The ABPM will refer candidate information to organizations delivering educational content, or soliciting professional membership in areas relevant to the specialty unless specifically declined by the candidate.

12. Disclosure

13. Maintenance of Certification

Further information may be found on the ABPM website.