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Focused Practice Designation in Pediatric and Adolescent Gynecology

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Each of the following is a requirement to sit for the PAG Focused Practice Designation exam.

You must meet all of the requirements in effect during the year for which admission to the computer-based exam is requested.
  1. Training and Practice Requirement – In order to qualify as a Focused Practice Designation in PAG, you must have completed a minimum of 3 years of clinical practice with a focus in PAG. Completion of a 1- or 2-year PAG fellowship may count toward the minimum 3-year requirement of focused practice. (Each year of fellowship counts as 1 year of clinical practice up to 2 years.)
  2. PAG CME Requirement – You must have completed a minimum of 20 AMA-PRA Category 1 CME Credits™ in PAG or relevant pediatric surgery CME in the last 3 years.
  3. Specialty ABOG Board Certification – You must hold current, active ABOG certification in Obstetrics and Gynecology to be eligible to apply and to sit for the PAG exam. In other words, you must be certified through Dec. 31, 2019.
  4. Maintenance of Certification (MOC) – All candidates with a time-limited certificate in Specialty Obstetrics and Gynecology must be meeting the ABOG MOC program requirements at the time the PAG Focused Practice written application is submitted, and at the time of the actual written examination. Each Diplomate who achieves a Focused Practice Designation in PAG must enter the PAG Focused Practice Maintenance of Certification (MOC) program in the year following successful attainment of Focused Practice Designation in PAG and must successfully complete all assignments to maintain a Focused Practice Designation in PAG. [Note: Candidates with non-time-limited certification in Specialty Obstetrics and Gynecology who pass the written examination for Focused Practice in PAG will be issued a time-limited Focused Practice Designation in PAG and will be required to enter the PAG Focused Practice MOC program and fulfill all the yearly MOC requirements for Focused Practice Designation in PAG.]
  5. Medical License – You must have an active, full, and unrestricted license to practice medicine in any and all of the states or territories (United States or a Province of Canada) in which you hold a current medical license. Each license must not be restricted, suspended, on probation, revoked, nor include conditions on practice.
  6. Moral and Ethical Behavior – ABOG requires evidence of your professionalism and professional standing. This will include verification of your professional reputation, moral and ethical character, and in-hospital practice privileges from administrative officials of organizations and institutions that know you and your practice. You must have demonstrated good moral and ethical behavior in the practice of medicine and interaction with peers and other medical personnel. A felony conviction, even if unrelated to the practice of medicine, will be considered evidence of failure to meet this standard.
  7. Unrestricted Hospital Privileges – You must have unrestricted hospital (or surgical center) privileges for a Focused Practice in PAG. If you are under investigation or on probation, your application will not be approved. You must re-apply and pay a new application fee after the probation and/or restrictions have been resolved. However, resolution of these matters does not guarantee that your application will be approved.
  8. Twelve-Month Case Log – You'll be required to submit a 12-month case log documenting a practice that demonstrates sufficient depth and breadth of focused practice in PAG. The case log must document that you are caring for patients under the age of 12 and show evidence of focused practice by having a minimum of 100 gynecologic office practice cases in patients less than 21 years of age within a 12-month interval. The case log must be completed at the time of application on the form(s) provided with the online applications. See "Case Logs" tab on this page for more details. 
  9. Surgical Procedures – You'll be required to submit the number of operative procedures that you performed on patients less than 21 years of age in the year used for case collection. See "Case Logs" tab on this page for more details.
  10. Physicians in International Practice Settings – If you practice in a country other than the United States and its territories or Canada, a letter from the senior responsible medical officer in the hospital or clinical setting where you practice must be submitted with the application. The letter must be submitted to ABOG and must attest that you have independent, unsupervised privileges in PAG. In addition, it should attest that your practice of medicine meets all the local standards and verify that you have unrestricted privileges in PAG.
  11. Falsification of Information – Falsification of any information or failure to disclose any adverse action on hospital privileges, medical license, or MOC application will result in a denial of your eligibility to sit for the written examination for focused practice designation in PAG.

Request for Special Consideration

If you have made major contributions to the field of PAG but are no longer in full-time practice and cannot submit an adequate case log, you may request special consideration from the Committee on Focused Practice in PAG.

You should write a detailed letter of request to the Associate Executive Director for MOC of ABOG. The letter must include a summary of your contributions to the field and a copy of your CV. If the request is granted, you will be allowed to sit for the PAG computer-based exam. However, once Focused Practice Designation in PAG is attained, you must enroll in the PAG MOC process.

Application Process for the June 21, 2019 Exam

  1. Applications will be accepted online at www.abog.org beginning September 17, 2018. You must be logged into the physician portal to access the application.
  2. The final day applications will be accepted for the 2019 exam is May 31, 2019.
  3. The fee must be paid by credit card through the ABOG website (www.abog.org) at the time of application. If you are found to be ineligible to sit for the test, a portion of the fee will be refunded.
  4. You must supply ABOG with a working email address as part of the application process. It is your responsibility to notify ABOG of any change in this address.
  5. Following submission of your online application, payment of the appropriate fee, and receipt at ABOG of the 12-month case log, your application will be considered in accordance with the requirements in effect for that year. You will be notified of admissibility to the computer-based exam. An ABOG subcommittee will make the final decision as to your eligibility after the review of your application and qualifications.
  6. Two business days (not less than 48 hours) after you have received the email notification of acceptance as a candidate, you should contact Pearson VUE to obtain a seat for the exam. Instructions for contacting Pearson VUE will be included in the acceptance email. Seats at Pearson VUE in individual cities are limited and are assigned on a “first-come, first-served” basis.

Exam content was determined by a blueprint (see below) developed by the Committee on Focused Practice in PAG. The questions will be in a multiple-choice, one-best-answer format.

Blueprint for 2019 PAG Written Exam

Prepubertal gynecology: 20%

  • Medical conditions: 18%
    • Vulvovaginal disease
    • Congenital and developmental abnormalities
    • Ovarian cysts/adnexal masses
    • Urethral prolapse
    • Normal and abnormal growth and development
    • Psychosocial problems
  • Surgical conditions: 2%
    • Labial agglutination
    • Genital trauma

Adolescent gynecology: 80%

  • Medical conditions: 60%
    • Endocrine disorders
    • Infectious disorders
    • Oncofertility
    • Disorders of sexual development
    • Transgender health
    • Psychosocial problems
    • Growth and development
    • Disabilities
    • Menstrual management
    • Contraception
    • Chronic pain
  • Surgical conditions: 20%
    • Pelvic masses
    • Congenital anomalies
    • Trauma
    • Torsion

Exam Conduct

Exam Format and Length

The PAG Focused Practice Written Examination is scheduled to last approximately 2 hours and 30 minutes and consists of 100 questions. If you finish before the full time has elapsed, you may leave the Pearson VUE Testing Center early, but if you do so, you may not return.

You'll receive information after registering on the Pearson Vue Testing Center website concerning the location of your exam, as well as the time you must arrive.


You must present 2 forms of identification to be admitted for the PAG Examination at Pearson VUE Testing Center.

  • One document must include both your photograph and signature.
  • The second document must include your signature.
  • If you had a name change between your application and the day of the test, you must bring a copy of an official document that verifies the name change. Examples could include, but are not limited to, a marriage certificate, divorce decree, court ordered name change, etc.
Screening Process

You must submit to a screening process that may include any or all of the following:

  • fingerprinting
  • palm vein scanning
  • wanding
  • walkthrough scanning for metallic objects
  • any other screening that may be in place at the Pearson VUE Testing Center

If you refuse to submit to any screening procedure, you will not be allowed to take the exam, and no portion of the fee will be refunded.

Electronic Devices

You may not take electronic devices into the exam area.

  • You are not allowed to possess or access recording devices, cellular phones, paging devices, other electronic communication and/or recording devices, and writing instruments at any time during the written exam or while taking a break.
  • You may not wear any device that can access the internet, such as an Apple Watch or similar devices.     
  • The one exception is an insulin pump.
  • If such a device is discovered at any time during the exam, or if you access any such device for any reason, you will not receive a grade for any portion of the written examination, and all fees will be forfeited.

There is no scheduled break during the exam.

  • You may take unscheduled breaks to use the restroom facilities. Unscheduled breaks should not exceed 10 minutes in length.
  • During such breaks, you may not talk with any individual or access any electronic device.
  • You are not allowed to leave the Pearson VUE Testing Center for any reason before completing the test.

If you violate any of these regulations, you will not receive a grade for any portion of the PAG written examination, and all fees will be forfeited.

Designation Length

All Specialty and Subspecialty Certificates issued by ABOG after 1986 are time-limited. Similarly, Focused Practice Designation in PAG issued by ABOG when you successfully pass the PAG written exam is time-limited and remains only in effect if you participate in and successfully complete the PAG Maintenance of Certification (MOC) process each year.

If you successfully pass the 2019 computer-based PAG exam, your Focused Practice Designation in PAG will expire on Dec. 31, 2020, unless all of the 2020 PAG MOC assignments have been completed successfully and on time.

If your focused practice designation is allowed to lapse, it can only be re-established by passing a secure re-entry computer-based exam in PAG.

Special Accommodations

If you require special accommodations, notify the ABOG office no later than March 22, 2019 by emailing moc@abog.org. It may not be possible to accommodate requests received after that date. See details by clicking through to the tab titled Exam Accommodations.



If you postpone or fail the written examination in PAG, you must complete a new online application to be considered for the next scheduled written exam in PAG and pay a new application fee.

Applicants Ruled Inadmissable

If a decision is made by ABOG that you have not met the requirements for admission to the written exam in PAG, you may appeal the decision in writing to the ABOG Associate Executive Director for MOC by emailing moc@abog.org. Such appeals will be forwarded to the appropriate ABOG Review Committee for consideration. If a successful decision occurs after the date of the computer-based exam, you will be scheduled for the next available computer-based exam in PAG, and no additional application fee will apply.

PAG Case Log Requirements

  1. A case log form must be completed and submitted online as a part of your application process. 
  2. The deadline for submission of all application materials, including the case log, is May 31, 2019.
  3. The numbers reported in the case log must be from any consecutive 12-month period between January 1, 2016 and December 31, 2018.

Candidates' Twelve Month Case Log For Focused Practice Designation in Pediatric Adolescent Gynecology

Candidates for the Focused Practice Designation in PAG have to submit a case log. The log must document a minimum of 100 outpatient cases of patients less than 21 years of age and include patients under 12 years of age in the 12-month collection period.

Candidates must also document on the case log the surgeries they have performed on patients under 21 years of age. Although there is no minimum number of surgeries required, case logs without any surgical experience will be reviewed by the ABOG Committee on Focused Practice in PAG for application approval. A draft example of the case log follows. Candidates will be asked to submit the case log at the time of application.


Example of Case Log Form 

A. Outpatient Office Procedures

Quantify office procedures/patient encounters without procedures in patients less than 21 years of age.

Type of ProcedureNumber of CasesNumber of Cases
 Age Less Than 12Age 12 to 20
Insertion of contraceptive implants  
Insertion of IUDs  
Lysis of adhesions  
Removal of hymenal band  
Vaginal irrigation  
Vulvar biopsy  
Other/patient encounters w/o procedure  
TOTAL (must be at least 100)  

B. Surgical Procedures

Number of procedures on patients under the age of 21.

Type of ProcedureNumber of Procedures
External genital tract procedures