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If you are currently board qualified, you may submit your application for part 2 only by July 19, 2019
All applicable fields are required.
Date of Birth:
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.
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.
Copy Mailing Address
Enter your 4-digit graduation year beside each school you have attended.
Arizona School of Podiatric Medicine at Midwestern University (Glendale, AZ)
Barry University School of Podiatric Medicine (Miami Shores, FL)
California School of Podiatric Medicine at Samuel Merritt University (Oakland, CA)
College of Podiatric Medicine and Surgery at Des Moines University (Des Moines, IA)
Kent State University College of Podiatric Medicine (Independence, OH)
New York College of Podiatric Medicine (New York, NY)
Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science (North Chicago, IL)
Temple University School of Podiatric Medicine (Philadelphia, PA)
Western University of Health Sciences, College of Podiatric Medicine (Pomona, CA)
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
My residency certificate was sent to ABPM in a prior application.
“I understand that I am required to attain all minimum activity volumes (MAVs) as set forth in the CPME 320 document to complete my residency program. Failure to provide the certificate of residency completion may affect my eligibility to sit for the certification examination.”
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.
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
“I am requesting special accommodations.”
Add a Supporting Document
ABPM will notify candidate via e-mail once accommodation is approved and advise them on how to schedule their appointment.
If you answered Yes to any of the above questions, please explain:
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.
“I do not wish my name to be provided to other organizations by the ABPM.”
“The information provided on or attached to this application is complete to the best of my knowledge. I fully understand and agree that, as a condition of making this application, any misrepresentation, misstatements, or omissions, whether intentional or unintentional, may constitute cause for automatic and immediate rejection of this applications and/or membership classification achieved with the ABPM.”
“I understand that upon achieving Board Certification, I will be automatically enrolled in the ABPM Maintenance of Certification (MOC) Program.” The enrollment fee for the MOC program is either a single payment of $1,635 or a payment plan of $200 annually. (This is in addition to annual dues.) The components and requirements of the MOC Program must be completed over a 10-year cycle.
Further information may be found on the ABPM website.
The American Board of Podiatric Medicine
1060 Aviation Blvd. #100
Hermosa Beach, CA 90254
Phone: (310) 375-0700
Fax: (310) 861-0445
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