Specialty board certification, though voluntary, has become an indispensable designation for many osteopathic physicians. The authors report rates of osteopathic specialty board certification and recertification. On the recommendation of the Bureau of Osteopathic Specialists--and as a result of recent action by the American Osteopathic Association Board of Trustees--a new osteopathic continuous certification model will be used by all 18 member boards. This model firmly establishes osteopathic specialty board certification as an ongoing process that helps to ensure patient health and safety by measuring and monitoring physician competence. In addition, time limits on board eligibility have been established for certification candidates. As the healthcare environment continues to evolve, the American Osteopathic Association, the Bureau of Osteopathic Specialists, and the 18 osteopathic specialty boards continue to adapt to meet the professional needs of osteopathic physicians.