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 for osteopathic physicians. Earlier this year, at the recommendation of the Bureau of Osteopathic Specialists, the American Osteopathic Association Board of Trustees approved the use of an osteopathic continuous certification model by member boards. This model firmly establishes osteopathic specialty board certification as an ongoing process that ensures physician competence and patient safety. The various components involved in the implementation of this new methodology are outlined, including practice performance assessment. 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.