About the Examination

The 2024 initial application is open! To apply online, click here. 

The certification for hospice medical directors, or physicians who provide hospice care, offered by HMDCB represents a standard of knowledge and practice. Professionals working in the field of hospice and palliative medicine can demonstrate the knowledge and skills of their specialty by meeting the HMDCB’s eligibility requirements, passing the examination, and participating in HMDCB’s Continuing Certification Program. The HMDCB certification program is designed to promote excellence and professionalism by documenting individual performance as measured against a predetermined level of knowledge about hospice care. HMDCB's certification examination is a valid, reliable, and legally defensible assessment instrument that measures the competence of potential certificants against a codified and relevant body of hospice tasks.

The HMDCB examination consists of 165 multiple-choice questions (150 scored questions). Candidates will be allowed three (3) hours to complete the exam, which is administered by computer at more than 300 PSI Candidate Services assessment centers throughout the United States. Examinations are administered by appointment only.

Protecting the Public

A primary purpose of certification is protection of the public and promotion of the safety and health of individuals requiring the hospice services. By measuring knowledge through a standardized comprehensive examination, certification can help achieve those purposes.

Because hospice medical directors and physicians who provide hospice car provide services of critical importance to individuals as they approach the end of life, it is beneficial for the general public as well as other healthcare providers to be able to recognize this group who has demonstrated minimum core competence in the knowledge and skills necessary to function as a hospice physician and/or medical director.

Assessing the Body of Knowledge

Each candidate must therefore assess their own body of knowledge, skills, and understanding of the specialty in deciding when to apply for the exam.

Clinical experience in the field of hospice and palliative medicine is required for initial certification, and must use the knowledge and skills described in the Content Blueprint. The exam is designed individuals who have actively practiced in the field for a minimum number of hours over a certain time period as outlined in the eligibility requirements.

Exam Development

An essential element of the HMDCB certification process is its dedicated team of volunteer subject matter experts (SMEs) who generously donate their time to create the examination content. The high standards of the certification program are upheld by the close working relationship between HMDCB, volunteer content experts, and testing experts. HMDCB adheres to the standards of the National Commission for Certifying Agencies (NCCA) in the development and implementation of its certification program.

When HMDCB was created, SMEs identified within the field, along with HMDCB and its highly qualified psychometric consultants at PSI Candidate Services, developed an initial bank of test items. These items are routinely updated by HMDCB’s item writing committee to ensure an examination with real-life relevance. An examination committee, consisting of diverse hospice medical directors then reviews each item for content accuracy and relevance, categorizes questions within the content domains of the exam blueprint, reviews the psychometrics of test items and examinations, and determines the passing score. By having SMEs and PSI working in conjunction, HMDCB has developed an exam that is legally defensible and psychometrically sound.

HMDCB continually evaluates and updates its certification and recertification processes. Approximately every five years, a new practice analysis study will be conducted to identify any role changes of the hospice medical director, with examinations modified accordingly.

Exam Scoring

Passing Scores

The methodology used to set the minimum passing score is the modified Angoff procedure. This universally accepted procedure employs the judgment of HMD subject matter experts from around the country as well as the assistance of professional psychometricians from PSI Candidate Services to estimate the passing probability of each item on the examination.

Scaled Scores

Because of the need for security, multiple versions (or forms) of the HMDCB examination are created, each containing a different combination of questions. Although much care is taken to assure that all forms of the examination are similar, the difficulty of the forms will vary slightly. Each exam form can be thought of as a fixed measure of knowledge; imagine a measuring stick with increments of knowledge level instead of inches or centimeters. Since two exam forms may vary slightly in difficulty, the space between the increments of knowledge level may also be slightly different.

In order to account for differences, raw scores are transformed to scaled scores. Raw scores are the number of questions answered correctly; the range of possible raw scores is from 0 to 150 on the HMDCB examination. Scaled scores for the HMDCB examination range from 0 to 200. A raw score on one form of the exam may not represent the same amount of knowledge as that same raw score on a different form. However, the same scaled score on two different forms will represent the same amount of knowledge. The scaled score required to pass will always be 100; however, the raw passing score may vary depending on the difficulty of the form. Easier forms will have a higher raw passing score and more difficult forms will have a lower raw passing score. Scaled scores are used to provide a consistent measurement, so that from one test administration to the next, the same scaled score represents the same level of ability or knowledge.

Examination Results

Candidates will receive a score report at the test center immediately after completing their examination. The score report will detail their examination results, including feedback on performance in the major competency areas tested. Neither HMDCB nor PSI will report scores by phone, email, or fax. The HMDCB initial application portal will be updated after the exam window closes. For a copy of your score report, please contact PSI at 855-579-4641 or HMDCB at This email address is being protected from spambots. You need JavaScript enabled to view it..  

"HMDCB certification provides a methodology that patients can compare providers by meeting benchmark standards of quality care. I’ve encouraged not only our staff providers to become HMDCB-certified, but also our fellows, to ensure uniform quality standards in this select group of clinicians."

Reuben Smith MD JD FAAFP HMDC
Associate Medical Director
Community Hospice and Palliative Care
Jacksonville, FL