Every year, the ABFPRS fields a written exam composed of 300 multiple-choice questions and an oral exam covering 12 different cosmetic and reconstructive patient problems. Three to four times that number of questions are banked so that the test is never the same from year to year. This bank is continually updated to ensure that the examination reflects the ever-changing field of knowledge.

It costs about $100 to develop just one usable question for the written examination and more than $1,000 to prepare a protocol for the oral exam. Over the next few years, hundreds of new written items and dozens of new oral cases are needed to ensure the exam's continued integration with the recently updated AAFPRS Foundation Fellowship Bibliography.

In 2002, a major effort was launched to digitize all exam art. Digitizing the art facilitates administration of the pen-and-paper exam now and prepares the way for future delivery of the exam at regional testing centers.

Although all existing written exam art is now digitized, two-thirds of the oral exam art needs conversion. It costs about $325 to digitize the art for each case, and nearly 100 cases will need conversion over the next few years.

Gifts to the FPS Fellowship Examination Corporation (FPS FEC) have supported ABFPRS exam development through a memorandum of understanding between the two organizations in effect since 1992.