CROMIC certification is offered in two distinct streams:

• Spine Certification
  
• Periphery Certification

Candidates may pursue certification in one or both streams, depending on their clinical focus and training.  

To be eligible for the CROMIC examination, candidates must meet the following minimum prerequisites:

• Completion of the CAOM Regenerative MSK Injection Course in the corresponding track (Spine and/or Periphery) in a prior year (2026 or earlier)
  
• A minimum of one year of clinical experience applying regenerative injection techniques in practice

These criteria represent the minimum standard. Many candidates who sit for the examination have significantly greater clinical experience, reflecting CAOM’s commitment to maintaining a high standard of practice. 

The CROMIC certification examination is a comprehensive, multi-component assessment designed to evaluate both theoretical knowledge and practical clinical skills. The exam is composed of three mandatory sections:

• Written Examination
  
• Palpation and Marking (OSCE format)
  
• Injection Examination (OSCE format) 

Candidates must successfully pass all three sections to achieve certification.

The written component assesses foundational and track-specific knowledge in regenerative medicine and prolotherapy.

• Format: Multiple-choice questions (MCQs) with some true/false items 
• Content: General topics (e.g., principles of prolotherapy, injectates), Track-specific questions (Spine and/or Periphery) 
• Duration: Approximately 45–90 minutes 
• Structure: 20 general questions, 20 spine questions, 20 periphery questions 

Candidates pursuing dual certification are required to complete all sections. The spine track includes interpretation of ultrasound imaging. 

This component follows an Objective Structured Clinical Examination (OSCE) format and evaluates anatomical knowledge and physical examination skills.

• Identification of relevant anatomical structures through palpation
  
• Marking of structures and landmarks
  
• Assessment of patient positioning techniques

Candidates are assigned to spine and/or periphery stations depending on their selected certification stream, with each station examining multiple anatomical regions.

The injection exam is a hands-on assessment, also delivered in an OSCE format, and evaluates procedural competency.

• Format: Multiple stations (typically 3 spine and 3 periphery stations) 
• Duration: Approximately 60–70 minutes total 
• Key competencies assessed: Patient positioning, Anatomical accuracy and identification, Injection technique and precision, Procedural efficiency and safety 

Ultrasound guidance is mandatory for spine injections and optional for periphery procedures. Candidates are evaluated based on safety, accuracy, and efficiency rather than adherence to a single technique.

• The written and palpation components are conducted during the course schedule following the lecture sessions
  
• The injection examination is held on Saturday afternoon following completion of the practical workshop
  
• All exam components take place at the University of Calgary Medical School, adjacent to Foothills Medical Centre 

• Candidates must achieve a minimum score of 80% in each section
  
• A pass/fail safety assessment applies to the injection exam; failure in this category results in automatic failure of the injection component, regardless of score
  
• Candidates who do not pass may repeat only the section(s) they failed in future examinations
  
• Results are issued via email within one week of the exam

Successful candidates will receive an official certificate indicating their CROMIC designation (Spine and/or Periphery).