AAA Exam Domains 2026: Complete Guide to All 5 Content Areas

How the Assessment Is Built

The Point-of-Care Ultrasound (POCUS) Abdominal Aortic Aneurysm (AAA) Certification is administered by the Point-of-Care Ultrasound Certification Academy, part of Inteleos, and delivered online through myPOCUS and its learning management system. Before you can plan your study time, you need to understand that the credential has two components, and both must be passed:

1. The Clinical Case Assessment: five simulated clinical cases containing multiple-choice questions and interactive image-hotspot questions.
2. The Peer Evaluation: a practical-abilities review completed by healthcare-provider peers who know your scanning.

The five domains discussed in this article are the official weighted objectives of the Clinical Case Assessment. They are not headings from a preparation curriculum, and their weights add up to 100% for that assessment only. The "5 cases" figure is a case count, not a question count; the public sources reviewed do not give a fixed current total number of questions or a numeric passing mark, so anyone quoting one deserves skepticism. For more on how scoring is discussed publicly, see our breakdown of the AAA passing score.

The Five Domains and Their Weights

The distribution tells a clear story. Two domains carry 64% of the Clinical Case Assessment, and a third carries another 24%. Together, Anatomical Features, Sonographic Findings and Diagnostic Findings account for 88%. The remaining 12% is split between views and named pathologies. If you want a broader plan that wraps these weights into a timeline, our AAA study guide walks through a full preparation sequence.

Domain 1: Standard POCUS Views (8%)

At 8%, you should not over-invest here, but do not skip it. Questions in other domains frequently assume you can orient yourself in an image. A candidate who is shaky on views will lose points on anatomy and findings questions that are nominally about something else.

Domain 2: Anatomical Features (24%)

The strategic point is that normal anatomy is also the foundation for recognizing pathology. The published pathology examples include normal abdominal aortic findings as an explicit category, so being confident about what "normal" looks like is tested directly rather than assumed.

Domain 3: Sonographic Findings (32%)

Candidates often blur this domain with the next one. Keep them separate in your mind. A sonographic finding is an observation; a diagnostic finding is the conclusion you draw from it. A question might show an image and ask you to describe the finding accurately, and an answer that jumps straight to a clinical conclusion may not be the best answer.

Domain 4: Diagnostic Findings (32%)

That last bullet is easy to underestimate. The content outline expressly includes recognizing when POCUS cannot establish an initial diagnosis. In a simulated case, the correct answer may be that the study is non-diagnostic or inadequate rather than a confident positive or negative. Overconfident reading is a real clinical risk, and the assessment is built to test your judgment about it.

An original teaching example

Consider a hypothetical case: a patient with abdominal pain, and an image set in which gas obscures much of the mid-abdomen. A candidate who forces a measurement from an unreliable view and declares the aorta normal has made a diagnostic error, even if the aorta happened to be normal. A stronger response recognizes the limitation and acknowledges that this scan cannot rule anything out. This scenario is an original teaching illustration, not a live examination item.

Domain 5: Abdominal Aortic Aneurysm (AAA) Pathologies (4%)

Do not read the 4% weight as permission to ignore pathology. The pathology list is effectively the vocabulary you need to answer Domain 3 and Domain 4 questions. Because the list is described as non-exhaustive, expect that a case could touch an entity you have not rehearsed by name. Understanding underlying principles serves you better than memorizing a list.

The Peer Evaluation Is Not a Sixth Domain

A common mistake is to treat the Peer Evaluation as an additional content area. It is a separate component with its own structure: seven evenly weighted criteria.

• Diagnostic Quality
• Gain
• Depth
• Views
• Measurement
• Pathology
• Color Doppler

These criteria assess your actual scanning ability as observed by at least two healthcare-provider peer evaluators with an ultrasound clinical background who know your relevant skills. The first two completed peer questionnaires determine the peer result. These criteria do not change the five-domain count of the Clinical Case Assessment.

It is useful to notice the overlap in concepts, even though the formats differ. Gain, depth and views on the peer form are the hands-on counterparts to what Standard POCUS Views and Sonographic Findings test on screen. Clinical video submissions that appear on the shared outline apply only to specialty certifications, not to this standalone clinical certification. For a candid look at the effort involved, read how hard the AAA exam is.

Sequencing Your Preparation Around the Weights

This is the one place we will talk about scheduling, and it is anchored to the domain weights rather than generic technique. A sensible order starts with the foundation and finishes with integration:

Adjust the length to your own experience, but keep the logic: the 64% domains deserve the most repetition, and the case format means integration practice matters more than isolated recall. When you are ready to test yourself, try a timed run on our AAA practice test, and keep our one-page AAA cheat sheet handy for last-minute review.

Registration, Fees and Retakes

The domain content is only half of the planning picture. A few mechanics from the issuer's published information are worth knowing up front:

• Case experience: you attest to performing and participating in the interpretation of at least 15 AAA POCUS cases within the preceding 2 years.
• Prerequisite: POCUS Fundamentals is required unless waived, for example by a qualifying SPI examination passed within 5 years or a current qualifying ARDMS or APCA credential.
• Fees: the standard clinical certification fee is USD 150, with reductions for eligible countries. When Fundamentals must also be purchased, it is a separate USD 125, for USD 275 combined in initial issuer fees, excluding optional courses.
• Time window: both components must be completed within 90 days of purchase. This is an access and completion window, not a timed sitting, and online assessments can be stopped and resumed.
• Confidentiality: a nondisclosure agreement applies, so no one can legitimately share live examination items.

Our companion articles cover these in more depth: AAA requirements, AAA certification cost and AAA exam dates.

If you do not pass

The issuer's retake policy allows 2 total content-specific assessment attempts before a 1-year waiting period, with a 30-day wait following an unsuccessful attempt. A retake application and fee are required, and you apply within 90 days of failure. Any component you already passed is retained for the first retake application, which is another reason to treat the Clinical Case Assessment and the Peer Evaluation as separate projects.

Staying certified

Certification is valid for 5 years. Clinical renewal requires an active-practice and good-standing attestation, the relevant knowledge check and USD 50.

Frequently Asked Questions

Mapping your effort to these five weighted domains, and treating the Peer Evaluation as its own track, is the clearest way to prepare for this certification. For a view of the career side, our ROI analysis of the AAA certification takes a role-based look at the value of earning it.