A total of 510 candidates took the 1989 Examination for Added Qualifications in Surgery of the Hand, including 412 diplomates of the American Board of Orthopaedic Surgery and ninety-eight diplomates of the American Board of Surgery. Most candidates reported that they had intensive practices in hand surgery and large annual case-loads, and most had taken a hand fellowship. However, there were significant differences between diplomates of the American Board of Orthopaedic Surgery and diplomates of the American Board of Surgery regarding these variables. The psychometric characteristics of the examination were very good. The average difficulty value was 77.6 per cent correct. The average item-discrimination value was high, and the total test reliability coefficient was 0.89. In general, the candidates' performance was very good, although there was a wide range in scores. A passing score of 66.3 per cent correct was selected, resulting in an over-all failure rate of 7.6 per cent, with 471 candidates passing and thirty-nine failing the examination. There were significant relationships between performance on the examination and several background variables, such as percentage of practice in hand surgery, having taken a hand fellowship, and size of the annual case-load.