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Board Certification
What Does It Mean?

Stephen Barrett, M.D.

Question

I live in a Florida city that has a high percentage of retired people and as a consequence, a large medical services population. In their advertising it seems almost all the MD's are "Board Certified", but the board is never mentioned. Somewhere, I heard that there are a few boards considered to be "legitimate" that require a high level of experience and recommendation, and who have passed stringent exams in their specialty. Somewhere I learned there are boards whose main purpose is to allow the use of "Board Certified" after the name. Could you comment on this? Is there a way to tell the difference?

Answer

Because scope of modern medical knowledge is vast, most medical school graduates take additional training before entering clinical practice. Those choosing to become specialists take at least three years of residency training during which they are designated as PGY 1 (postgraduate-year-one resident), PGY 2 (postgraduate-year-two resident), and so on. The recognized standard-setting organization is the American Board of Medical Specialties (ABMS, which is composed of 24 primary medical specialty boards and six associate members: the American Hospital Association, American Medical Association, Association of American Medical Colleges, Council of Medical Specialty Societies, Federation of State Medical Boards of the United States, and National Board of Medical Examiners. The American Osteopathic Association (AOA) sets standards for osteopathic physicians (DOs) who undergo residency training at osteopathic institutions. (ABMS also certifies DOs who train at MD-run programs.)

Medical specialty boards require high standards of training and performance and ensure them by rigid examinations. Successful applicants receive diplomas and are considered "board-certified." They are also referred to as "diplomates" in their particular specialties. The number of ABMS-approved credentials has risen sharply during the past ten years. Certificates are now available for 37 specialties and about 75 subspecialties [1]. Most certificates expire within seven or ten years and require reexamination for renewal.

Physicians who complete all requirements for certification except the examination may be identified as "board-eligible." Although the American Board of Medical Specialties has officially abandoned the term, it is still in common use.

In 1995, Medical Economics magazine reported that more than 75 boards not ABMS- or AOA-affiliated had issued certificates to thousands of physicians. Although a few of these self-designated boards are run legitimately and may eventually achieve ABMS or AOA recognition, most do not require residency training in their specialty. The author stated that "some physicians use fringe board certification to attract patients, who usually don't know the difference. . . . And only a handful of states restrict the advertising of board certifications or specialties." [2] Certification by any of the following suggests that a pracitioner is involved with dubious methods:

Most physicians identified as specialists in the Yellow Pages have completed accredited specialty training. However, telephone directory publishers rarely attempt to verify credentials, so self-proclaimed specialists may be listed also. The ABMS Verification Service provides a simple way to check whether a doctor has ABMS-recognized certification. The Board also has been placing lists of board-certified physicians in many telephone directories, but many board-certified physicians are not included because they do not wish to pay the required fee (over $200 per year).

Reference

1. ABMS Web site, July 1998. The list spans seven pages. To navigate, use the "Next Page Down" link at the bottom of each page.
2. Terry T. Visit Vegas! Get your boards while you're there. Medical Economics 72(3):26-36, 1995.
 
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This article was revised on December 5, 2000.