HOSPITAL LOCATOR
Choosing a health care provider in the U.S.A.
International patients seeking medical treatment
in the United States of America may use the following resources to select
a physician.
Introduction | Training
of a Specialist | Credentialing
a Specialist and/or Subspecialist | Purpose
of Certification
What is "Board Certified"?
Introduction
Everyone knows that a "medical doctor" is a physician who has had years
of training to understand the diagnosis, treatment, and prevention of
disease. The basic training of a physician specialist includes four years
of premedical education in a college or university, four years of medical
school, and after receiving the M.D. degree, at least three years of specialty
training under supervision (called a residency). Training in certain subspecialties
can take an additional two to three years.
The process most widely used by physicians to tell whether and why you
are sick is to ask you, and/or your family members, questions about your
health and your past medical history. This process, called taking a history,
is usually followed by an appropriate examination of your body (a physical
examination) to determine how well it is functioning and whether there
are signs of disease. Doctors also use a variety of tests such as x-rays,
other imaging techniques, and additional procedures to evaluate your health
and identify any diseases or other health problems that may be present.
Some of these diagnostic procedures (e.g., cardiac catheterization, CAT
scans, biopsy of body tissues) are very complicated. They call for many
years of training in order to use them safely and accurately.
After the diagnostic process is completed, the doctor will recommend
what treatment is needed, if any. Treatment may involve surgery (there
are many types of surgical specialists), medication, or other complex
procedures.
The complexity of the body's structure and the way it functions calls
for high levels of skill in understanding body systems and in knowing
the effect that each system has on the whole, in health and in disease.
That is why today, most physicians choose to specialize.
Specialists are physicians who have chosen a specific knowledge area
of medicine and have completed a residency in that field. Specialization
in medicine combined with continued medical education is necessary because
of the rapidly expanding body of knowledge about health and illness and
the constantly evolving techniques for the prevention, diagnosis, and
treatment of disease. A subspecialist is a physician who has completed
training in a general medical specialty and then takes additional training
in a more specific sub-area of that specialty called a subspecialty. This
training increases the depth of knowledge of the specialist in that particular
field. For example, cardiology is a subspecialty of internal medicine,
pediatric surgery is a subspecialty of surgery, and child and adolescent
psychiatry is a subspecialty of psychiatry. The training of a subspecialist
within a specialty requires an additional one or more years of full-time
education.
Training of a Specialist
The training of a specialist begins after the doctor has received the
M.D. degree from a medical school, in what is called a residency. Resident
physicians dedicate themselves for three to seven years to full-time experience
in a hospital or ambulatory care setting, caring for patients under the
supervision of experienced teaching specialists. Educational conferences
and research experience are also part of that training. A doctor in training
to be a specialist is called a resident, although the first year of residency
used to be called an internship.
In each state, the privilege to practice medicine is governed by state
law and is not designed to recognize the knowledge and skills of a trained
specialist. The physician is licensed to practice general medicine and
surgery by a state board of medical examiners after passing a licensure
examination. Each state has its own examining procedure to license physicians,
and this board sets the general standards for all physicians.
Who Credentials a Specialist and/or Subspecialist?
Specialty boards certify physicians as having met certain published standards.
There are 24 specialty boards that are recognized by the American
Board of Medical Specialties (ABMS) and the American
Medical Association (AMA). Remember, a subspecialist first must be
trained and certified as a specialist.
In order to be certified as a medical specialist by one of these recognized
boards, a physician must complete certain requirements. Generally, these
include:
1. Completion of a course of study leading to the M.D. or D.O.
(Doctor of Osteopathy) degree from a recognized school of medicine.
2. Completion of three to seven years of full-time training in
an accredited residency program designed to train specialists in the field.
3. Some specialty boards require assessments of individual performance
and competence from the residency training director, or from the chief
of service in the hospital where the specialist has practiced.
4. Most specialty boards require that the person who seeks certification
has an unrestricted license to practice medicine in order to take the
certification examination.
5. Some boards require that the doctor has a period of experience
in full-time practice in the specialty prior to examination for certification,
usually two years following training.
6. Finally, each candidate for certification must pass a written
examination given by the specialty board. Fifteen of the 24 specialty
boards also require an oral examination conducted by senior specialists
in that field. Candidates who have passed the exams and other requirements
are then given the status of Diplomate and are certified as specialists.
A similar process is followed for specialists who want to become subspecialists.
Some boards issue certificates for a limited period of time, usually
seven to ten years. In order to retain certification, Diplomates of those
boards must become recertified, and must periodically go through an additional
process involving continuing education in the specialty, review of credentials
and further examination. Some boards that may not require recertification
have provided voluntary recertification with similar requirements.
The Purpose of Certification
The intent of the certification process, as defined by the member boards
of the American Board of
Medical Specialties, is to provide assurance to the public that a
certified medical specialist has successfully completed an approved educational
program and an evaluation, including an examination process designed to
assess the knowledge, experience and skills requisite to the provision
of high quality patient care in that specialty.
Reprinted with permission from the American
Board of Medical Specialties Public Education Program
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