Board certified, board eligible: what’s the difference? Does it matter?

Does your doctor have something on the wall that starts with “American Board of . . . ?

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The terms “board certified” and “board eligible” are confusing to people not in the medical profession. It doesn’t help that more than a few doctors blur the distinctions to their own benefit. This post gives you a brief rundown on what’s at stake in the distinctions.

The first thing to understand is that anybody who has graduated from medical school is a physician. They can put those letters M.D. (or D.O.) after their name. But they can’t practice medicine yet on their own. To do that they need a medical license. The granting of medical licenses is one of the powers of each individual state. They all have their own rules, although they are all broadly the same. For example, I have medical licenses in several states, and they are all pretty much the same in how I got them. All states require some additional training time beyond medical school before you can get a license. This is called residency. The older term, intern, which used to apply to the first year of post-medical training, doesn’t mean much anymore — except in one respect. All states I’m aware of let you get a medical license after only one year of postgraduate training. The key point is that the states, through their licensing system, have virtually nothing to do with regulating how a doctor gets to say he has the advanced training that lets him call himself a specialist.

Residency, which is training in one of the many medical specialities (e.g. pediatrics, internal medicine, surgery, obstetrics and gynecology, family practice, etc.), lasts anywhere from three to five years after medical school. Training time is longer if you want to be a subsupecialist (e.g. critical care, cardiology, gastroenterology, heart surgery, etc.). At the end of training you take a test: if you pass, you are “board certified” in the specialty or subspecialty. You can have several of these. For example, I am board certified in pediatrics and in pediatric critical (intensive) care medicine.

So what is “board eligible”? That means a physician who has completed the residency in a specialty or subspecialty but has not passed the test, either because he hasn’t taken it yet or he failed it. You can see the problem here, where patients can get confused. “Board eligible” sounds pretty fancy, not much different from “board certified.” But some physicians have been calling themselves “board eligible” for years and years without ever passing the test. Doing that will restrict what you can do in a hospital, but there is nothing to prevent somebody practicing a specialty outside the hospital, say allergy, from advertising to the public as “board eligible in allergy” for many years. It’s not false, but it can be misleading.

The American Board of Medical Specialties, the organization that oversees all this, has just put in place a rule forbidding people from claiming to be “board eligible” for their entire careers. After finishing an approved residency they’ve got several years to pass the board examination; if they can’t, they can’t use the term anymore or will face sanctions. I think it’s a good thing.

All of the specialty and subspecialty boards have websites where you can check if a physician really is certified or not. The ABMS site above has links to all of the member boards for your convenience. For example, you can go to the American Board of Pediatrics site and easily verify if your child’s doctor is certified (and when).