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 . . . ?
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).
Hey Chris. A while since we talked. I noted in my book that even Board Certification isn’t helpful because almost all of us pass them. Over 85% do. The real test is the actual score and where that score fits in with others who took the exam. Good luck getting that.
Yes, Board Eligible is a bad nomer. Usually those few who can’t pass the boards.
I like your postings and read them all the time. Great work. Best to you.
This is very helpful… thank-you!
Thank you for your article. It is one of the best I found by doing ask.com.
Is it possible to do board certification exams with training/residency elsewhere other than United states? Must a doctor complete residency in (say Pediatrics)in the US before he can apply for the board exams or would training elsewhere suffice.
I’m not certain of the answer to your question, but I believe it depends upon where the training is done. Training in Canada, for example, transfers to the US. In general a person has to complete a residency at a program approved by the US Board, so most of the time a physician trained outside the US must do at least some training in a US program to take the board exam. A good place to find an answer at least for pediatrics would be at the American Board of Pediatrics: http://www.abp.org. I would contact them for details. When I’ve called them about various things they have always been very helpful.
I would like to ask you there is possibility to get place in US system, as I am graduated from medical school, and I have master and PhD degree in my speciality Obstetric&Gynaecologist from UK University(Nottingham University) and in addition to that I have 8 years experience in my speciality.
I have many pediatric colleagues who have trained in the UK, so there must be a pathway of some sort. I don’t know the details, however. I suggest you contact the American Board of Obstetrics and Gynecology to see what the rules are regarding reciprocity of credentials.
Does board status affect a physician’s ability to get contracts with insurance companies?
It actually does matter sometimes. Insurance payers can set their own rules and I believe some require it. I’m not entirely sure of that, though.
Is a resident that has completed two years of internal medicine residency training, but stopped training/left the residency program, board eligible?
No, to be board eligible you have to have completed the entire residency and have a certificate from your program that you did so successfully. Further, the residency program must have been one approved by the council on medical graduate education. That means the training program has met the proper criteria for their graduates to take the board exam.
I have done residency in Urology in my own country. I am currently doing a fellowship in Urology Oncology in US. Will I be considered board eligible after completing fellowship ( considering that it is in an ACGME program)?
Good question. At least in pediatrics I know pediatric subspecialists who have gone that route — pediatric residency in their home country and then fellowship in the US and the pediatrics board was OK with that. But I think the individual boards vary in how they handle that situation. You would have to check with the Board of Urology. According to their website (https://www.abu.org/residencyRequirements.aspx) they require a residency from an ACGME or Canadian-approved program but they do say this: “A variance from these requirements may be considered on a case by case basis.” So I’d ask them about it, or maybe check with your fellowship director.
MRI shows an urgent need for cervical spine surgery. The DO I met with is board eligible / Fellowship trained spine surgeon. A young doctor for sure. He was a spine surgeon at the major trauma center hospital nearby and is now in a respected ortho clinic in my town. They all have to start somewhere with willing patients but I am concerned about having him do the work when there are other board certified spine surgeons in the same clinic. Does his acceptance by the older surgeons at the clinic have any weight and is that worth considering him as my surgeon?
Well, I can’t really give you specific advice. However, as you say, somebody who is well trained and is accepted by the other members of his group should be an endorsement of his skills. If you are really concerned it is always reasonable to get a second opinion. No physician should be concerned by such a request.
I would like to add that board eligible doesnt only mean that you’ve failed the boards. . My specialty, for example, includes a written test right after residency but then also an oral exam about 2 years after graduating. You’re board-eligible until both are complete.
Yes, that’s how pediatric boards were when I took them (1981). There was first a written test, then an oral exam once you’d passed the written and been out of residency for 2 years. They did away with the orals in pediatrics a few years back (decades, I think) because they were felt to be unfairly inconsistent.
Internal medicine was notorious for that in my father’s day — 1950s. There were some oral examiners who had never passed anybody.
does this mean going to a board registered vs board certified is not good?
There is no such category as “board registered” in the US.
I am board certified in adult psychiatry. I am board eligible in child psychiatry, although I won’t waste the money as I practice in geriatrics. Although I am a geriatric specialist for 20 years, I am neither board eligible or certified as I did not do a residency in this area. ( I had no idea this would be my calling instead of child psychiatry when I was in my late 20s. I recertified in adult a few years ago ( required every two years) but I am not sure I will do it again. Board certification is a money making scam, IMHO. The cost is obscene. I have many colleagues who are not board certified and are excellent doctors and work in the same settings I do. There may have been a day when being a physician was lucrative enough to support the exorbitant fees, but in this day and age, it is a struggle just to pay the bills and raise children. While I might recertify, I will have to really consider this as my other colleagues have done fine without the cost. Again I think this is a scam to scare doctors out of thousands of dollars.
Thank you for addressing this matter. I am scheduled for colorectal surgery and the surgeon i was referred to is certified in general surgery, and board eligible in colorectal surgery. I have developed a set of questions for her for our meeting this Friday.
I would also like know, if someone could be certified in America since their home country certification doesn’t apply in America based on the following subjects: 1. State Licenses 2. Board Certifications 3. Professional Membership
I think it depends upon the country. The boards generally concentrate on where training happened. I know Canada boards are accepted. I don’t know about other countries. You’d have to contact the relevant board and ask them. I know the American Board of Pediatrics is quite responsive to questions like that, and I presume the others are as well.
I graduated from a pediatric residency program in the USA in 1999
but never got to clear my boards.am I still board eligible and if not what is the best path to eligibility and do I get credit for working as a pediatrician both outpatient and inpatient
You would have to contact the American Board of Pediatrics. Their new rule is, I believe, that you can only be “board eligible” for a limited time after completing residency. I think it’s 5-7 years.