Today I’m going to discuss two topics in medicine that are confusing, maybe a little bit boring, but incredibly important in the arena of Plastic Surgery— licensure vs. board certification.
The difference between the two is vast, but I find even nurses I work with, and yes, even my parents, confuse the two. Today I’m going to explain the difference to you, and tell you why it matters to you as a patient.
Licensure — Any physician who is currently practicing has to a hold a license in the state he or she is practicing in. Getting a license as a physician requires that you:
- Do one year of residency training. This is informally known as your “Intern year”.
- Pass the United States Medical Licensing Exam (USMLE). The exam is three steps, but by the time you make it to residency, you’ve already taken (and passed) steps 1 and 2. You are eligible to take step 3 after your Intern year of residency, and it is a general knowledge exam covering all of medicine (e.g. OB-gyn, surgery, internal medicine etc.)
- Fill out an extensive amount of paperwork, including a background check and fingerprinting.
If you want to get a license in another state, you only need to repeat the paperwork portion. Please take note– none of the above steps are specialty specific. That is, an Internist, a General Surgeon, and a Pediatrician all have to do the same things to become licensed.
So what does this license let you do? Basically, it allows you to practice medicine. You can open up an office, see patients, and treat them. Now here’s the scary thing- in the United States, there is no law limiting the scope of your practice based on your training. That means you could train in something totally unrelated to Plastic Surgery, take a weekend course on liposuction, and decide to start to performing lipo on unsuspecting patients.
So how do patients protect themselves? And where does board certification come in?
Board Certification is specialty specific. That means a doctor is board certified in Internal Medicine, or Plastic Surgery, or General Surgery. What adds confusion are the “junk boards”, which are unrecognized by the American Board of Medical Specialties (see the 24 member boards here). The board of cosmetic surgery is one of these boards. These non-recognized boards were created to lend authority to their members, but they do not have the oversight or strict membership requirement of the Boards belonging to the American Board of Medical Specialities.
Most hospitals require their physicians to become board certified. This means that non-board certified physicians generally operate out of office or outpatient surgery centers. Now, please be aware that board certification is a looong process (in the case of plastic surgery, it takes nearly two years after you finish residency). So if your physician has finished residency relatively recently, he or she may not be board certified yet, but is eligible to take the boards.
You can look your physician up to see if he is board certified. Yep- that’s right. The power is in the hands of the consumer. Look your doctor up, and if he or she is not board certified, ask why. If you’re uncomfortable with the answer, find another physician.
Have you found this post helpful? Do you have any other questions about licensure or board certification?