How to become a licensed, board certified doctor

I am licensed to practice medicine and surgery in Georgia. But that doesn’t mean I should, or that you ought to let me—at least not the surgery part. I’m actually pretty good at carving a turkey, but that’s pretty much the only kind of surgery that I’m qualified to do.

Don’t let the license fool ya, I’m no surgeon. So what, exactly, does a doctor have to do to practice the kind of medicine it says out on the shingle in front of the office? In some cases, maybe less than you think. Time for the insider scoop on what, exactly, doctor qualifications mean. You want to be a doctor? These are the hoops.

Step 1: Go to medical school, and graduate. Here’s an old joke:

Q: What do you call the person who graduates last in the class at med school?

A: Doctor.

Anyone who graduates med school gets that title, “Dr.”, plus a two letter degree after their name (MD or DO in the USA.) Lots of other folks call themselves “Doctor”—podiatrists, dentists, chiropractors, and people with doctoral degrees in anything from archeology to zoology. So “Doctor”, itself, that doesn’t mean much, at least as a way of demonstrating that you’re qualified to practice medicine.

Step 2: Get accepted into, and then complete, a one-year internship in any medical field. This could be in general medicine, surgery, psychiatry, pediatrics, anything. Once you’ve completed this one year past medical school, you can take a board exam and apply for a medical license. Pass the board, get that license, and you can practice medicine and prescribe medications. Surgery? Sure, you bet. The licensing for physicians and surgeons is the same.

That’s right: a practicing doctor or surgeon only needs a one year internship past medical school to get a license. Now, these people may have trouble getting credentialed at a hospital, or getting malpractice insurance, but nothing legal is stopping them from plying their trade, prescribing medicine, or operating on grandma’s blocked salivary gland.

Step 3: Get accepted into, and complete, a residency program. Sometimes this is combined with that first intern year, or it might be a separate program. The length varies—general internal medicine and pediatrics takes three years; general surgery generally five; cardiothoracic heart surgery I think takes fifty years, or something like that. After completing residency, a doctor can now call themselves a member of a specific profession within medicine, like a pediatrician, psychiatrist, gynecologist, or family medicine physician.

Step 4: Take the specialty boards, pass them, and get a bunch more letters to hang on that shingle outside of the office. Now we’re talking qualified! By doing this, the physician can now claim to be “board certified.” In pediatrics, passing the boards allows you to call yourself a “Fellow of the American Academy of Pediatrics,” and put the abbreviation FAAP after your professional designation: Lawrence G. Kidfriendly, MD, FAAP. That’s a real, genuine, qualified pediatrician. It is a guarantee that he’s any good? Of course not. But he’s at least jumped through the hoops, gotten his training, and passed the boards. That does count for something.

In most cases, to call yourself “board certified” requires periodic re-certification. Most specialties require ongoing educational classes, re-taking board exams, and other steps to re-qualify every 7-10 years.

Should all physicians be board certified? There are some legitimate reasons why some good docs haven’t jumped through all of the hoops. Some are fresh out of residency and just haven’t had the time to get their passing scores. Some are of an older generation, when board exams weren’t  required. And some doctors find the expense and hassle of recertification to just not be worth it.

In other cases docs who aren’t fully boarded were just unable to pass the certifying exam. Remember, if they completed their residency, they can still call themselves a member of their medical specialty. Even if they didn’t finish residency, they can still legally practice medicine (and surgery) as long as they’ve got a license.

Is your doctor board-certified? He or she ought to be—or have a good excuse to have skipped or delayed this step. If you don’t know, ask.

Roy Benaroch is a pediatrician who blogs at The Pediatric Insider. He is also the author of Solving Health and Behavioral Problems from Birth through Preschool: A Parent’s Guide and A Guide to Getting the Best Health Care for Your Child.

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  • http://fertilityfile.com IVF-MD

    Can anybody comment on the logic why a doctor licensed to do open heart surgery in California is not permitted to write a prescription for antibiotics in New York?

    C. Terence Lee ( MD / FACOG )

    • jsmith

      New York needs the license money.

    • pj

      Because specialty boards think alot like state gov’ts. Pls see my post below.

  • Visitor

    You are simplifying too much the number of tests we take. Don’t forget about USMLE Step 1 taken after the basic science years, Step 2 Clinical Knowledge and Clinical Skills taken before graduation plus the Step 3 exam that you mentioned. 4 National exams needed to qualify for a medical license, not just one year of GME.

  • soloFP

    It amazes me how many docs list themselves as board eligible, but never get board certified. Even more perplexing is how docs advertise that they are board certified but then do not maintain their certification. Patients should look up the certification status of their doctors, as board certification is a quality indicator.

    • pj

      Pure propaganda for the Am. board of medical specialities. For the other side of this point, pls see

      tinyurl.com/4gzpwru

      Physicians Practice editor Bob keaveny wrote an excellent series on the disingenuous nature of certification. Too many good points to reiterate here. One ex.- If BC is so critical to quality care, why were so many older docs allowed to grandfather (become certified without ever completing a residency) in?

      I put little faith in the integrity of the BC process. Why? The requirements for BC in some specialties are not just academic and moral, (complete the residency and be a good citizen) but political! E.g. one board requires the applicant to be a member of the AOA for the past three years. Paying membership dues has NO bearing on how “good” a Doc is.

      If I finished a residency and discovered a cure for all cancers, I would not be allowed to take the BC exam since I am not a member of the AOA.

      Perhaps the best argument against BC as a requirement for a successful practice- and believe me, it it TOUGH to practice without it as more and more insurance plans and employers buy into this nonsense- is Mr. Keaveny’s question- “Who certifies the certifiers? What makes them more qualified than those being examined by them?”

      Reminds me of cops who often drive 95 mph on the interstate but God forbid if they catch US doing that.

      • http://fertilityfile.com IVF-MD

        Agreed. Continued learning is something that doctors WANT to do, especially in a free market where we need to be skilled and up to date in order to keep patients wanting to see us.

        The re-certification process is not based on knowledge and skills of being a good doctor, but more on obeying the lessons of the board. It takes up a lot of our time that could best be used taking care of patients. It’s always been tempting to let the certification expire, but there’s always the threat that we would no longer be allowed to see patients if we don’t play along.

        • pj

          Just one more reason for going cash only.

  • DOBob

    There is a caveat on the ABMS site that says”

    “Reports (of credentialing) provided by this service are not accepted by The Joint Commission, NCQA or URAC to verify physician credentials because no dates are supplied.”

    The message comes up after you’ve searched a doctor’s name.

  • Anil

    Wow, it must be a lot of work. But, still there are millions writing the GMAT every year, millions going to the carribean med schools, millions coming in from foriegn medical schools to pursue residency who have to go through the above said exams. Don’t understand Whyy??
    There are doctors who are leaving there practices, students struggling to pay back their loans even after years of practice. Is it the immense respect you get to be a doctor that is enticing so many, I don’t think so I hear every one of my family & friends who have only harsh words for their doctors.
    This is a mystery? If it is the money, then listen to this, there are 101 proffessions/businesses where you will reach the 150k target within 5 years of work, with good lifestyle, party & family life. And, you don’t have to re-certify, study , do night shifts,calls, weekends and still expand your business even international & even become a billionaire which I think anyone as a “doctor” ever was capable….

  • gioacchino aj patuto,MD

    our european counter parts could give a hoot about american board certification!
    show me the compassion and handson and i would let any physician take care of me or my family…
    dr. without borders and beyond——

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