The medical board certification process
1. After graduating from an accredited medical school either in the US or abroad, the physician must pass a number of licensing exams. Under the auspices of the “National Board of Medicine,” doctors take either the FLEX exam or the USMLE exam, a three-part exam.
2. The doctor then applies for a provisional license to practice while undergoing further training in a residency program. Toward the end of their first year of training, the internship, the doctor can take the third part of the MLE exam and become licensed by a state to practice medicine and surgery, after showing appropriate transcripts, letters of recommendation, etc.
So after one year of training after medical school, the doctor can hang up a shingle as a “doctor”!
3. Most plastic surgeons in practice today trained another four years after their internship in a specialty, such as general surgery, ENT or orthopedics. That makes five years total before starting plastic surgery. Some surgeons actually take the exams in the “preliminary specialty” to become board-certified in, say, ENT before starting plastic surgery training.
4. After the preliminary training, plastic surgeons begin a residency/fellowship in plastic surgery that lasts 2-3 years. That makes eight years total after graduating from medical school.
5. The plastic surgeon then begins the process of board certification. Each medical specialty has its own rules and regulations. For plastic surgery, there is a two-part process administered by The American Board of Plastic Surgery.
a. A written exam during the residency/fellowship.
b. An oral examination that includes a review of multiple patient files where the examiner asks you why you treated the patient a particular way, etc. This exam is taken two years after the plastic surgeon has started practicing. During these two years, the surgeon is “board-eligible” until they pass the oral exam. Some surgeons (20%) never pass and remain board-eligible for a number of years until their eligibility runs out. If they want to try again, they have to do another residency in plastic surgery and start all over!
6. Your board-certified plastic surgeon gets a certificate that is good for only 10 years. Also, to maintain their certification, there are checks on their practice and performance during that decade imposed by The Board of Plastic Surgery. There are also requirements for CME (continued medical education) that must be fulfilled for both The Board of Plastic Surgery AND the state licensing authority (the board of medicine of the state).
7. Re-certification occurs after the initial 10 years. At this time the plastic surgeon chooses to be examined on their area of expertise, be it cosmetic surgery, craniofacial surgery or general plastic surgery. The written exam leads to another certification for ten years.
So when your plastic surgeon says he or she is board-certified in plastic surgery, it really means something!
Confusion in board certification
A great deal of confusion arises when doctors performing cosmetic surgery who are certified in other specialties like internal medicine or ENT call themselves “board-certified.” These physicians are not being truthful in their advertising. The consumer assumes that they are board-certified in plastic surgery—not ENT, dentistry, dermatology or anesthesia!
Another source of confusion and trickery is practiced by doctors who belong to and advertise being certified by bogus medical boards. The American Board of Cosmetic Surgery is one such “board.” This group is not recognized by The American Board of Medical Specialties, the governing organization that monitors all proper board certification procedures.
To be a board-certified cosmetic surgeon you just pay a fee. To be a board-certified cosmetic plastic surgeon you pay with years of your life.
2020- and nothing has changed. More non plastic surgeons are performing plastic surgery procedures and the public remains ignorant.