We consistently advise consumers to select physicians who are “board certified,” and we report on board certification status in our ratings of doctors here at Checkbook.org.

What does board certification mean, and why is it important?

Care, diagnosis, and treatment are broken down into more than 100 medical specialties and subspecialties. Overseeing the profession’s education standards and assessments of knowledge, skills, and clinical judgment in those specialties are at least three certifying organizations: The American Board of Medical Specialties (ABMS), the American Board of Physician Specialties (ABPS), and the American Osteopathic Association.

Board certification is different than getting a medical license. In the U.S., a physician can only practice medicine if they receive a state license. Rules vary by states, but generally doctors obtain a license by demonstrating they have received graduate medical education, have pursued as many as seven years of supervised in-practice training, and have passed a state medical board test. (All states have their own medical boards with varying requirements. Physicians may only practice in states where they are licensed). The Federation of State Medical Boards directs state board licensing standards and assessments.

Specialty board certification is voluntary. It goes one step beyond obtaining a state medical license and signifies that a physician is engaged in continual learning efforts to care for patients. Around 90 percent of the nation’s 1.1 million physicians obtain a board certification, according to ABMS, the largest organization overseeing physician certifications.

ABMS represents 24 specialty boards, such as the American Board of Internal Medicine (ABIM), which certifies a doctor has met the knowledge and training requirements for internal medicine; the American Board of Neurological Surgery, which certifies a doctor has the skills and knowledge to practice brain surgery; and the American Board of Family Medicine, which certifies a physician has the skills to provide primary care services, including preventive and mental health care plus healthy lifestyle counseling.

Board certification matters to patient safety. Many studies have found that doctors with board certifications experience fewer disciplinary actions and that patients have fewer medical complications, says Furman S. McDonald, M.D., MPH and CEO of the ABIM. “Patients get better care if their doctor has more medical knowledge … and we see that with certification,” he says.

Each specialty board has its own programs and requirements for initial and continuing certification. Generally, they require physicians to demonstrate that they are up to date in their knowledge and skills to practice their specialty, adhere to professional standards, and are engaged in improving the quality, safety, and value of their care.

As Robert Oshel, Ph.D., a medical malpractice researcher and advisor for Public Citizen’s Health Research Group puts it, board certification matters because “you don’t want a plastic surgeon doing heart surgery. You want an expert in cardiac surgery” and board certification ensures that the physician has that expertise.

Patients can verify a physician’s certification status by searching at Certification Matters, a database maintained by ABMS, the American Board of Physician Specialties website, or, for doctors with osteopathic medical degrees, by checking the website of the American Osteopathic Association. Patients can also search the Federation of State Medical Board’s database for physician certification information.

How often must doctors update their certification?

After attaining board certification, physicians used to keep it for life. But, beginning in 2000, most ABMS boards began implementing “maintenance of certification” programs, which require physicians to participate in regular training and assessments to keep their certifications. (Some specialty boards launched their maintenance of certification programs as much as a decade earlier.) The aim is for doctors to stay current with evolving science and changes in diagnostics, treatments, and practices related to improving patient care. ABMS specialty boards vary in whether they offer the option of either requiring doctors to sit for one in-person test periodically or participate in continuous learning programs throughout the year.

By 2007, most of the medical specialty boards had adopted maintenance of certification requirements for doctors seeking certifications. But physicians who received certification prior to these new requirements can hold on to their lifelong certifications, and aren’t required to take part in board specialty trainings or tests to keep it—although many voluntarily do so.

According to ABMS, about 75 percent of currently practicing physicians participate in maintenance of certification programs.

What is involved in getting and maintaining board certification?

Each specialty board has its own process, which generally includes a mix of continuing education credits, question-based assessments customized to a physician’s specialty, peer reviews, and practice-improvement modules, such as participating in a laboratory simulation of care. For some boards, like Obstetrics and Gynecology, a physician must also have hospital privileges (meaning the right to admit a patient to a particular hospital) to maintain certification.

Most specialty boards also offer their physicians an option of “longitudinal knowledge assessments,” which can involve taking online tests multiple times a year (every quarter, four months or six months, depending upon the board) instead of sitting for one extended on-site, in-person test. The goal is to encourage physicians’ continual learning about the latest care practices, treatments and diagnoses.

For example, physicians certified by the American Board of Internal Medicine can choose to answer 30 assessment questions quarterly to maintain their certification instead of sitting for an in-person test every 10 years.

Requirements to maintain certification have been controversial among some doctors who argue the process is onerous and aimed at making money for the profession’s specialty boards rather than one that improves care.

After a decade of review and discussion, ABMS determined that continuing certification requirements and longitudinal knowledge assessments remain the best way to ensure physicians remain “current in medical knowledge; prepare them to address emerging medical and public health issues and help them identify and address opportunities for improvement within the systems in which they work,” said Greg Ogrinc, M.D., M.S., and ABMS’ senior vice president, certification standards and programs and clinical professor of medicine and medical education at the University of Illinois College of Medicine in Chicago.

Does specialty board certification results in better medical care?

According to ABMS, studies show physician knowledge and clinical skills decline over time. Without continual learning, many doctors have difficulty staying current with the accelerated pace of medical science and some physicians may not follow recommended care guidelines for patients, studies show. Requirements for maintaining certification aim to address those potential challenges to patient care.

Research shows board-certified physicians are subject to fewer disciplinary actions by a state medical board, said ABMS. Another set of studies found that doctors participating in continual learning required for maintaining certification were more likely to adhere to recommended clinical guidelines and treatment protocols and were better at managing patients with diabetes, asthma, and coronary disease. They were also less likely to prescribe inappropriate medication to patients and were more accurate with their diagnoses.

When looking for a new doctor, is checking on a doctor’s board status enough?

No. Since most doctors are board certified, patient safety experts say you should seek additional information, including whether the physician has hospital privileges and if the physician has been subject to any disciplinary actions.

“The first thing I would do if you were looking for a new doctor is see if the physician has had any disciplinary action anywhere,” said Public Citizen’s Oshel. “Physicians can get into trouble in one state, move to another, not tell the new state board” and get licensed there.

Oshel recommends going to the Federation of State Medical Board’s database, which maintains state medical licensing and disciplinary information as well as professional background and licensing history to find out that information. Hospitals also usually conduct additional vetting information before they grant a physician admitting privileges, adding one more layer of scrutiny to a doctor’s background, Oshel said.