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Board Certification: What does it really mean and what should I look for?

Many patients interested in facial rejuvenation surgical procedures have heard, read or been instructed to look for and to be treated by only board certified facial plastic or plastic surgeons.  But, for most people this requirement can be quite confusing and raise certain questions, such as what does it really mean to be board certified and are all board certifications the same?  To better appreciate the importance of board certification an understanding of the path your surgeon has taken to become board certified is very helpful and informative.  This is especially so when considering facial rejuvenation surgery. 

To become eligible for board certification a doctor/surgeon must meet several strict requirements.  First, he or she must graduate from an accredited medical school, which is typically a four year commitment that follows graduation with a degree from a four year college or university.  Following completion of medical school, the doctor must then successfully complete a “residency” in a specific field of medicine or surgery, which they tyically decide upon during his or her final years of medical school.  Most surgical based residencies are 5 years in duration.

A residency can be thought of as on-the-job training following medical school.  For example, a person interested in infants and children may elect to do a 3 year residency in pediatrics, in order to prepare themselves for a career as a pediatrician.  Likewise an interest in pregnancy and birth may lead to a four year residency and career in obstetrics and gynecology (OB/GYN).  A doctor interested in surgically treating conditions and aesthetics exclusive to the face and neck would complete a five-year surgical residency in Otolaryngology-Head and Neck Surgery.  After this residency those interested in obtaining more intensive experience in facial aesthetic surgery would then go on to complete a one-year AAFPRS accredited fellowship in facial plastic surgery.  Dr. Miller followed this path.     

In general, only after successful completion of a residency, with or without a fellowship, can a doctor seek board certification.    Board certification requires intensive oral and written examinations, which are now required to be completed again every 10 years**.  Each specialty has its own recognized board with their own specialty specific questions, examinations and requirements, (e.g., American Board of Dermatology for dermatologists, American Board of Obstetrics and Gynecology for obstetricians and gynecologists, American Board of Ophthalmology for ophthalmologists, American Board of Facial Plastic and Reconstructive Surgery for facial plastic surgeons, etc.). 

As a result, a doctor seeking board certification in obstetrics and gynecology would not be asked questions or be tested for competence in facial plastic surgery but would instead be asked only questions regarding their own specialty (i,e., OB/GYN).  Similarly, a doctor seeking board certification in facial plastic surgery would be examined on his or her training in facial plastic surgery.  Furthermore, the facial plastic surgeon candidate must meet other requirements, such as having their surgical records examined by other facial plastic surgeons and be board certified in another surgical specialty such as otolaryngology-head and neck surgery or general plastic surgery.  Dr. Miller is double board certified.

After successful completion of these stringent requirements and examinations, a doctor can state or advertise that he or she is board certified, but only in their particular specialty (e.g. Dematology, Pediatrics, Internal Medicine, Ophthalmology, etc.).  Therefore, a board certified dermatologist or ophthalmologist can not legally represent themselves as board certified in facial plastic surgery or plastic surgery because of the stringent rules governed by the Medical Board of California.  Unfortunately, some physicians or surgeons will only state that they are board certified, thereby disingenuously letting the consumer assume they are referring to board certification in facial plastic or plastic surgery when offering aesthetic surgical procedures.  Moreover, some doctors are DOs (Doctor of Osteopathic Medicine), which is different than an M.D., and DOs have a totally different medical board overseeing their standards, it is not the Medical Board of California. 

Consequently, the only doctors (M.D.'s) in California who can state that they are board certified in facial plastic surgery or plastic surgery, by the guidleines set forth by the Medical Board of California, are those who have become board certified by the American Board of Facial Plastic and Reconstructive Surgery or the American Board of Plastic Surgery.  Therefore, knowing what type of doctor (M.D. vs. D.O.) and what board certification your doctor has achieved is important, especially when considering facial plastic surgery.  Click here to read what boards certifications are recognized by the Medical Board of California.  Of note, the Amercian Board of Cosmetic Surgery is not recognized by the Medical Board of California and can not be legally advertised by those members in the state of California (e.g., board certified in cosmetic surgery).  

** Dr. Miller has successfully passed the examinations and met the 10 year re-certification requirements for both his board certifications.  Interestingly, those surgeons with residency and fellowship training completed prior to 2001 do not, (by rule), have to undergo the intensive re-certification process, but many respected surgeons do anyway because of the ever changing field of facial plastic surgery.  Consequently, this is an invaluable requirement to look for and ask questions about when seeking facial plastic surgical procedures.  

 

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Dr. Timothy R. Miller