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FAQ: Diplomas, Degrees, and Board Certification: Page 1 Note: This 5-page essay is a chapter from an as-yet-unpublished book that Dr. Denenberg has written on how to find a competent plastic surgeon. "If your doctor is a board certified plastic surgeon, you are assured that he is highly skilled and can give you the results you desire." Have you ever run across that advice in a magazine article? Well, don't believe it: it's not true. Surprised? Every magazine article, newspaper report, and advertisement about plastic surgery mentions the issue of board certification, so it's crucial that you understand why that frequently-heard assertion is false. In this essay, we'll discuss the boards, academies, and institutions that you see on diplomas, in articles and in advertisements. You'll learn what they mean to you in your search for the right plastic surgeon. The road to board certification To understand board certification, you should first learn a little about how a surgeon is trained. After college, a future doctor enters medical school. Four years later, the med student receives his M.D. degree. He is now able to call himself a "doctor" or a "physician," and to sign his name with an "M.D." He is not yet ready to practice surgery. The new physician will then enter a one-year internship, during which he continues his study of medicine and surgery at a university. The "intern" is closely supervised, and he is not in private practice. He does not yet have his own patients. During medical school and internship, the physician takes a series of examinations. He must pass these exams in order to obtain a license to practice medicine and continue with the next step in his education, the residency. During the residency, the doctor receives detailed instruction in his primary field of surgery. We now call the doctor a "resident physician," or simply a "resident." It has nothing to do with where he lives. He is still at the university, and he is still learning how to care for patients, but now he is more advanced in his knowledge, in his final stage of training. The residency can last longer than medical school! If the doctor successfully completes his residency, he graduates (without receiving another degree), leaves the university, and may now hang out a shingle and practice his field of surgery. (We jokingly say that he is now an "R.D.," a "real doctor.") He can have his own office, his own practice, his own patients. He is not yet board certified. He does not have to be board certified to practice medicine; he just needs to have successfully completed his residency training. In fact, many of the certifying boards require that a doctor practice in his field of surgery for a year or two before he will even be allowed to take the board certification exam. Some doctors will take another year or two of training after the residency. This additional training is called a fellowship, and its purpose is to sharply hone the doctor's skills in one highly-specialized area of surgery. For example, an orthopedic surgeon might take a fellowship in surgery of the hand. Or in the field of cosmetic surgery, a doctor might take a fellowship in plastic surgery of the face. After the doctor has completed his residency, he is ready to take the board certification exam in his field of surgery. For example, a doctor who completed a neurosurgery residency would take the exam given by the American Board of Neurosurgery. Most boards have both written exams and oral exams, given at different times of the year, and the doctor must pass both exams in order to receive his certification. A doctor is not a "member" of a board; he is "board certified" by the board. He is also called a "diplomate" of the board. Diplomate doesn't mean that he's an ambassador; it means that the certifying board has given him a diploma for passing the exams. 
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