Most patients seeking plastic surgery are aware that they should look for "board certification" among the credentials of their plastic surgeon. Many, however, are not aware of exactly what this means. There are many types of different boards and certifications. Furthermore, most patients are surprised to learn that any licensed medical doctor, regardless of training, can legally perform plastic surgery and call her or himself a plastic surgeon. There is minimal regulation in advertising, and doctors can advertise themselves as a plastic or cosmetic surgeon, regardless of the training, skills, and background. There are several states like California that are trying to regulate this through legislation. Numerous doctors listed under the title of "Plastic and Reconstructive Surgery" in the yellow pages have not completed an approved residency in plastic surgery. When you consider plastic surgery, my intention is that the following information will help you to better evaluate the board certification information and choices given to you.

Specialty boards certify physicians as having met certain published standards. There are 24 specialty boards that are recognized by the American Board of Medical Specialties (ABMS) and the American Medical Association (AMA). Remember, a sub-specialist first must be trained and certified as a specialist.

In order to be certified as a medical specialist by one of these recognized boards, a physician must complete certain requirements. Generally, these include:

1. Completion of a course of study leading to the M.D. or D.O. (Doctor of osteopathy) degree from a recognized school of medicine.
2. Completion of three to seven years of full-time training in an accredited residency program designed to train specialists in the field.
3. Some specialty boards require assessments of individual performance and competence from the residency training director, or from the chief of service in the hospital where the specialist has practiced.
4. Most specialty boards require that the person who seeks certification has an unrestricted license to practice medicine in order to take the certification examination.
5. Some boards require that the doctor has a period of experience in full-time practice in the specialty prior to examination for certification, usually two years following training.
6. Finally, each candidate for certification must pass a written examination given by the specialty board. Fifteen of the 24 specialty boards also require an oral examination conducted by senior specialists in that field. Candidates who have passed the exams and other requirements are then given the status of Diplomat and are certified as specialists. A similar process is followed for specialists who want to become sub-specialists.
   Some boards issue certificates for a limited period of time, usually seven to ten years. In order to retain certification, Diplomats of those boards must become re-certified, and must periodically go through an additional process involving continuing education in the specialty, review of credentials and further examination. Some boards that may not require re-certification have provided voluntary re-certification with similar requirements.

The Purpose of Certification

The intent of the certification process, as defined by the member boards of the American Board of Medical Specialties, is to provide assurance to the public that a certified medical specialist has successfully completed an approved educational program and an evaluation, including an examination process designed to assess the knowledge, experience and skills requisite to the provision of high quality patient care in that specialty.

Many years ago the American Board of Medical Specialties (ABMS) was set up as a national agency to regulate, establish standards, and govern the different medical fields and sub-specialty boards. Over the years more than 100 boards have requested certification from the ABMS, but only 24 have met their strict educational and examination criteria. These specialty boards are as follows:

The American Board of Plastic Surgery is the evaluating body that is responsible for determining and evaluating the training and certification of plastic and reconstructive surgeons. It is the only plastic surgery board approved by the American Board of Medical Specialties at this point in time.

In order to become certified by the American Board of Plastic Surgery, a surgeon must first complete an approved residency in surgery other then plastic surgery. The surgical training can be in either general surgery or otolaryngology. General surgeons may be accepted after three years of training. But be aware that to complete training in General Surgery five years is required. So, you may want to inquire if your plastic surgeon has other board certifications, such as in General Surgery or Otolaryngology, or if they just did the minimum required to enter a plastic surgery training program. Dr. Romano for instance is double board certified because he completed a full five years of training in General Surgery before beginning Plastic Surgery residency. Training in Plastic Surgery is then two or three years and may involve fellowships for six months or even a year after that. After being in practice a minimum of two years, applicants are then required to pass a rigorous written qualifying examination, and if this is passed, an oral certifying examination is taken a year later. The board and plastic surgery society continually monitors their members. Applicants may fail the exam and are allowed to retake it many times after. You may want to inquire from your doctor how many times he or she took the exam or if they passed the written and the oral on their first attempt.

There are other surgeons who have the ability and experience to perform certain aspects of cosmetic surgery that they may have been specifically trained to do. For example, otolaryngologists (Ear Nose and Throat specialists) perform nose surgery, hair transplant surgery, and facial plastic surgery; Ophthalmologists (eye specialists) may perform eyelid surgery; and specially trained dermatologists do dermabrasion, laser skin surgery, and more recently, liposuction.

There are also boards other than the American Board of Plastic Surgery which provide certification for other surgeons who perform cosmetic surgery. A few of the boards, which are not certified by the American Board of Medical Specialties (ABMS), include:

• Facial Plastic and Reconstructive Surgery
• Oculoplastic Surgery
• Dermatological Surgery
• Cosmetic Surgery
• Oral and Maxillo Facial Cosmetic Surgery
• Liposuction Surgery

Simply being "board certified" can have a variety of meanings. By knowing exactly which board has certified your surgeon, and whether or not the American Board of Medical Specialties recognizes that board, you will better understand your surgeon's training and qualifications.

• You may call the ABMS at 1-800-776-2378 to see if the American Board of Plastic Surgery certifies your surgeon. Give them the name of your physician or surgeon and they will tell you if and when he or she is certified by the plastic surgery board of the ABMS. Visit their website at www.certifieddoctor.org
• You can also find the names of board certified plastic surgeons, listed by state and city, in the Directory of Medical Specialists, published by Marquis Who's Who, and available in most public libraries.
• You may also refer to the American Society of Plastic Surgery or their website for this information. Call 1-800-766-4955 or visit their website at www.plasticsurgery.org 
  You may also access the website www.surgery.org  for more information.