The training of a specialist begins after the doctor has received the M.D. degree from a medical school, in what is called a residency. Resident physicians dedicate themselves for three to seven years to full-time experience in a hospital or ambulatory care setting, caring for patients under the supervision of experienced teaching specialists. Educational conferences and research experience are also part of that training. A doctor in training to be a specialist is called a resident, although the first year of residency used to be called an internship.
In each state, the privilege to practice medicine is governed by state law and is not designed to recognize the knowledge and skills of a trained specialist. The physician is licensed to practice general medicine and surgery by a state board of medical examiners after passing a licensure examination. Each state has its own examining procedure to license physicians, and this board sets the general standards for all physicians.
Who Credentials a Specialist and/or Subspecialist?
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 subspecialist 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:
- Completion of a course of study leading to the M.D. or D.O. (Doctor of Osteopathy) degree from a recognized school of medicine.
- Completion of three to seven years of full-time training in an accredited residency program designed to train specialists in the field.
- 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.
- Most specialty boards require that the person who seeks certification has an unrestricted license to practice medicine in order to take the certification examination.
- 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.
- 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.