Board certification is not something that can be legislated, because the value of board certification to those who wish to be certified, to providers, and to consumers depends on the autonomy of the certifier. Board certification should be recognized or unrecognized, depending on whether the certifier meets an established set of meaningful standards. By reviewing the proposed resolutions for this year's HOD, perhaps the concept of board certification can be better elucidated. For the first time in the history of the profession, students will enter residency programs this year that will not lead to certification. This arises because alternate pathways may not be available to these students.
Alternate pathways have a role to play in the development of new specialty boards.
The establishment of a new specialty board signifies the differentiation of a new specialty, which must be based on major new concepts in medical science. A new board first starts as a specialty society of the national organization, and when it applies to become a specialty board, it must establish its training, experience and testing criteria. If approved by the accrediting agency of the national organization, the new board may be permitted, in its initial years, to accept training, experience, or a combination of both, as equivalent to that acquired in accredited training programs. In other words, there may be an initial period of grandfathering and alternative pathways. There is a finite period of time, however, that this can be allowed, then access to the certifying board may only be through accredited training, experience and examination pathways.