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September 20, 1976

Credentials vs Incompetence

Author Affiliations

President American Board of Internal Medicine Portland, Ore

JAMA. 1976;236(12):1353. doi:10.1001/jama.1976.03270130017011

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To the Editor.—  In his commentary (235:1849, 1976), Dr Aring and Dr Wolf, in an editorial, suggested that specialty boards be phased out. The readers of The Journal should understand that standard-setting need not standardize and that examinations do not equal certification.Certification is a process that now extends far beyond an examination. Qualifications for admission to examinations include not "much the same training" for all candidates but a diversity of training in a variety of hospitals with varying emphases on basic science and general internal medicine and its subspecialties. The Board's requirements represent a minimum, and the training of many candidates transcends that minimum. Moreover, in North America, training programs are required to meet the published guidelines of residency review committees, and they are subjected to external accreditation at regular intervals. To reduce rigidity and increase flexibility, many boards are generous in their acceptance of the diverse training and