Today there are basically three methods of recognizing, formally and publicly, professional competence to provide medical services to the public. These consist of receipt of the MD degree, acquisition of a license to practice medicine, and certification by a specialty board. The historical development of these methods of recognition is a fascinating and almost incredible story, documented most effectively by Shryock.1 The history of this development displays degrees of parochialism by medical educators, practitioners, and administrators alike that could easily deter the most sanguine advocate for change from proceeding with any realistic analysis of existing conditions and recommendations for improvement. If the medical profession intends to keep its own house in order, however, it must recognize the changing significance of the MD degree, state licensure, and board certification. Adaptation to the changes is essential if these awards are to be meaningful to the individual, the profession, and the public.
Holden WD. Specialty Board Certification as a Measure of Professional Competence. JAMA. 1970;213(6):1016–1018. doi:10.1001/jama.1970.03170320044009
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