To pursue any type of board certification, notes Randall K. Roenigk, M.D., "A physician must go through a training program that's accredited by the ACGME, which is the main accrediting body in U.S. medicine."
Dr. Roenigk is professor and chairman of dermatology at the Mayo Clinic, Rochester, Minn.; president of the American Board of Dermatology (ABD); and chairman of the ABD Residency Review Committee for dermatology.
ACGME certification has always been coupled with accredited training, he notes.
"In other words," Dr. Roenigk says, "when the ACGME accredits a program, it's looking at whether the program is good enough to be training people."
Certification applies to individuals — and not all will make the grade.
"Not everybody who finishes an accredited program will pass the test," but it's a full-circle process, Dr. Roenigk says.
"The ACGME defines a body of knowledge that's to be taught, and the American Board of Medical Specialties (ABMS) gives examinations to certify to the public that these people have mastered or become competent in the body of knowledge."
The ABD administers certifying exams in dermatology, including exams for general dermatology, dermatopathology (in conjunction with the American Board of Pathology) and pediatric dermatology, he says.
In 2003, says Dr. Roenigk, "The ACGME determined that there was enough structure to the surgical subspecialty and a sufficient body of knowledge that the ACGME would recognize the subspecialty and accredit these programs."
Before the ACGME began accrediting procedural dermatology fellowship programs, he says, surgical training occurred in widely varying settings, from healthcare institutions to physicians or physician groups offering fellowships through their academic departments or private offices.
For the surgical subspecialty's first three decades, "Training requirements were somewhat diverse and not well-regulated," except for those approved by the American College of Mohs Surgery, a professional society which seeks to strengthen and standardize the subspecialty, Dr. Roenigk says.
The ACGME is not a professional society, but a nongovernmental organization whose mission is to serve and protect the public with regard to medical education, he emphasizes.
"The ACGME is overseen by the government, the public and other groups, and has standards that are cross-checked" by experts inside and outside the medical field, Dr. Roenigk says. "That's distinctly different from a group of doctors just training their own fellows."