You don't have to be board certified in order to practice medicine.
You must be licensed to practice but you don't have to be board certified.
Let's go back to basics for a moment...
In order for a doctor to be licensed to practice medicine in New York he has to go through four years of college.
Once he graduates and applies for licensing in NY, he will receive his license to practice.
But just like when your 17 year old gets their drivers license, it doesn't mean they're a great or even a good driver yet.
It's just a license to practice.
A new medical school graduate then goes on to do post-graduate training.
Typically, it's just called a 'residency' now.
Some people refer to their residency as post-graduate year 1, 2, 3, etc.
Or as PGY 1, PGY 2, etc.
A residency means a young doctor is now in training to learn a specialty.
It might be surgery.
It might be dermatology.
It might be cardiology.
These doctors-in-training are supposed to be supervised by senior attending physicians at the hospital.
That's how they learn the standard of care.
That's how they learn what to do and importantly what not to do.
A doctor doing his residency training works for a hospital.
They are an employee of the hospital.
In the 'old days' residents would work 36 hours shifts and then have 12 hours off.
Working straight 36 hours.
Is it possible?
But since the old timers trained that way, of course that's how the young un's had to do it.
Well, all that changed after a case involving the death of a girl known as Libby Zion in New York City.
After that highly publicized case which was tried by high profile New York medical malpractice trial attorney Tom Moore, the law in New York changed for doctors.
These young doctors-in-training, these residents, would no longer be working 36 hour shifts.
Now, it's a maximum of 24 hours on.
If that time frame is violated, both the residency program and the hospital can suffer financial penalties.
The number of years a doctor trains varies depending on which specialty they go into.
Internal medicine is three years.
Surgery is five years.
Some doctors even choose to do additional years of training known as fellowship training.
These are super-specialty training programs that are often highly competitive to get into.
They can last one to three additional years.
What that really means is that now they have completed almost all the prerequisites to take their board certification exams.
Basically, becoming board certified is the highest certification a physician can obtain in his specialty.
It establishes the basic standards of care for a doctor in that specialty regardless of where in the United States he practices.
It used to be that the standard of care for a small rural town would be different than a busy metropolitan city like New York City.
Now, virtually all doctors strive to become board certified.
Let's recap for a moment...
A doctor's schooling starts with college, then medical school, then residency training and possibly fellowship training.
Once they finish their residency it's now time for them to go into practice.
Some will go into private practice.
In order to qualify to take the exam, these newly minted doctors must first practice in their specialty for two years.
This gives them time to get their feet wet and to experience different types of cases and patients with medical problems related to their specialty.
During these initial two years, a doctor must keep track of those cases and those patients.
This list will be submitted to the board examiners.
The examiners want to see what kind of patients they've been seeing.
They want to see how these patients were treated.
They want to see the young doctor defend their treatment plans and progression of the patient's medical problem.
There are often two parts.
The first is written.
The second is the oral exam.
The oral examination is given by one or more highly experienced physicians in that specialty.
These questions lead the young doctor to think on his feet and take him into many 'what if this were done' scenarios.
"If the patient had this problem, what would you then do?"
"What if instead, he had presented with this problem. Would you treat him differently?"
A doctor must pass both parts in order to achieve board certification status.
If the doctor passes his board certification exam, he is then awarded the title of "Diplomate of the American Board of..." whatever specialty that is... Emergency Room Medicine, Surgery, Radiology, Gastroenterology, Obstetrics & Gynecology, etc.
Can a doctor practice medicine in New York without becoming board certified?
The answer is yes.
However, the majority of doctors want to show their patients and the world that they have the knowledge and experience that enables them to achieve the highest level of certification in their medical field.
One final comment worth noting.
It does NOT mean he has the most experience handling a specific type of medical problem.
Nor does it mean he's perfect.
It simply means that through his schooling, his education and training that he has learned the basic standards of medical care for his specialty and has achieved board certification status.
You should know that there are plenty of doctors who have been sued who are board certified.
Likewise, being board certified does not insulate you from liability for doing something wrong and causing harm to a patient.
If you were careless on a particular day and that carelessness caused harm to your patient, you will be held accountable for your actions.