Board Certification is Gaining Ground Across All Healthcare Professions

Post-licensure board certification was first discussed in medicine in 1908, as physicians worked to establish a way to elevate standards in medical practice and ensure highly trained and competent practitioners.  In 1933, the American Board of Medical Specialties (ABMS) was officially established with four founding member boards: Ophthalmology, Dermatology, Obstetrics & Gynecology and Otolaryngology. Since that time, ABMS has grown to 24 member boards, with the American Board of Medical Genetics and Genomics the last added board in 1991.

Initially, physicians were certified following formal training and retained that certification throughout their career. In 1968, recertification was introduced as a method for measuring continued competency as practitioners moved further away from formal training and education. In the 1990’s, concern for ongoing quality care and patient safety started to grow. Research pointed to several factors, including physician specialization, which limited exposure to broader advancements in medicine, and loss of fundamental knowledge outside of a focused practice area. To address this concern, Maintenance of Certification (MOC) was introduced in the year 2000.

As new programs continued to develop in medicine, board certification began to take hold in allied health professions as well. Dentists, orthodontists, nurses, physical therapists, physician assistants, pharmacists, podiatrists, optometrists and others have established board certification programs to ensure providers are meeting established practice standards and keeping up with contemporary knowledge and skill.

While each organization develops their own standards and requirements, the goal of assessing knowledge and maintaining competence through lifelong learning is shared by all. Similarities in program structure and requirements are also common among the different healthcare boards. At its core, participation in MOC demonstrates that standards of knowledge, clinical skills, and professionalism, as measured by certification, continue to be met.

With mounting evidence that supports the value of board certification, the number of board-certified providers across all health care professions is growing. Board-certified providers are recognized and sought after by the public as an assurance that they will receive quality care. Similarly, healthcare organizations seek board-certified providers to ensure highly trained and competent staff. Twenty years ago, the number of board-certified healthcare professionals outside of MDs was minimal. Today that is no longer the case.

ABMS reports an increase of over 10% in the number of board-certified physicians since 2016. As of October 2024, a record 997,864 physicians and medical specialists are certified by an ABMS member board, representing approximately 87% of practicing US physicians.

But even more impressive is the growth in numbers among non-ABMS boards. These boards represent the many allied health professions where board certification numbers haven’t traditionally been high. As a sampling of certification growth among non-ABMS boards:

• The National Commission of Certification for Physician Assistants (NCCPA) reports a 76.1% increase in the number of certified physician assistants in the last decade.
• The Board of Pharmacy Specialties (BPS) reports growth from 3,004 board certified pharmacists in 2008 to 41,802 board certified pharmacists in 2020. Growth is projected to reach over 62,000 by the end of 2025. Residency-trained pharmacists account for a little under 51% of those board certified.
• The American Board of Podiatric Medicine (ABPM) reports significant growth from 3,289 Diplomates in 2016 to over 6,000 Diplomates in 2024, representing over 40% of podiatrists in the US. The ABPM is one of two board certification organizations recognized by the Joint Committee on the Recognition of Specialty Boards (JCRSB) and the American Podiatric Medical Association (APMA).
• The American Board of Orthodontics has reached a high participation with over 33% of all practicing orthodontists board certified and over 65% of American Orthodontic Association (AAO) orthodontists board certified.
• The American Board of Physical Therapy Specialties Certification has seen the number of physical therapists taking a certification exam increase from a total of 399 in 2000 to 1,933 in 2015 and 2,672 in 2024. In total, there are over 40,000 board certified physical therapists in the US.

Despite the surge of board-certified providers across healthcare professions in recent years, optometry remains slow to adopt this standard credential for quality care. The American Board of Optometry has experienced a definite uptick in the number of candidates seeking board certification from specific areas, including residency-trained ODs, young ODs (less than 5 years out of school) and ODs employed by large healthcare organizations. However, the optometric profession in general has not embraced the voluntary process of a structured, lifelong learning and assessment program.

Other healthcare professions have accepted the commitment of professional self-regulation that board certification represents – an assurance to the public that healthcare practitioners are held to rigorous, peer-established standards of knowledge, skills, and ethics. If optometry intends to retain parity with other healthcare professions, perhaps it’s time to make this same commitment to self-regulation.