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AOA Communication  |   March 2008
Osteopathic Certification Evolving Into a Continuous Certification Model
Author Notes
  • From the Departments of Obstetrics and Gynecology (Dr Ayres) and Psychiatry (Dr Scheinthal) at the University of Medicine and Dentistry of New Jersey-School of Osteopathic Medicine in Stratford, where Dr Scheinthal also serves at the New Jersey Institute for Successful Aging. Also from the American Osteopathic Association (AOA) Department of Education's Division of Certification and Trainee Services (Mr Ramirez and Ms Bell). Dr Ayres currently serves as chairman of the AOA Bureau of Osteopathic Specialists; Dr Scheinthal as vice chairman, and Mr Ramirez as secretary. 
  • Address correspondence to Armando F. Ramirez, BS, CAE, Department of Education, American Osteopathic Association, 142 E Ontario St, Chicago, IL 60611-2864. E-mail: aramirez@osteopathic.org 
Article Information
AOA Communication   |   March 2008
Osteopathic Certification Evolving Into a Continuous Certification Model
The Journal of the American Osteopathic Association, March 2008, Vol. 108, 159-165. doi:10.7556/jaoa.2008.108.3.159
The Journal of the American Osteopathic Association, March 2008, Vol. 108, 159-165. doi:10.7556/jaoa.2008.108.3.159
Abstract

Specialty board certification, though voluntary, has become an indispensable designation for many osteopathic physicians. The authors report rates of osteopathic specialty board certification and recertification for osteopathic physicians. Earlier this year, at the recommendation of the Bureau of Osteopathic Specialists, the American Osteopathic Association Board of Trustees approved the use of an osteopathic continuous certification model by member boards. This model firmly establishes osteopathic specialty board certification as an ongoing process that ensures physician competence and patient safety. The various components involved in the implementation of this new methodology are outlined, including practice performance assessment. As the healthcare environment continues to evolve, the American Osteopathic Association, the Bureau of Osteopathic Specialists, and the 18 osteopathic specialty boards continue to adapt to meet the professional needs of osteopathic physicians.

The Bureau of Osteopathic Specialists (BOS) (known as the Advisory Board of Osteopathic Specialists until 1993) was established in 1939 by the American Osteopathic Association Board of Trustees (AOA BOT) to assess the skills of osteopathic physicians (DOs) in response to the growth of medical specialization.1 The BOS is the authoritative body that develops, reviews, and enforces all policies and requirements for osteopathic certification as approved by the AOA. The Bureau views the certification process as an assessment tool, a method of enhancing healthcare quality, and a means of protecting the public. 
The AOA has 18 approved specialty certifying boards, each of which elects one representative to the BOS. The American Osteopathic Board of Radiology, the first approved certifying board, was established in 1939. Thereafter, additional certifying osteopathic specialty boards were created in response to the evolving needs of the osteopathic medical profession (Figure 1). Since 1939, the Bureau has issued a total of 30,529 general, special, and added qualification certifications. 
As of the end of December 2007, a total of 20,985 DOs have current certification from the AOA and hold a combined total of 24,029 active certificates. In 2007, a total of 984 certificates were awarded in specialty and subspecialty areas (Table 1) as well as 36 certificates of added qualifications (Table 2). In addition, 1267 recertifications were issued in 2007 (Table 3). 
Table 1
American Osteopathic Association: General Certification Awarded by Osteopathic Medical Specialty Boards, 2003-2007 *


Year
General Certification Awarded
2003
2004
2005
2006
2007
Adolescent Medicine00001 (<1)
Allergy and Immunology 1 (<1) 0 0 0 0
Anatomic Pathology0001 (<1)0
Anatomic Pathology and Laboratory Medicine 0 0 0 0 0
Anesthesiology15 (1)8 (1)20 (2)12 (1)12 (1)
Cardiology 11 (1) 26 (2) 4 (<1) 29 (2) 0
Child Neurology0001 (<1)0
Child Psychiatry 3 (<1) 0 4 (<1) 2 (<1) 3 (<1)
Dermatology10 (1)14 (1)18 (2)22 (2)20 (2)
Diagnostic Radiology 17 (2) 28 (3) 19 (2) 29 (2) 26 (3)
Emergency Medicine120 (12)104 (10)120 (12)118 (9)119 (12)
Endocrinology 1 (<1) 0 1 (<1) 0 0
Facial Plastic Surgery00000
Family Practice and Osteopathic Manipulative Treatment 435 (42) 445 (42) 343 (34) 391 (30) 338 (34)
Forensic Pathology00000
Gastroenterology 6 (<1) 9 (1) 3 (<1) 12 (1) 1 (<1)
General Vascular Surgery08 (1)7 (1)7 (1)3 (<1)
Gynecologic Oncology 1 (<1) 1 (<1) 1 (<1) 0 1 (<1)
Hematology02 (<1)05 (<1)0
Infectious Diseases 5 (<1) 3 (<1) 0 6 (<1) 1 (<1)
Internal Medicine157 (15)118 (11)155 (15)259 (20)58 (6)
Laboratory Medicine 0 0 0 0 2 (<1)
Maternal and Fetal Medicine2 (<1)001 (<1)1 (<1)
Neonatology 1 (<1) 0 0 0 2 (<1)
Nephrology9 (2)7 (1)3 (<1)4 (<1)4 (<1)
Neurological Surgery 1 (<1) 4 (<1) 3 (<1) 6 (<1) 5 (<1)
Neurology4 (<1)10 (1)1 (<1)20 (2)0
Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine35 (3)28 (3)62 (6)110 (8)43 (4)
Nuclear Medicine 0 0 0 0 0
Obstetrics and Gynecology53 (5)36 (3)50 (5)85 (6)85 (9)
Oncology 7 (1) 4 (<1) 5 (<1) 7 (1) 2 (<1)
Ophthalmology12 (1)10 (1)10 (1)11 (1)11 (1)
Orthopedic Surgery 44 (4) 72 (7) 55 (5) 45 (3) 67 (7)
Otolaryngology1 (<1)1 (<1)1 (<1)00
Otolaryngology and Facial Plastic Surgery 11 (1) 9 (1) 27 (3) 11 (1) 20 (2)
Pediatrics18 (2)17 (2)18 (2)25 (2)50 (5)
Pediatric Pulmonology 0 0 0 0 2 (<1)
Physical Medicine and Rehabilitation6 (1)31 (3)1 (<1)6 (<1)6 (1)
Plastic and Reconstructive Surgery 0 2 (<1) 2 (<1) 1 (<1) 3 (11)
Preventive Medicine and Aerospace Medicine4 (<1)01 (<1)2 (<1)6 (1)
Preventive Medicine and Public Health 1 (<1) 2 (<1) 0 2 (<1) 6 (1)
Preventive Medicine (Occupational and Environmental)5 (<1)1 (<1)5 (<1)03 (<1)
Proctology 1 (<1) 1 (<1) 0 0 2 (<1)
Psychiatry13 (1)6 (1)11 (1)8 (1)4 (<1)
Pulmonary Diseases 4 (<1) 6 (1) 5 (<1) 5 (<1) 3 (<1)
Radiation Oncology001 (<1)3 (<1)0
Radiology 0 0 0 0 0
Reproductive Endocrinology002 (<1)00
Rheumatology 5 (<1) 3 (<1) 0 3 (<1) 0
Surgery (General)14 (1)39 (4)39 (4)53 (4)61 (6)
Thoracic Cardiovascular Surgery 0 2 (<1) 1 (<1) 2 (<1) 0
Urological Surgery 3 (<1)
2 (<1)
5 (<1)
4 (<1)
13 (1)
Total 1036 1059 1003 1308 984
 Abbreviations: NA, not applicable.
 *Data are presented as No. (%). Some percentages do not total 100 because of rounding. Totals are calculated by date of final approval by the American Osteopathic Association Bureau of Osteopathic Specialists (December 31, 2007).
Table 1
American Osteopathic Association: General Certification Awarded by Osteopathic Medical Specialty Boards, 2003-2007 *


Year
General Certification Awarded
2003
2004
2005
2006
2007
Adolescent Medicine00001 (<1)
Allergy and Immunology 1 (<1) 0 0 0 0
Anatomic Pathology0001 (<1)0
Anatomic Pathology and Laboratory Medicine 0 0 0 0 0
Anesthesiology15 (1)8 (1)20 (2)12 (1)12 (1)
Cardiology 11 (1) 26 (2) 4 (<1) 29 (2) 0
Child Neurology0001 (<1)0
Child Psychiatry 3 (<1) 0 4 (<1) 2 (<1) 3 (<1)
Dermatology10 (1)14 (1)18 (2)22 (2)20 (2)
Diagnostic Radiology 17 (2) 28 (3) 19 (2) 29 (2) 26 (3)
Emergency Medicine120 (12)104 (10)120 (12)118 (9)119 (12)
Endocrinology 1 (<1) 0 1 (<1) 0 0
Facial Plastic Surgery00000
Family Practice and Osteopathic Manipulative Treatment 435 (42) 445 (42) 343 (34) 391 (30) 338 (34)
Forensic Pathology00000
Gastroenterology 6 (<1) 9 (1) 3 (<1) 12 (1) 1 (<1)
General Vascular Surgery08 (1)7 (1)7 (1)3 (<1)
Gynecologic Oncology 1 (<1) 1 (<1) 1 (<1) 0 1 (<1)
Hematology02 (<1)05 (<1)0
Infectious Diseases 5 (<1) 3 (<1) 0 6 (<1) 1 (<1)
Internal Medicine157 (15)118 (11)155 (15)259 (20)58 (6)
Laboratory Medicine 0 0 0 0 2 (<1)
Maternal and Fetal Medicine2 (<1)001 (<1)1 (<1)
Neonatology 1 (<1) 0 0 0 2 (<1)
Nephrology9 (2)7 (1)3 (<1)4 (<1)4 (<1)
Neurological Surgery 1 (<1) 4 (<1) 3 (<1) 6 (<1) 5 (<1)
Neurology4 (<1)10 (1)1 (<1)20 (2)0
Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine35 (3)28 (3)62 (6)110 (8)43 (4)
Nuclear Medicine 0 0 0 0 0
Obstetrics and Gynecology53 (5)36 (3)50 (5)85 (6)85 (9)
Oncology 7 (1) 4 (<1) 5 (<1) 7 (1) 2 (<1)
Ophthalmology12 (1)10 (1)10 (1)11 (1)11 (1)
Orthopedic Surgery 44 (4) 72 (7) 55 (5) 45 (3) 67 (7)
Otolaryngology1 (<1)1 (<1)1 (<1)00
Otolaryngology and Facial Plastic Surgery 11 (1) 9 (1) 27 (3) 11 (1) 20 (2)
Pediatrics18 (2)17 (2)18 (2)25 (2)50 (5)
Pediatric Pulmonology 0 0 0 0 2 (<1)
Physical Medicine and Rehabilitation6 (1)31 (3)1 (<1)6 (<1)6 (1)
Plastic and Reconstructive Surgery 0 2 (<1) 2 (<1) 1 (<1) 3 (11)
Preventive Medicine and Aerospace Medicine4 (<1)01 (<1)2 (<1)6 (1)
Preventive Medicine and Public Health 1 (<1) 2 (<1) 0 2 (<1) 6 (1)
Preventive Medicine (Occupational and Environmental)5 (<1)1 (<1)5 (<1)03 (<1)
Proctology 1 (<1) 1 (<1) 0 0 2 (<1)
Psychiatry13 (1)6 (1)11 (1)8 (1)4 (<1)
Pulmonary Diseases 4 (<1) 6 (1) 5 (<1) 5 (<1) 3 (<1)
Radiation Oncology001 (<1)3 (<1)0
Radiology 0 0 0 0 0
Reproductive Endocrinology002 (<1)00
Rheumatology 5 (<1) 3 (<1) 0 3 (<1) 0
Surgery (General)14 (1)39 (4)39 (4)53 (4)61 (6)
Thoracic Cardiovascular Surgery 0 2 (<1) 1 (<1) 2 (<1) 0
Urological Surgery 3 (<1)
2 (<1)
5 (<1)
4 (<1)
13 (1)
Total 1036 1059 1003 1308 984
 Abbreviations: NA, not applicable.
 *Data are presented as No. (%). Some percentages do not total 100 because of rounding. Totals are calculated by date of final approval by the American Osteopathic Association Bureau of Osteopathic Specialists (December 31, 2007).
×
Table 2
American Osteopathic Association: Certification of Added Qualifications Awarded by Osteopathic Medical Specialty Boards, 2003-2007 *


Year
Certification Awarded
2003
2004
2005
2006
2007
Anesthesiology
□ Critical care00000
□ Pain management 1 (3) 1 (2) 0 2 (2) 0
Dermatology
□ Dermatopathology 0 0 0 1 (1) 0
□ Mohs micrographic surgery1 (3)0000
Emergency Medicine
□ Emergency medical services01 (2)01 (1)0
□ Medical toxicology 0 0 0 0 4 (11)
□ Sports medicine00000
Family Physicians
□ Addiction medicine00000
□ Adolescent medicine 0 0 0 0 0
□ Geriatrics1 (3)2 (4)6 (17)6 (7)5 (14)
□ Sports medicine 0 13 (26) 1 (3) 16 (18) 7 (19)
Internal Medicine
□ Addiction medicine 0 0 0 0 0
□ Cardiac electrophysiology01 (2)04 (4)0
□ Critical care 5 (15) 0 10 (29) 7 (8) 3 (8)
□ Geriatrics04 (8)04 (4)0
□ Interventional cardiology 16 (47) 12 (24) 2 (6) 36 (40) 2 (6)
□ Sports medicine00002 (6)
Neurology
□ Neurophysiology0001 (1)2 (6)
Neurology and Psychiatry
□ Addiction medicine01 (2)000
Opthalmology and Otolaryngology
□ Otolaryngic allergy003 (9)1 (1)0
Orthopedic Surgery
□ Hand surgery6 (18)02 (6)02 (6)
Pathology
□ Dermatopathology00000
Physical Medicine and Rehabilitation
□ Sports medicine001 (3)00
□ Sports medicine — special proficiency in osteopathic manipulative medicine 0 0 0 0 0
Preventive Medicine
□ Occupational medicine 4 (12) 6 (12) 3 (9) 2 (2) 4 (11)
□ Sports medicine00000
Radiology
□ Body imaging0001 (1)0
□ Neuroradiology 0 2 (4) 4 (11) 0 1 (3)
□ Nuclear radiology00000
□ Pediatric radiology 0 0 0 1 (1) 3 (8)
□ Vascular interventional radiology04 (8)2 (6)2 (2)1 (3)
Surgery
□ Critical care — surgery 0
3 (6)
1 (3)
5 (6)
0
Total 34 50 35 90 36
 Abbreviation: NA, not applicable.
 *Data are presented as No. (%). Some percentages do not total 100 because of rounding. Totals are calculated by date of final approval by the American Osteopathic Association Bureau of Osteopathic Specialists (December 31, 2007).
Table 2
American Osteopathic Association: Certification of Added Qualifications Awarded by Osteopathic Medical Specialty Boards, 2003-2007 *


Year
Certification Awarded
2003
2004
2005
2006
2007
Anesthesiology
□ Critical care00000
□ Pain management 1 (3) 1 (2) 0 2 (2) 0
Dermatology
□ Dermatopathology 0 0 0 1 (1) 0
□ Mohs micrographic surgery1 (3)0000
Emergency Medicine
□ Emergency medical services01 (2)01 (1)0
□ Medical toxicology 0 0 0 0 4 (11)
□ Sports medicine00000
Family Physicians
□ Addiction medicine00000
□ Adolescent medicine 0 0 0 0 0
□ Geriatrics1 (3)2 (4)6 (17)6 (7)5 (14)
□ Sports medicine 0 13 (26) 1 (3) 16 (18) 7 (19)
Internal Medicine
□ Addiction medicine 0 0 0 0 0
□ Cardiac electrophysiology01 (2)04 (4)0
□ Critical care 5 (15) 0 10 (29) 7 (8) 3 (8)
□ Geriatrics04 (8)04 (4)0
□ Interventional cardiology 16 (47) 12 (24) 2 (6) 36 (40) 2 (6)
□ Sports medicine00002 (6)
Neurology
□ Neurophysiology0001 (1)2 (6)
Neurology and Psychiatry
□ Addiction medicine01 (2)000
Opthalmology and Otolaryngology
□ Otolaryngic allergy003 (9)1 (1)0
Orthopedic Surgery
□ Hand surgery6 (18)02 (6)02 (6)
Pathology
□ Dermatopathology00000
Physical Medicine and Rehabilitation
□ Sports medicine001 (3)00
□ Sports medicine — special proficiency in osteopathic manipulative medicine 0 0 0 0 0
Preventive Medicine
□ Occupational medicine 4 (12) 6 (12) 3 (9) 2 (2) 4 (11)
□ Sports medicine00000
Radiology
□ Body imaging0001 (1)0
□ Neuroradiology 0 2 (4) 4 (11) 0 1 (3)
□ Nuclear radiology00000
□ Pediatric radiology 0 0 0 1 (1) 3 (8)
□ Vascular interventional radiology04 (8)2 (6)2 (2)1 (3)
Surgery
□ Critical care — surgery 0
3 (6)
1 (3)
5 (6)
0
Total 34 50 35 90 36
 Abbreviation: NA, not applicable.
 *Data are presented as No. (%). Some percentages do not total 100 because of rounding. Totals are calculated by date of final approval by the American Osteopathic Association Bureau of Osteopathic Specialists (December 31, 2007).
×
Table 3
American Osteopathic Association: Physician Recertifications Awarded by Osteopathic Medical Specialty Boards, 2003-2007 *


Year
Recertifications Awarded
2003
2004
2005
2006
2007
Addiction MedicineNANANANA3 (<1)
Adolescent Medicine 0 0 0 0 1 (<1)
Allergy and Immunology02 (1)001 (<1)
Anesthesiology 3 (2) 32 (11) 0 3 (<1) 2 (<1)
Anatomic PathologyNANANANA2 (<1)
Cardiac Electrophysiology 0 0 3 (1) 5 (1) 3 (<1)
Cardiology8 (5)8 (3)23 (5)12 (1)19 (1)
Critical Care Medicine
□ Internal Medicine11 (6)3 (1)12 (2)12 (1)8 (1)
□ Surgery NA NA NA NA 1 (<1)
Dermatology00000
Dermatopathology
□ DermatologyNANANANA3 (<1)
□ Pathology NA NA NA NA 1 (<1)
Diagnostic Radiology1 (1)7 (2)3 (1)10 (1)5 (<1)
Diagnostic Roentgenology 0 0 0 0 0
Emergency Medicine20 (11)21 (7)29 (6)63 (8)59 (5)
Emergency Medical Services NA NA NA 3 (<1) 2 (<1)
Endocrinology03 (1)3 (1)2 (<1)0
Family Practice and Osteopathic Manipulative Medicine 17 (10) 41 (14) 229 (47) 435 (53) 971 (77)
Gastroenterology13 (7)8 (3)12 (2)10 (1)9 (1)
Geriatrics
□ Family Practice002 (<1)47 (6)24 (2)
□ Internal Medicine 3 (2) 7 (2) 6 (1) 11 (1) 3 (<1)
Hand SurgeryNANANA7 (1)0
Hematology 3 (2) 1 (<1) 0 1 (<1) 1 (<1)
Infectious Diseases2 (1)3 (1)1 (<1)2 (<1)2 (<1)
Internal Medicine 61 (35) 83 (29) 71 (14) 84 (10) 17 (1)
Laboratory MedicineNANANANA2 (<1)
Mohs Micrographic Surgery NA NA NA 4 (<1) 0
Neonatology2 (1)2 (1)000
Nephrology 2 (1) 0 4 (1) 3 (<1) 3 (<1)
NeurologyNANANA2 (<1)6 (<1)
Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine 0 3 (1) 19 (4) 13 (2) 14 (1)
Neuroradiology02 (1)000
Nuclear Medicine 0 0 0 0 0
Obstetrics and Gynecology0002 (<1)0
Oncology 7 (4) 0 5 (1) 1 (<1) 0
OphthalmologyNANA1 (<1)00
Orthopedic Surgery034 (12)47 (10)29 (4)38 (3)
Osteopathic Manipulative Medicine 0 0 0 0 0
OtolaryngologyNANA000
Pathology 0 0 0 0 0
Pediatrics10 (6)9 (3)1 (<1)10 (1)14 (1)
Pediatric Allergy Immunology NA NA NA 1 (<1) 0
Pediatric EndocrinologyNANANA2 (<1)0
Physical Medicine and Rehabilitation 0 0 1 (<1) 6 (1) 0
Preventive Medicine
□ Aerospace Medicine 0 1 (<1) 1 (<1) 1 (<1) 3 (<1)
□ Environmental Medicine1 (1)04 (1)7 (1)16 (1)
□ Occupational Medicine 0 4 (1) 1 (<1) 0 6 (<1)
□ Public Health0001 (<1)0
Proctology 0 2 (1) 1 (<1) 0 1 (<1)
PsychiatryNANANA4 (<1)13 (1)
Pulmonary Diseases 9 (5) 9 (3) 5 (1) 6 (1) 8 (1)
Rheumatology3 (2)3 (1)2 (<1)4 (<1)0
Sports Medicine
□ Family Practice005 (1)17 (2)5 (<1)
□ Internal Medicine 0 0 0 1 (<1) 0
Surgery0001 (<1)0
Thoracic Cardiovascular Surgery NA NA NA NA 1 (<1)
Urological Surgery 0
0
0
0
0
Total 176 288 491 823 1267
 Abbreviation: NA, not applicable.
 *Data are presented as No. (%). Some percentages do not total 100 because of rounding. Totals are calculated by date of final approval by the American Osteopathic Association Bureau of Osteopathic Specialists (December 31, 2007).
 For the following five specialty areas, there were no recertification candidates prior to 2007: Addiction Medicine, Adolescent Medicine, Critical Care Medicine (Surgery), Dermatopathology (Dermatology and Pathology), and Thoracic Cardiovascular Surgery. Likewise, there were no recertification candidates for the following six specialty areas before 2006: Anatomic Pathology and Laboratory Medicine, Emergency Medical Services, Hand Surgery, Mohs Micrographic Surgery, Pediatric Allergy Immunology, and Pediatric Endocrinology. As of January 1, 2004, all 18 member boards had a time-limited certificate in place (ie, all new certificates are issued with an expiration date).3 Certificates issued before the time-limit requirement was instituted, however, are valid for the life of the physician.
 Reports published in previous editions of The Journal's Osteopathic Medical Education issue2 combined Anatomic Pathology and Laboratory Medicine under a single heading for recertification statistics. They have been separated here. Likewise, previous reports combined Ophthalmology and Otolaryngology as well as Neurology and Psychiatry under single headings. Beginning with the data reported for 2005 and 2006, respectively, these numbers were likewise separated.
Table 3
American Osteopathic Association: Physician Recertifications Awarded by Osteopathic Medical Specialty Boards, 2003-2007 *


Year
Recertifications Awarded
2003
2004
2005
2006
2007
Addiction MedicineNANANANA3 (<1)
Adolescent Medicine 0 0 0 0 1 (<1)
Allergy and Immunology02 (1)001 (<1)
Anesthesiology 3 (2) 32 (11) 0 3 (<1) 2 (<1)
Anatomic PathologyNANANANA2 (<1)
Cardiac Electrophysiology 0 0 3 (1) 5 (1) 3 (<1)
Cardiology8 (5)8 (3)23 (5)12 (1)19 (1)
Critical Care Medicine
□ Internal Medicine11 (6)3 (1)12 (2)12 (1)8 (1)
□ Surgery NA NA NA NA 1 (<1)
Dermatology00000
Dermatopathology
□ DermatologyNANANANA3 (<1)
□ Pathology NA NA NA NA 1 (<1)
Diagnostic Radiology1 (1)7 (2)3 (1)10 (1)5 (<1)
Diagnostic Roentgenology 0 0 0 0 0
Emergency Medicine20 (11)21 (7)29 (6)63 (8)59 (5)
Emergency Medical Services NA NA NA 3 (<1) 2 (<1)
Endocrinology03 (1)3 (1)2 (<1)0
Family Practice and Osteopathic Manipulative Medicine 17 (10) 41 (14) 229 (47) 435 (53) 971 (77)
Gastroenterology13 (7)8 (3)12 (2)10 (1)9 (1)
Geriatrics
□ Family Practice002 (<1)47 (6)24 (2)
□ Internal Medicine 3 (2) 7 (2) 6 (1) 11 (1) 3 (<1)
Hand SurgeryNANANA7 (1)0
Hematology 3 (2) 1 (<1) 0 1 (<1) 1 (<1)
Infectious Diseases2 (1)3 (1)1 (<1)2 (<1)2 (<1)
Internal Medicine 61 (35) 83 (29) 71 (14) 84 (10) 17 (1)
Laboratory MedicineNANANANA2 (<1)
Mohs Micrographic Surgery NA NA NA 4 (<1) 0
Neonatology2 (1)2 (1)000
Nephrology 2 (1) 0 4 (1) 3 (<1) 3 (<1)
NeurologyNANANA2 (<1)6 (<1)
Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine 0 3 (1) 19 (4) 13 (2) 14 (1)
Neuroradiology02 (1)000
Nuclear Medicine 0 0 0 0 0
Obstetrics and Gynecology0002 (<1)0
Oncology 7 (4) 0 5 (1) 1 (<1) 0
OphthalmologyNANA1 (<1)00
Orthopedic Surgery034 (12)47 (10)29 (4)38 (3)
Osteopathic Manipulative Medicine 0 0 0 0 0
OtolaryngologyNANA000
Pathology 0 0 0 0 0
Pediatrics10 (6)9 (3)1 (<1)10 (1)14 (1)
Pediatric Allergy Immunology NA NA NA 1 (<1) 0
Pediatric EndocrinologyNANANA2 (<1)0
Physical Medicine and Rehabilitation 0 0 1 (<1) 6 (1) 0
Preventive Medicine
□ Aerospace Medicine 0 1 (<1) 1 (<1) 1 (<1) 3 (<1)
□ Environmental Medicine1 (1)04 (1)7 (1)16 (1)
□ Occupational Medicine 0 4 (1) 1 (<1) 0 6 (<1)
□ Public Health0001 (<1)0
Proctology 0 2 (1) 1 (<1) 0 1 (<1)
PsychiatryNANANA4 (<1)13 (1)
Pulmonary Diseases 9 (5) 9 (3) 5 (1) 6 (1) 8 (1)
Rheumatology3 (2)3 (1)2 (<1)4 (<1)0
Sports Medicine
□ Family Practice005 (1)17 (2)5 (<1)
□ Internal Medicine 0 0 0 1 (<1) 0
Surgery0001 (<1)0
Thoracic Cardiovascular Surgery NA NA NA NA 1 (<1)
Urological Surgery 0
0
0
0
0
Total 176 288 491 823 1267
 Abbreviation: NA, not applicable.
 *Data are presented as No. (%). Some percentages do not total 100 because of rounding. Totals are calculated by date of final approval by the American Osteopathic Association Bureau of Osteopathic Specialists (December 31, 2007).
 For the following five specialty areas, there were no recertification candidates prior to 2007: Addiction Medicine, Adolescent Medicine, Critical Care Medicine (Surgery), Dermatopathology (Dermatology and Pathology), and Thoracic Cardiovascular Surgery. Likewise, there were no recertification candidates for the following six specialty areas before 2006: Anatomic Pathology and Laboratory Medicine, Emergency Medical Services, Hand Surgery, Mohs Micrographic Surgery, Pediatric Allergy Immunology, and Pediatric Endocrinology. As of January 1, 2004, all 18 member boards had a time-limited certificate in place (ie, all new certificates are issued with an expiration date).3 Certificates issued before the time-limit requirement was instituted, however, are valid for the life of the physician.
 Reports published in previous editions of The Journal's Osteopathic Medical Education issue2 combined Anatomic Pathology and Laboratory Medicine under a single heading for recertification statistics. They have been separated here. Likewise, previous reports combined Ophthalmology and Otolaryngology as well as Neurology and Psychiatry under single headings. Beginning with the data reported for 2005 and 2006, respectively, these numbers were likewise separated.
×
Evolution of the Osteopathic Certification Process
The process of receiving osteopathic board certification has traditionally involved the use of comprehensive examinations. These examinations, in addition to other stringent board-specific requirements,2 are written and formulated by subject matter experts in the respective specialties. Through the years, enhancements to this process have begun addressing the issue of continued physician competence—namely through the physician recertification process and issuing time-limited certification. In July 1992, all osteopathic specialty boards were directed by the AOA BOT to offer a recertification mechanism to diplomates by January 1, 1995.1 
In conjunction with implementation of the recertification process, many osteopathic specialty boards began issuing time-limited certification (ie, certification with expiration dates). In fact, effective January 1, 2004, the BOS mandated this change for all member boards that had not yet restricted certification to 10 years or less. Certification issued before time-limited certification was introduced is valid for the life of the physician—provided that he or she meets the other requirements of certification. However, all diplomates are eligible to sit for recertification examinations—even if they currently hold lifetime osteopathic specialty board certification. 
The use of time-limited certification reflects the Bureau's view that it is not enough to test specialists only once in their professional careers; to help protect the public, continued physician competence should be assessed on a periodic basis. 
Figure 1.
The American Osteopathic Association's 18 approved certifying specialty boards by year founded. *From 1940 through 1996, the American Osteopathic Boards of Ophthalmology and Otolaryngology were known as the American Osteopathic Board of Ophthalmology and Otorhinolaryngology. †The American Osteopathic Board of Anesthesiology was formerly under the American Osteopathic Board of Surgery, as was the American Osteopathic Board of Orthopedic Surgery. ‡The American Osteopathic Board of Family Physicians was known as the American Osteopathic Board of General Practice from 1972 through 1993. §The American Osteopathic Board of Neuromusculoskeletal Medicine was originally known as the American Osteopathic Board on Fellowship of the American Academy of Osteopathy from 1977 through 1990. Then, from 1990 to 1999, they were known as the American Osteopathic Board of Special Proficiency in Osteopathic Manipulative Medicine. //In 1982 and 1983, the American Osteopathic Board of Preventive Medicine was known as the American Osteopathic Board of Public Health and Preventive Medicine.
Figure 1.
The American Osteopathic Association's 18 approved certifying specialty boards by year founded. *From 1940 through 1996, the American Osteopathic Boards of Ophthalmology and Otolaryngology were known as the American Osteopathic Board of Ophthalmology and Otorhinolaryngology. †The American Osteopathic Board of Anesthesiology was formerly under the American Osteopathic Board of Surgery, as was the American Osteopathic Board of Orthopedic Surgery. ‡The American Osteopathic Board of Family Physicians was known as the American Osteopathic Board of General Practice from 1972 through 1993. §The American Osteopathic Board of Neuromusculoskeletal Medicine was originally known as the American Osteopathic Board on Fellowship of the American Academy of Osteopathy from 1977 through 1990. Then, from 1990 to 1999, they were known as the American Osteopathic Board of Special Proficiency in Osteopathic Manipulative Medicine. //In 1982 and 1983, the American Osteopathic Board of Preventive Medicine was known as the American Osteopathic Board of Public Health and Preventive Medicine.
In addition, to ensure that AOA board–certified physicians keep up with the latest advances in medicine, AOA specialty certifying boards also mandate that physicians meet board-specified continuing medical education (CME) requirements. Certificate holders are required to complete no less than 50 credit hours in their respective specialties for each 3-year CME cycle.4 
When combined, these changes (ie, recertification, time-limited certificates, and CME requirements) reflect an evolution in osteopathic specialty board certification: osteopathic continuous certification (OCC). 
The Quality Movement and OCC: Why—and Why Now?
To understand why continuous certification is the next evolutionary step in the model for board certification of physicians, one must take into consideration the influence “the quality movement” has had over the medical community in the past several years. 
Concerns over medical errors, patient safety, and the quality of healthcare have been noted in numerous reports from the Institute of Medicine (IOM).5,6 In particular, the report published in 2000, To Err Is Human: Building a Safer Health System,7 prompted a number of influential groups from government, medicine, the public interest, and industry to address the quality of the nation's healthcare system by supporting a reduction in the number of medical errors.5,6 
This coalition led the medical community to implement various initiatives designed to improve the quality of patient care. Numerous initiatives—such as the teaching of core competencies at the residency level—have been adopted by medical residency programs.6,8 
The introduction of continuous certification models by the BOS and the American Board of Medical Specialties is another step intended to ensure quality of care.6 Adding to these efforts, the Federation of State Medical Boards (FSMB) has been active in the discussion to assess continued physician competence for the maintenance of licensure, enacting stricter requirements for renewal.6,9 
The intentions of the quality movement are clear and understandable and have a noble purpose: to protect patients and assist the medical community in ongoing improvements to healthcare delivery. For this reason, during the past 4 years, the Bureau has been engaged in high-level discussions regarding how best to implement a certification process that addresses the challenges of ensuring continual physician competence. 
The OCC process is currently under development and, at the recommendation of the BOS, was recently approved by the AOA BOT at their February 2008 meeting (Resolution [No. pending] [M/2008]—Implementation of Osteopathic Continuous Certification Process by 2012). This AOA policy change not only addresses concerns launched by the quality movement, it is consistent with the Bureau's long-standing objective of helping to protect the public through assessment of physician competence. 
Consistent with the quality movement's emphasis on continuous improvement in the delivery of quality healthcare, the BOS believes certification should be an ongoing process rather than an episodic one. To that end, the Committee on Implementation of OCC has proposed the creation of a four-component process to address the assessment of continued physician competence and improvement (Figure 2). 
A comparison of the current AOA recertification process with the proposed OCC process reveals that many components of the “new” process were already under evolution within the existing system. In fact, the first three components of OCC are simply enhanced versions of the existing osteopathic recertification process. The one remaining component, practice performance assessment, is designed to ensure that AOA board–certified physicians will be asked to “[engage] in the continuous quality improvement loop of identifying opportunities to improve patient care, [develop]...a systematic method of acting on the identified opportunity gap, [implement...a] plan to improve and [remeasure outcomes]” (Suppl Resolution 59 [A/2007]—Osteopathic Continuing Certification). 
Practice performance assessment—probably the most challenging component of the OCC model to implement—will involve the use of national benchmarks and will be determined by each member board. Some of the methodology the boards may use to establish their performance assessment models could include such innovative tools as the AOA Clinical Assessment Program (CAP), which acts as a repository of quality benchmarks and provides feedback on improvement to participating physicians.8 
What Lies Ahead for AOA Board–Certified Physicians?
Implementation of OCC is under way. As is the case with any critical initiative, some details on OCC are yet to be resolved. Implementation of this process is a goal of the BOS. As previously noted, the Bureau presented the OCC concept to the AOA BOT for their approval at their February 2008 meeting, recommending that all 18 member boards implement this process by 2012. How each of the four components outlined is handled or addressed will be left to the discretion of the 18 approved specialty certifying boards. 
In the coming years, AOA board–certified physicians will receive more detailed information on the transition from the traditional recertification model to the OCC model. The intended objective of OCC is to assist physicians in maintaining competency—enhancing the quality of healthcare nationwide. 
Conclusion
Much in the same way as it responded to the needs of osteopathic physicians in its early days, the AOA's certification program continues to respond to the needs of the osteopathic medical profession and to the interests of public health. Osteopathic board certification will undoubtedly continue to adapt to the changes of the healthcare environment while also providing a valuable mechanism to help assess ongoing physician competence. 
Figure 2.
Four components of the proposed osteopathic continuous certification process.
Figure 2.
Four components of the proposed osteopathic continuous certification process.
American Osteopathic Association. Handbook of the Bureau of Osteopathic Specialists. Chicago, Ill: American Osteopathic Association; 2007.
Ramirez AF, Bell EC. Osteopathic specialty board certification. J Am Osteopath Assoc. 2007;107:117-125. Available at: http://www.jaoa.org/cgi/content/full/107/3/117. Accessed March 6, 2008.
Maintenance of Certification (MOC) page. American Board of Medical Specialties Web site. Available at: http://www.abms.org/About_Board_Certification/MOC.aspx. Accessed March 2, 2007.
Rodgers DJ. AOA continuing medical education. J Am Osteopath Assoc. 2008;108:141-156. Available at: http://www.jaoa.org/cgi/content/full/108/3/141.
Brennan TA, Horwitz RI, Duffy FD, Cassel CK, Goode LD, Lipner RS. The role of physician specialty board certification status in the quality movement. JAMA. 2004;292:1038-1043.
Federation of State Medical Boards – Special Committee on Maintenance of Licensure. Draft Report. Dallas, Tex: Federation of State Medical Boards of the United States Inc; 2007. Available at: http://www.fsmb.org/pdf/Draft%20report%20FSMB%20Special%20Comittee%20on%20Maintenance%20of%20Licensure.pdf. Accessed February 28, 2008.
Kohn LT, Corrigan JM, Donaldson MS, eds; for the Committee on Quality of Health Care in America. To Err Is Human: Building a Safer Health System. Washington, DC: Institute of Medicine; 2000. Available at: http://darwin.nap.edu/books/0309068371/html/. Accessed April 18, 2006.
Tunanidas AG, Burkhart DN. American Osteopathic Association commitment to quality and lifelong learning. J Am Osteopath Assoc. 2005;105:404-407. Available at: http://www.jaoa.org/cgi/content/full/105/9/404. Accessed February 28, 2008.
Adams D. Stricter requirements sought for relicensure as medical boards draft proposal. amednews.com [serial online]. Chicago, Ill: American Medical Association; December 24/31, 2007. Available at: http://www.amaassn.org/amednews/2007/12/24/prl21224.htm. Accessed March 28, 2008.
Figure 1.
The American Osteopathic Association's 18 approved certifying specialty boards by year founded. *From 1940 through 1996, the American Osteopathic Boards of Ophthalmology and Otolaryngology were known as the American Osteopathic Board of Ophthalmology and Otorhinolaryngology. †The American Osteopathic Board of Anesthesiology was formerly under the American Osteopathic Board of Surgery, as was the American Osteopathic Board of Orthopedic Surgery. ‡The American Osteopathic Board of Family Physicians was known as the American Osteopathic Board of General Practice from 1972 through 1993. §The American Osteopathic Board of Neuromusculoskeletal Medicine was originally known as the American Osteopathic Board on Fellowship of the American Academy of Osteopathy from 1977 through 1990. Then, from 1990 to 1999, they were known as the American Osteopathic Board of Special Proficiency in Osteopathic Manipulative Medicine. //In 1982 and 1983, the American Osteopathic Board of Preventive Medicine was known as the American Osteopathic Board of Public Health and Preventive Medicine.
Figure 1.
The American Osteopathic Association's 18 approved certifying specialty boards by year founded. *From 1940 through 1996, the American Osteopathic Boards of Ophthalmology and Otolaryngology were known as the American Osteopathic Board of Ophthalmology and Otorhinolaryngology. †The American Osteopathic Board of Anesthesiology was formerly under the American Osteopathic Board of Surgery, as was the American Osteopathic Board of Orthopedic Surgery. ‡The American Osteopathic Board of Family Physicians was known as the American Osteopathic Board of General Practice from 1972 through 1993. §The American Osteopathic Board of Neuromusculoskeletal Medicine was originally known as the American Osteopathic Board on Fellowship of the American Academy of Osteopathy from 1977 through 1990. Then, from 1990 to 1999, they were known as the American Osteopathic Board of Special Proficiency in Osteopathic Manipulative Medicine. //In 1982 and 1983, the American Osteopathic Board of Preventive Medicine was known as the American Osteopathic Board of Public Health and Preventive Medicine.
Figure 2.
Four components of the proposed osteopathic continuous certification process.
Figure 2.
Four components of the proposed osteopathic continuous certification process.
Table 1
American Osteopathic Association: General Certification Awarded by Osteopathic Medical Specialty Boards, 2003-2007 *


Year
General Certification Awarded
2003
2004
2005
2006
2007
Adolescent Medicine00001 (<1)
Allergy and Immunology 1 (<1) 0 0 0 0
Anatomic Pathology0001 (<1)0
Anatomic Pathology and Laboratory Medicine 0 0 0 0 0
Anesthesiology15 (1)8 (1)20 (2)12 (1)12 (1)
Cardiology 11 (1) 26 (2) 4 (<1) 29 (2) 0
Child Neurology0001 (<1)0
Child Psychiatry 3 (<1) 0 4 (<1) 2 (<1) 3 (<1)
Dermatology10 (1)14 (1)18 (2)22 (2)20 (2)
Diagnostic Radiology 17 (2) 28 (3) 19 (2) 29 (2) 26 (3)
Emergency Medicine120 (12)104 (10)120 (12)118 (9)119 (12)
Endocrinology 1 (<1) 0 1 (<1) 0 0
Facial Plastic Surgery00000
Family Practice and Osteopathic Manipulative Treatment 435 (42) 445 (42) 343 (34) 391 (30) 338 (34)
Forensic Pathology00000
Gastroenterology 6 (<1) 9 (1) 3 (<1) 12 (1) 1 (<1)
General Vascular Surgery08 (1)7 (1)7 (1)3 (<1)
Gynecologic Oncology 1 (<1) 1 (<1) 1 (<1) 0 1 (<1)
Hematology02 (<1)05 (<1)0
Infectious Diseases 5 (<1) 3 (<1) 0 6 (<1) 1 (<1)
Internal Medicine157 (15)118 (11)155 (15)259 (20)58 (6)
Laboratory Medicine 0 0 0 0 2 (<1)
Maternal and Fetal Medicine2 (<1)001 (<1)1 (<1)
Neonatology 1 (<1) 0 0 0 2 (<1)
Nephrology9 (2)7 (1)3 (<1)4 (<1)4 (<1)
Neurological Surgery 1 (<1) 4 (<1) 3 (<1) 6 (<1) 5 (<1)
Neurology4 (<1)10 (1)1 (<1)20 (2)0
Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine35 (3)28 (3)62 (6)110 (8)43 (4)
Nuclear Medicine 0 0 0 0 0
Obstetrics and Gynecology53 (5)36 (3)50 (5)85 (6)85 (9)
Oncology 7 (1) 4 (<1) 5 (<1) 7 (1) 2 (<1)
Ophthalmology12 (1)10 (1)10 (1)11 (1)11 (1)
Orthopedic Surgery 44 (4) 72 (7) 55 (5) 45 (3) 67 (7)
Otolaryngology1 (<1)1 (<1)1 (<1)00
Otolaryngology and Facial Plastic Surgery 11 (1) 9 (1) 27 (3) 11 (1) 20 (2)
Pediatrics18 (2)17 (2)18 (2)25 (2)50 (5)
Pediatric Pulmonology 0 0 0 0 2 (<1)
Physical Medicine and Rehabilitation6 (1)31 (3)1 (<1)6 (<1)6 (1)
Plastic and Reconstructive Surgery 0 2 (<1) 2 (<1) 1 (<1) 3 (11)
Preventive Medicine and Aerospace Medicine4 (<1)01 (<1)2 (<1)6 (1)
Preventive Medicine and Public Health 1 (<1) 2 (<1) 0 2 (<1) 6 (1)
Preventive Medicine (Occupational and Environmental)5 (<1)1 (<1)5 (<1)03 (<1)
Proctology 1 (<1) 1 (<1) 0 0 2 (<1)
Psychiatry13 (1)6 (1)11 (1)8 (1)4 (<1)
Pulmonary Diseases 4 (<1) 6 (1) 5 (<1) 5 (<1) 3 (<1)
Radiation Oncology001 (<1)3 (<1)0
Radiology 0 0 0 0 0
Reproductive Endocrinology002 (<1)00
Rheumatology 5 (<1) 3 (<1) 0 3 (<1) 0
Surgery (General)14 (1)39 (4)39 (4)53 (4)61 (6)
Thoracic Cardiovascular Surgery 0 2 (<1) 1 (<1) 2 (<1) 0
Urological Surgery 3 (<1)
2 (<1)
5 (<1)
4 (<1)
13 (1)
Total 1036 1059 1003 1308 984
 Abbreviations: NA, not applicable.
 *Data are presented as No. (%). Some percentages do not total 100 because of rounding. Totals are calculated by date of final approval by the American Osteopathic Association Bureau of Osteopathic Specialists (December 31, 2007).
Table 1
American Osteopathic Association: General Certification Awarded by Osteopathic Medical Specialty Boards, 2003-2007 *


Year
General Certification Awarded
2003
2004
2005
2006
2007
Adolescent Medicine00001 (<1)
Allergy and Immunology 1 (<1) 0 0 0 0
Anatomic Pathology0001 (<1)0
Anatomic Pathology and Laboratory Medicine 0 0 0 0 0
Anesthesiology15 (1)8 (1)20 (2)12 (1)12 (1)
Cardiology 11 (1) 26 (2) 4 (<1) 29 (2) 0
Child Neurology0001 (<1)0
Child Psychiatry 3 (<1) 0 4 (<1) 2 (<1) 3 (<1)
Dermatology10 (1)14 (1)18 (2)22 (2)20 (2)
Diagnostic Radiology 17 (2) 28 (3) 19 (2) 29 (2) 26 (3)
Emergency Medicine120 (12)104 (10)120 (12)118 (9)119 (12)
Endocrinology 1 (<1) 0 1 (<1) 0 0
Facial Plastic Surgery00000
Family Practice and Osteopathic Manipulative Treatment 435 (42) 445 (42) 343 (34) 391 (30) 338 (34)
Forensic Pathology00000
Gastroenterology 6 (<1) 9 (1) 3 (<1) 12 (1) 1 (<1)
General Vascular Surgery08 (1)7 (1)7 (1)3 (<1)
Gynecologic Oncology 1 (<1) 1 (<1) 1 (<1) 0 1 (<1)
Hematology02 (<1)05 (<1)0
Infectious Diseases 5 (<1) 3 (<1) 0 6 (<1) 1 (<1)
Internal Medicine157 (15)118 (11)155 (15)259 (20)58 (6)
Laboratory Medicine 0 0 0 0 2 (<1)
Maternal and Fetal Medicine2 (<1)001 (<1)1 (<1)
Neonatology 1 (<1) 0 0 0 2 (<1)
Nephrology9 (2)7 (1)3 (<1)4 (<1)4 (<1)
Neurological Surgery 1 (<1) 4 (<1) 3 (<1) 6 (<1) 5 (<1)
Neurology4 (<1)10 (1)1 (<1)20 (2)0
Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine35 (3)28 (3)62 (6)110 (8)43 (4)
Nuclear Medicine 0 0 0 0 0
Obstetrics and Gynecology53 (5)36 (3)50 (5)85 (6)85 (9)
Oncology 7 (1) 4 (<1) 5 (<1) 7 (1) 2 (<1)
Ophthalmology12 (1)10 (1)10 (1)11 (1)11 (1)
Orthopedic Surgery 44 (4) 72 (7) 55 (5) 45 (3) 67 (7)
Otolaryngology1 (<1)1 (<1)1 (<1)00
Otolaryngology and Facial Plastic Surgery 11 (1) 9 (1) 27 (3) 11 (1) 20 (2)
Pediatrics18 (2)17 (2)18 (2)25 (2)50 (5)
Pediatric Pulmonology 0 0 0 0 2 (<1)
Physical Medicine and Rehabilitation6 (1)31 (3)1 (<1)6 (<1)6 (1)
Plastic and Reconstructive Surgery 0 2 (<1) 2 (<1) 1 (<1) 3 (11)
Preventive Medicine and Aerospace Medicine4 (<1)01 (<1)2 (<1)6 (1)
Preventive Medicine and Public Health 1 (<1) 2 (<1) 0 2 (<1) 6 (1)
Preventive Medicine (Occupational and Environmental)5 (<1)1 (<1)5 (<1)03 (<1)
Proctology 1 (<1) 1 (<1) 0 0 2 (<1)
Psychiatry13 (1)6 (1)11 (1)8 (1)4 (<1)
Pulmonary Diseases 4 (<1) 6 (1) 5 (<1) 5 (<1) 3 (<1)
Radiation Oncology001 (<1)3 (<1)0
Radiology 0 0 0 0 0
Reproductive Endocrinology002 (<1)00
Rheumatology 5 (<1) 3 (<1) 0 3 (<1) 0
Surgery (General)14 (1)39 (4)39 (4)53 (4)61 (6)
Thoracic Cardiovascular Surgery 0 2 (<1) 1 (<1) 2 (<1) 0
Urological Surgery 3 (<1)
2 (<1)
5 (<1)
4 (<1)
13 (1)
Total 1036 1059 1003 1308 984
 Abbreviations: NA, not applicable.
 *Data are presented as No. (%). Some percentages do not total 100 because of rounding. Totals are calculated by date of final approval by the American Osteopathic Association Bureau of Osteopathic Specialists (December 31, 2007).
×
Table 2
American Osteopathic Association: Certification of Added Qualifications Awarded by Osteopathic Medical Specialty Boards, 2003-2007 *


Year
Certification Awarded
2003
2004
2005
2006
2007
Anesthesiology
□ Critical care00000
□ Pain management 1 (3) 1 (2) 0 2 (2) 0
Dermatology
□ Dermatopathology 0 0 0 1 (1) 0
□ Mohs micrographic surgery1 (3)0000
Emergency Medicine
□ Emergency medical services01 (2)01 (1)0
□ Medical toxicology 0 0 0 0 4 (11)
□ Sports medicine00000
Family Physicians
□ Addiction medicine00000
□ Adolescent medicine 0 0 0 0 0
□ Geriatrics1 (3)2 (4)6 (17)6 (7)5 (14)
□ Sports medicine 0 13 (26) 1 (3) 16 (18) 7 (19)
Internal Medicine
□ Addiction medicine 0 0 0 0 0
□ Cardiac electrophysiology01 (2)04 (4)0
□ Critical care 5 (15) 0 10 (29) 7 (8) 3 (8)
□ Geriatrics04 (8)04 (4)0
□ Interventional cardiology 16 (47) 12 (24) 2 (6) 36 (40) 2 (6)
□ Sports medicine00002 (6)
Neurology
□ Neurophysiology0001 (1)2 (6)
Neurology and Psychiatry
□ Addiction medicine01 (2)000
Opthalmology and Otolaryngology
□ Otolaryngic allergy003 (9)1 (1)0
Orthopedic Surgery
□ Hand surgery6 (18)02 (6)02 (6)
Pathology
□ Dermatopathology00000
Physical Medicine and Rehabilitation
□ Sports medicine001 (3)00
□ Sports medicine — special proficiency in osteopathic manipulative medicine 0 0 0 0 0
Preventive Medicine
□ Occupational medicine 4 (12) 6 (12) 3 (9) 2 (2) 4 (11)
□ Sports medicine00000
Radiology
□ Body imaging0001 (1)0
□ Neuroradiology 0 2 (4) 4 (11) 0 1 (3)
□ Nuclear radiology00000
□ Pediatric radiology 0 0 0 1 (1) 3 (8)
□ Vascular interventional radiology04 (8)2 (6)2 (2)1 (3)
Surgery
□ Critical care — surgery 0
3 (6)
1 (3)
5 (6)
0
Total 34 50 35 90 36
 Abbreviation: NA, not applicable.
 *Data are presented as No. (%). Some percentages do not total 100 because of rounding. Totals are calculated by date of final approval by the American Osteopathic Association Bureau of Osteopathic Specialists (December 31, 2007).
Table 2
American Osteopathic Association: Certification of Added Qualifications Awarded by Osteopathic Medical Specialty Boards, 2003-2007 *


Year
Certification Awarded
2003
2004
2005
2006
2007
Anesthesiology
□ Critical care00000
□ Pain management 1 (3) 1 (2) 0 2 (2) 0
Dermatology
□ Dermatopathology 0 0 0 1 (1) 0
□ Mohs micrographic surgery1 (3)0000
Emergency Medicine
□ Emergency medical services01 (2)01 (1)0
□ Medical toxicology 0 0 0 0 4 (11)
□ Sports medicine00000
Family Physicians
□ Addiction medicine00000
□ Adolescent medicine 0 0 0 0 0
□ Geriatrics1 (3)2 (4)6 (17)6 (7)5 (14)
□ Sports medicine 0 13 (26) 1 (3) 16 (18) 7 (19)
Internal Medicine
□ Addiction medicine 0 0 0 0 0
□ Cardiac electrophysiology01 (2)04 (4)0
□ Critical care 5 (15) 0 10 (29) 7 (8) 3 (8)
□ Geriatrics04 (8)04 (4)0
□ Interventional cardiology 16 (47) 12 (24) 2 (6) 36 (40) 2 (6)
□ Sports medicine00002 (6)
Neurology
□ Neurophysiology0001 (1)2 (6)
Neurology and Psychiatry
□ Addiction medicine01 (2)000
Opthalmology and Otolaryngology
□ Otolaryngic allergy003 (9)1 (1)0
Orthopedic Surgery
□ Hand surgery6 (18)02 (6)02 (6)
Pathology
□ Dermatopathology00000
Physical Medicine and Rehabilitation
□ Sports medicine001 (3)00
□ Sports medicine — special proficiency in osteopathic manipulative medicine 0 0 0 0 0
Preventive Medicine
□ Occupational medicine 4 (12) 6 (12) 3 (9) 2 (2) 4 (11)
□ Sports medicine00000
Radiology
□ Body imaging0001 (1)0
□ Neuroradiology 0 2 (4) 4 (11) 0 1 (3)
□ Nuclear radiology00000
□ Pediatric radiology 0 0 0 1 (1) 3 (8)
□ Vascular interventional radiology04 (8)2 (6)2 (2)1 (3)
Surgery
□ Critical care — surgery 0
3 (6)
1 (3)
5 (6)
0
Total 34 50 35 90 36
 Abbreviation: NA, not applicable.
 *Data are presented as No. (%). Some percentages do not total 100 because of rounding. Totals are calculated by date of final approval by the American Osteopathic Association Bureau of Osteopathic Specialists (December 31, 2007).
×
Table 3
American Osteopathic Association: Physician Recertifications Awarded by Osteopathic Medical Specialty Boards, 2003-2007 *


Year
Recertifications Awarded
2003
2004
2005
2006
2007
Addiction MedicineNANANANA3 (<1)
Adolescent Medicine 0 0 0 0 1 (<1)
Allergy and Immunology02 (1)001 (<1)
Anesthesiology 3 (2) 32 (11) 0 3 (<1) 2 (<1)
Anatomic PathologyNANANANA2 (<1)
Cardiac Electrophysiology 0 0 3 (1) 5 (1) 3 (<1)
Cardiology8 (5)8 (3)23 (5)12 (1)19 (1)
Critical Care Medicine
□ Internal Medicine11 (6)3 (1)12 (2)12 (1)8 (1)
□ Surgery NA NA NA NA 1 (<1)
Dermatology00000
Dermatopathology
□ DermatologyNANANANA3 (<1)
□ Pathology NA NA NA NA 1 (<1)
Diagnostic Radiology1 (1)7 (2)3 (1)10 (1)5 (<1)
Diagnostic Roentgenology 0 0 0 0 0
Emergency Medicine20 (11)21 (7)29 (6)63 (8)59 (5)
Emergency Medical Services NA NA NA 3 (<1) 2 (<1)
Endocrinology03 (1)3 (1)2 (<1)0
Family Practice and Osteopathic Manipulative Medicine 17 (10) 41 (14) 229 (47) 435 (53) 971 (77)
Gastroenterology13 (7)8 (3)12 (2)10 (1)9 (1)
Geriatrics
□ Family Practice002 (<1)47 (6)24 (2)
□ Internal Medicine 3 (2) 7 (2) 6 (1) 11 (1) 3 (<1)
Hand SurgeryNANANA7 (1)0
Hematology 3 (2) 1 (<1) 0 1 (<1) 1 (<1)
Infectious Diseases2 (1)3 (1)1 (<1)2 (<1)2 (<1)
Internal Medicine 61 (35) 83 (29) 71 (14) 84 (10) 17 (1)
Laboratory MedicineNANANANA2 (<1)
Mohs Micrographic Surgery NA NA NA 4 (<1) 0
Neonatology2 (1)2 (1)000
Nephrology 2 (1) 0 4 (1) 3 (<1) 3 (<1)
NeurologyNANANA2 (<1)6 (<1)
Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine 0 3 (1) 19 (4) 13 (2) 14 (1)
Neuroradiology02 (1)000
Nuclear Medicine 0 0 0 0 0
Obstetrics and Gynecology0002 (<1)0
Oncology 7 (4) 0 5 (1) 1 (<1) 0
OphthalmologyNANA1 (<1)00
Orthopedic Surgery034 (12)47 (10)29 (4)38 (3)
Osteopathic Manipulative Medicine 0 0 0 0 0
OtolaryngologyNANA000
Pathology 0 0 0 0 0
Pediatrics10 (6)9 (3)1 (<1)10 (1)14 (1)
Pediatric Allergy Immunology NA NA NA 1 (<1) 0
Pediatric EndocrinologyNANANA2 (<1)0
Physical Medicine and Rehabilitation 0 0 1 (<1) 6 (1) 0
Preventive Medicine
□ Aerospace Medicine 0 1 (<1) 1 (<1) 1 (<1) 3 (<1)
□ Environmental Medicine1 (1)04 (1)7 (1)16 (1)
□ Occupational Medicine 0 4 (1) 1 (<1) 0 6 (<1)
□ Public Health0001 (<1)0
Proctology 0 2 (1) 1 (<1) 0 1 (<1)
PsychiatryNANANA4 (<1)13 (1)
Pulmonary Diseases 9 (5) 9 (3) 5 (1) 6 (1) 8 (1)
Rheumatology3 (2)3 (1)2 (<1)4 (<1)0
Sports Medicine
□ Family Practice005 (1)17 (2)5 (<1)
□ Internal Medicine 0 0 0 1 (<1) 0
Surgery0001 (<1)0
Thoracic Cardiovascular Surgery NA NA NA NA 1 (<1)
Urological Surgery 0
0
0
0
0
Total 176 288 491 823 1267
 Abbreviation: NA, not applicable.
 *Data are presented as No. (%). Some percentages do not total 100 because of rounding. Totals are calculated by date of final approval by the American Osteopathic Association Bureau of Osteopathic Specialists (December 31, 2007).
 For the following five specialty areas, there were no recertification candidates prior to 2007: Addiction Medicine, Adolescent Medicine, Critical Care Medicine (Surgery), Dermatopathology (Dermatology and Pathology), and Thoracic Cardiovascular Surgery. Likewise, there were no recertification candidates for the following six specialty areas before 2006: Anatomic Pathology and Laboratory Medicine, Emergency Medical Services, Hand Surgery, Mohs Micrographic Surgery, Pediatric Allergy Immunology, and Pediatric Endocrinology. As of January 1, 2004, all 18 member boards had a time-limited certificate in place (ie, all new certificates are issued with an expiration date).3 Certificates issued before the time-limit requirement was instituted, however, are valid for the life of the physician.
 Reports published in previous editions of The Journal's Osteopathic Medical Education issue2 combined Anatomic Pathology and Laboratory Medicine under a single heading for recertification statistics. They have been separated here. Likewise, previous reports combined Ophthalmology and Otolaryngology as well as Neurology and Psychiatry under single headings. Beginning with the data reported for 2005 and 2006, respectively, these numbers were likewise separated.
Table 3
American Osteopathic Association: Physician Recertifications Awarded by Osteopathic Medical Specialty Boards, 2003-2007 *


Year
Recertifications Awarded
2003
2004
2005
2006
2007
Addiction MedicineNANANANA3 (<1)
Adolescent Medicine 0 0 0 0 1 (<1)
Allergy and Immunology02 (1)001 (<1)
Anesthesiology 3 (2) 32 (11) 0 3 (<1) 2 (<1)
Anatomic PathologyNANANANA2 (<1)
Cardiac Electrophysiology 0 0 3 (1) 5 (1) 3 (<1)
Cardiology8 (5)8 (3)23 (5)12 (1)19 (1)
Critical Care Medicine
□ Internal Medicine11 (6)3 (1)12 (2)12 (1)8 (1)
□ Surgery NA NA NA NA 1 (<1)
Dermatology00000
Dermatopathology
□ DermatologyNANANANA3 (<1)
□ Pathology NA NA NA NA 1 (<1)
Diagnostic Radiology1 (1)7 (2)3 (1)10 (1)5 (<1)
Diagnostic Roentgenology 0 0 0 0 0
Emergency Medicine20 (11)21 (7)29 (6)63 (8)59 (5)
Emergency Medical Services NA NA NA 3 (<1) 2 (<1)
Endocrinology03 (1)3 (1)2 (<1)0
Family Practice and Osteopathic Manipulative Medicine 17 (10) 41 (14) 229 (47) 435 (53) 971 (77)
Gastroenterology13 (7)8 (3)12 (2)10 (1)9 (1)
Geriatrics
□ Family Practice002 (<1)47 (6)24 (2)
□ Internal Medicine 3 (2) 7 (2) 6 (1) 11 (1) 3 (<1)
Hand SurgeryNANANA7 (1)0
Hematology 3 (2) 1 (<1) 0 1 (<1) 1 (<1)
Infectious Diseases2 (1)3 (1)1 (<1)2 (<1)2 (<1)
Internal Medicine 61 (35) 83 (29) 71 (14) 84 (10) 17 (1)
Laboratory MedicineNANANANA2 (<1)
Mohs Micrographic Surgery NA NA NA 4 (<1) 0
Neonatology2 (1)2 (1)000
Nephrology 2 (1) 0 4 (1) 3 (<1) 3 (<1)
NeurologyNANANA2 (<1)6 (<1)
Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine 0 3 (1) 19 (4) 13 (2) 14 (1)
Neuroradiology02 (1)000
Nuclear Medicine 0 0 0 0 0
Obstetrics and Gynecology0002 (<1)0
Oncology 7 (4) 0 5 (1) 1 (<1) 0
OphthalmologyNANA1 (<1)00
Orthopedic Surgery034 (12)47 (10)29 (4)38 (3)
Osteopathic Manipulative Medicine 0 0 0 0 0
OtolaryngologyNANA000
Pathology 0 0 0 0 0
Pediatrics10 (6)9 (3)1 (<1)10 (1)14 (1)
Pediatric Allergy Immunology NA NA NA 1 (<1) 0
Pediatric EndocrinologyNANANA2 (<1)0
Physical Medicine and Rehabilitation 0 0 1 (<1) 6 (1) 0
Preventive Medicine
□ Aerospace Medicine 0 1 (<1) 1 (<1) 1 (<1) 3 (<1)
□ Environmental Medicine1 (1)04 (1)7 (1)16 (1)
□ Occupational Medicine 0 4 (1) 1 (<1) 0 6 (<1)
□ Public Health0001 (<1)0
Proctology 0 2 (1) 1 (<1) 0 1 (<1)
PsychiatryNANANA4 (<1)13 (1)
Pulmonary Diseases 9 (5) 9 (3) 5 (1) 6 (1) 8 (1)
Rheumatology3 (2)3 (1)2 (<1)4 (<1)0
Sports Medicine
□ Family Practice005 (1)17 (2)5 (<1)
□ Internal Medicine 0 0 0 1 (<1) 0
Surgery0001 (<1)0
Thoracic Cardiovascular Surgery NA NA NA NA 1 (<1)
Urological Surgery 0
0
0
0
0
Total 176 288 491 823 1267
 Abbreviation: NA, not applicable.
 *Data are presented as No. (%). Some percentages do not total 100 because of rounding. Totals are calculated by date of final approval by the American Osteopathic Association Bureau of Osteopathic Specialists (December 31, 2007).
 For the following five specialty areas, there were no recertification candidates prior to 2007: Addiction Medicine, Adolescent Medicine, Critical Care Medicine (Surgery), Dermatopathology (Dermatology and Pathology), and Thoracic Cardiovascular Surgery. Likewise, there were no recertification candidates for the following six specialty areas before 2006: Anatomic Pathology and Laboratory Medicine, Emergency Medical Services, Hand Surgery, Mohs Micrographic Surgery, Pediatric Allergy Immunology, and Pediatric Endocrinology. As of January 1, 2004, all 18 member boards had a time-limited certificate in place (ie, all new certificates are issued with an expiration date).3 Certificates issued before the time-limit requirement was instituted, however, are valid for the life of the physician.
 Reports published in previous editions of The Journal's Osteopathic Medical Education issue2 combined Anatomic Pathology and Laboratory Medicine under a single heading for recertification statistics. They have been separated here. Likewise, previous reports combined Ophthalmology and Otolaryngology as well as Neurology and Psychiatry under single headings. Beginning with the data reported for 2005 and 2006, respectively, these numbers were likewise separated.
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