To cert. or not to cert.? -Reply

[Richard Machado <MACHRM@doe-md.gov>]

>>> "ZAPP, NEAL (JSC-SD)" <neal.zapp1@jsc.nasa.gov> 02/17/99
10:49am >>>

>If you take it in your first year of residency out of med school, or after
>your twentieth year of practicing medicine, makes no difference.  And
>yes, I do realize that the rules can be and are different not only in
>different states but with regard to different specialties in medicine.  

As Captain Thomas summarized, Medical credentialing is extremely
structured and is goverened by laws which require certion steps.  Take
away those laws and the employment issues between the two fields
would be similar.

Several tests that must be passed, demonstrating broad knowledge in
general medicine and then other tests for board certification.  I don't know
what most states require for a license, but it usually involves the first
year of residency (called internship) and another test in general medicine.
Not just anyone can apply. 

It is true that after your internship and once you have a license, you can
practice any branch of medicine you want without board certification. 
You probably won't get many customers though.  

>I'm stating that it's possible to receive medical board certification without
>a requisite period of employment as a staff physician in the area of your
>certification.    My problem is with declaring a certification that itself
>requires that a person have been working for a specified period of time
>in a capacity in which I understand the case to have been made that he
>or she wouldn't be hired without the certification.  

It is my understanding that it is IMpossible receive a board certification in a
branch of medicine without completing a residency program.  Residencies
ususally vary from 3 to 7 years.  Although you can be a licensed
physician (by a state) after the first year, you are not board eligible until
completing the residency program and passing a board test to be certified
in a given area.    The point is doctors must prove themselves several
times along the way and must go through low paying traing programs as
doctors to become eligible for a cert. Not so in HP.  Further med.
specialization requires a fellowship after residency (usually 3 more years
of low pay), and yet another certification exam to be board certified in
that specialty.

Until HP is structured as medicine we will be able to prove ourselves
different ways. Education, experience, certification, or all.  Each has its
place with no one being the definitive credential.  We all have anecdotes
of CHPs that could not write a useful procedure or take a measurement. 
Degreed persons who knew less than a navy nuke, and the list goes on. 
If certification becomes a requirement for a job I will either pass it or be
happy with the title HP instead of CHP.

Standard Disclaimers,
Richard Machado
BWO Mound
(machrm@doe-md.gov)
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