“Is your perinatologist board certified?” Many patients are told they should ask about this, but what does it really mean to be board certified? Is that something you should ask when looking for a doctor? While this may seem like a question with an easy answer, but it is truly a bit complicated. So, let’s break it down.
First, before a perinatolgist can become a specialist in Maternal-Fetal Medicine, they must become board certified as an Ob/Gyn. All Ob/Gyn doctors complete four years of medical school after college. During medical school, there are three major exams, or “Steps”, of certification that they must pass in order to journey on to the next stage in training. So, after medical school, you become a licensed physician but everyone must complete more specialty training before they are ready to practice (such as in Family Practice, Ob/Gyn, Pediatrics, Surgery, etc.). Following medical school, doctors enter into an Ob/Gyn residency program (also called internship and residency) which lasts an additional four years. During that time, they have numerous “in-training” examinations to make sure they are on track with learning.
At the end of residency, Ob/Gyns are eligible to sit for a long written examination on what they have learned over the past 4 years. It involves a combination of basic science type questions and practical questions on how to take care of patients. Once that is passed, the doctor becomes “board-eligible” and can practice Ob/Gyn independently. While they are not yet “board certified”, they have passed a detailed written exam, numerous “in-training” evaluations and been deemed competent to practice independently by their Ob/Gyn residency program. Many Ob/Gyns go on to join a practice and start to see patients, deliver babies, and perform surgery in this time. They MUST be in practice for at least a year, and then are eligible to begin to collect the “cases” they see over the next year (year two of practice). Basically, the doctors record all the surgeries, deliveries and many clinic patients they see during that year, which are then submitted to a national board (always without any identifying patient information). A few weeks later, they all go to Dallas, Texas, for a grueling oral examination on the practice of Ob/Gyn, during which they are grilled about both their patients and hypothetical patients. If they pass THAT exam, then they are considered “board-certified” in Obstetrics and Gynecology. So, it is very possible your Ob/Gyn may be in their first 1 to 2 years out of residency and thus not yet “board-certified”, but this does not mean you should avoid seeing them. Be assured they have gone through years of training and testing before they see you.
Some Ob/Gyns choose to further subspecialize in Maternal-Fetal Medicine, Gynecology-Oncology, Reproductive-Endocrinology or Urogynecology. Your perinatologist (Maternal-Fetal Medicine specialist) has gone on after residency to something called “fellowship”, where they spend an additional three years learning the subspecialty of Maternal-Fetal Medicine. This too has its own specialty board certification process, which includes a written exam taken at the end of the three year fellowship and, like general Ob/Gyn boards, a rigorous oral examination that lasts for several hours and covers a year’s worth of patients.
So, by the time your perinatologist becomes “board-certified” in both Ob/Gyn and Maternal-Fetal Medicine, they have been in training for at least 11 years AFTER college and undergone a battery of both written and oral examinations. But it doesn’t end there! Every year, all MFM doctors have to maintain their certification to practice medicine through a national certification board. We keep up with current practice by reading a set selection of current literature every year and answering questions on the topics covered- for the rest our career! So, while your perinatologist may not be “in-training”, they are continuing life-long learning to educate themselves on current practice while taking care of you! It’s a very involved process, but is designed to make sure patients are receiving the best medical treatment available.