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As the health care system in this
country continues to change and evolve,
the lines that define the various area of medical speciality become more
and more blurred. However, the training and skills that define medical
specialists and surgical specialists remain distinctly different.
In the United States, physicians are generally licensed as “medical
practitioners” by state licensing boards. Federal laws do not govern
the quality of speciality training or regulate the procedures a physician
may aspire to perform in his or her practice. This means that any medical
school graduate can claim to be a specialist in the area of his or her
own choosing regardless of whether of not he or she has legitimate residency
training in that area.
Medical directors, managed care executives, credentialing committees,
and hospital administrators have a responsibility to ensure that patients
are treated by qualified doctors and surgeons. The granting of clinical
privileges to various physicians by verification of their credentials
allows a hospital or health plan provider to assure its patients and members
of the training of its physicians. The following information is a brief
overview of the guidelines provided by the American Society of Plastic
Surgeons (ASPS) regarding the skills and qualifications that plastic surgeons
should have in order to be considered legitimate.
Plastic Surgery deals with the repair, reconstruction, or replacement
of physical defects of form or function involving the skin, musculoskeletal
system, cranio-maxillofacial structures, hands, extremities, breast and
trunk, and external genitalia. It uses aesthetic surgical procedures to
improve undesirable or counterproductive qualities of these anatomical
Special skills and knowledge in the design and surgery of grafts, flaps,
free tissue transfer, and replantation is essential. Competence in dealing
with complex wounds, the use of implantable materials, and tumor surgery
is also absolutely necessary. Plastic surgery has been prominent in the
development of techniques such as microvascular and cranio-maxillofacial
surgery, liposuction, and tissue transfer. Competency in plastic surgery
implies a combination of basic knowledge, surgical judgement, technical
expertise, ethics, and interpersonal skills to achieve satisfactory patient
Being a member of the American Board of Plastic Surgery-which is a member
board of the American Board of Medical Specialities-is an important qualifier
for those who request plastic surgery privileges. Qualifying physicians
are certified and known as diplomates of the American Board of Plastic
The main purposes of the American Board of Plastic Surgery are:
- 1.To establish requirements for the qualifications of applicants who
request a certificate of their ability as plastic surgeons.
- To conduct examinations of approved candidates who seek certification
by the Board.
- To issue certificates to those individuals who meet the Board’s
requirements by passing respective examinations.
- To do and engage in any and all lawful activities that may be incidental
or reasonably related to any of the foregoing purposes.
Certificates issued by the Board should not be considered degrees as
the American Board of Plastic Surgery is not an educational institution.
Certification through this board does not give a doctor legal qualification
or license to practice any form of medicine; however, doctors certified
by this institution are required to have legal qualification to practice
medicine in order to become certified.
Certificates of added qualification, or CAQ, provide board certified
surgeons with a way to highlight their interest in a specific area. Hand
surgery is the only area in which the ABPS offers a CAQ. However, treatment
and management of hand diseases and trauma are an integral part of plastic
surgery residency training.
Individuals who are certified by the American Board of Plastic Surgery
and members of the American Society of Plastic Surgeons have completed
several hours of rigorous training in their field as well as been carefully
evaluated by their peers from both technical and ethical perspectives
of their practice of plastic surgery.
Certified plastic surgeons should have the knowledge and skill to perform
most types of plastic surgery with competence and skill regardless of
his or her particular area of interest. A certified surgeon should also
be eligible for clinical privileges at all hospitals, clinics, managed
care facilities, military medical facilities, and third-party payment
organizations in operation in the United States and Canada.
Continuing medical education is very important to clinical competence
for plastic surgeons. The American Society of Plastic Surgeons requires
150 hours every 3 years of continuing medical education from its certified
members, a minimum of 50 which must be related to the practice and discipline
of plastic surgery.