Board-certified physicians in the United States: specialty distribution and policy implications of trends during the past decade.

Board certification is a universal ambition among graduates of American medical schools. It is a measure of postgraduate achievement and clinical ability that leads to staff appointments, promotions, clinical privileges, increased fees, and reduced malpractice premiums. The number of physicians receiving specialty-board diplomas each year has increased remarkably over the past 15 years. The annual mean for the years of 1976-1978 was 17,381--larger than the graduating medical class four years before. The number of board-certified physicians in medicine, surgery, and the clinical services increased from 106,300 in 1971 to 158,900 in 1978. The percentage of board-certified physicians in these fields has increased from 65 to 78 per cent. Board certification in family practice commenced in 1970 and is still increasing sharply (from 1523 [1970-1972] to 3444 [1976-1978]). The growth of internal medicine and its subjacent specialties is the most spectacular and has been more rapid than that of either surgery or the clinical services, in both which the board-certification rate and number of board-certified practitioners have stabilized since 1973. As board certification becomes a virtually universal criterion that carries the implication of de facto licensing, its social role should be reevaluated.