CREDENTIALING IN MEDICINE

This article describes the history and process of credentialing: accre ditation of programs and certification of individual practitioners. Un der accreditation, general (institutional) and discipline-specific req uirements, both for residencies and fellowships, are considered, along with possible outcomes and the appeals mechanism for an unfavorable r eview. Under certification, the relationship between individual specia lty boards and the American Board of Medical Specialties is defined, f ollowed by a consideration of the principles underlying subspecialty c ertification and recertification. It is concluded that enforced standa rds of learning are one of the pillars of accountability upon which a profession must rest; that if medicine abdicates its responsibility to impose credible standards on itself, its place will be taken by very interested, but less knowledgeable, others; and that we must, therefor e, rededicate ourselves to the requirement of reasonable standards as a professional obligation and use the best means possible to meet that responsibility.