Understanding Board Certification in Otolaryngology

When you are looking for an ENT professional, expertise can make all the difference. Join Dr. Undavia, Dr. Reddy, and Dr. Smith as they discuss what it means to be a board-certified otolaryngologist and why it matters. Learn about the extensive education, training, and rigorous testing required to achieve this prestigious certification.

What you’ll learn

What you’ll learn:

  • The educational journey, including undergraduate studies, medical school, residency, and optional fellowship, necessary to become a board-certified otolaryngologist
  • How may exams, including Step 1, Step 2, Step 3, and specialty-specific board exams, that candidates must pass to obtain board certification
  • Understand the ongoing commitment to learning and maintenance of certification (MOC) required to stay current with the latest advancements and maintain board certification status

Listen now for all your question about what it means to be board certified in Otolaryngology! For professional ENT support, schedule a consultation today at our Marlton, New Jersey location by visiting NJENT.com or call 609-710-NOES (6673).

Listen to the audio version below.

Audio Transcript:

Dr. Undavia:

Today we wanted to talk to you about what it means to be a board certified otolaryngologist. So a lot of our patients have actually seen either primary care physicians or other types of physicians, and they’ve gotten recommendations about what to do for problems within this area of the head and neck. And then, we end up seeing them for various reasons and patients don’t really understand what it means to be board certified in a specialty or even board certified because there are a lot of, unfortunately, a lot of providers and practitioners out in the community practicing medicine and sometimes patients don’t really know who they’re seeing. They kind of assume certain facts but they’re not always true.

So I wanted to just start with Dr. Reddy and say, why don’t you give us an estimation of how much school you’ve had.

Dr. Reddy:

Sure, so first of all, all three of us here are board certified in otolaryngology and head and neck surgery, and Dr. Undavia is also board certified in facial plastic surgery as well. But generally speaking, to become board certified in otolaryngology, we have to first go to a four-year college, right, an undergraduate degree, and usually that’s in some type of pre-medical science major like biology. And that’s followed by medical school, which is four years, generally speaking. And after that, you get your medical degree. After medical school, we then do a residency in otolaryngology, which is five years total. The first year is done with general surgery as an internship and then the subsequent four years are done with ear, nose, and throat or otolaryngology specialty.

And then once you graduate your residency, you have an optional fellowship. And then after that, then you can consider trying to be board certified. And then I’ll let you guys talk about that process.

Dr. Smith:

Sure.

Dr. Undavia:

I’m going to just kick in for one question. So when you technically you can practice medicine after a certain point of that, you don’t have to practice, you don’t have to wait to practice medicine. So where’s the point where you construct?

Dr. Reddy:

So it depends on the state, but there are some states that allow you to practice medicine after maybe one year of extra training after medical school.

Dr. Undavia:

After your internship.

Dr. Reddy:

After your internship essentially from, after medical school. But generally for most people, it’s going to be three years afterwards. Ear, nose and throat is a longer, a much longer training than most specialties and it’s five years.

Dr. Smith:

Along those lines with the, when you can start practicing, there are a list of steps that are board certification steps. So a series of tests that you must take to progress on to the next level. So within medical school, you’ll take two separate board exams. So there is a step one and a step two, and some of them have some clinical skills aspects to them as well to pass on. And then once you finish your intern year, you may take the step three at any time after medical school, and that allows you typically in most states to start practicing medicine.

The fourth kind of step to those testing for board certification then is your specialty specific board. And that is your fourth step, or your fourth test that you must take. And that test is just regulated by each individual board. So for us, it is the board associated with ENT or otolaryngology. And that also has a component that is both kind of clinical skills, as well as kind of written testing as well. And so those steps all kind of have to be taken in order in order for you to get to the board of kind of qualification point at that time. And then-

Dr. Reddy:

Do you want to go over the test, the actual board certification tests with ear, nose, and throat, divided up into two parts?

Dr. Undavia:

Yep, so we have, we have, you get, throughout residency, you get practice tests to prepare for this moment. But in general, you have a verbal test and you have a written test. For me, it was a whole weekend. And now they have part of it online and then part you have to go in person for. But the written test is an eight hour test. It is very difficult and we spend a long time studying for it.

After you have that, you have a full day of clinical scenarios with people in each specialty quizzing you and they kind of give you a patient presentation that’s somewhat typical and then they’ll give you patient presentations that are not so typical and you have to walk through the entire workup will your differential diagnosis your entire workup and what you do about it management. Yeah, and they go over a complication quiz you on complications. They they want to see how you would be dealing with the patient with your bedside manner and there is definitely, it’s a given fact that they are failing a certain number of people during those tests. It’s not how you perform, it’s how you performed compared to your peers. So there are definitely people that are not passing those exams.

Dr. Reddy:

Yeah. And the other thing is that we are required to have a certain number of procedures that we’ve had to have done. That’s what I wanted to talk to you about. During residency programs. So we have to maintain a certain core competency in surgical skills and case numbers. And typically by the time we’re graduating, we’ve done thousands of surgeries within the five years.

Dr. Smith:

Every residency program must go through an accreditation phase themselves where they show that they have this certain acuity and volume of cases, surgical volume, and training that shows that they are training qualified individuals to perform these procedures and surgeries.

Dr. Undavia:

So part of the reason that you have to do a certain number of procedures is because you can read everything you need to in an article or a textbook, but when it comes to actually practicing medicine, they use the word practice very specifically because practice makes perfect, and also we’re doing this for our entire lifetime. Our lifetime is a practice of medicine. You are constantly honing your skills, but in those five years for us, just from a sinus perspective, let’s say we did thousands of sinus procedures, you will have also seen many variations of presentation, many variations of anatomy, many variations of complications.

A lot of patients shy away from this feeling that there could be complications, but really what you want is a surgeon that knows how to deal with every complication. That is such a huge important part the board certification process, right? You want to have been able to see everything, you know how to take care of everything, then there’s nothing to worry about. If you have somebody that can take care of everything from start to finish, that is a board certified position. But I wanted to ask you, did you do the tally on how many years that was?

Dr. Reddy:

No, I don’t like to think about that. No, it was 12 years of high school, 12 years of primary school. Four years of college, that’s 16. Four years of med school, that’s 20. 21 for internship. 26 to finish residency. And then if you did an extra fellowship, that’s even more. So at least 26 years of schooling. Yeah. Yeah, but each step gets subsequently more difficult. Yep. That’s right. The other big piece of this is not only once you get board certification, you still have to maintain your board certification and that’s referred to as MOC or maintenance of certification. Did you guys want to just briefly go over what that process looks like?

Dr. Smith:

Sure. So throughout your timing of keeping your board certification both in medicine and your specialty there are ongoing education. So a lot of people have continuing education in medical terms, there’s continuing medical education or CMEs. And that is to maintain your medical license. And so we all must do continued education in medicine, depending on your field, it may change a little bit what areas you educate yourself in. So most of us will do some general things, but also most of it will be specialty specific for our education. And then there are within each board, a certain set of regulations as to how you’re going to show that you’re keeping up with changing procedures, changing management and diagnoses steps for otolaryngology and its kind of subspecialties within otolaryngology.

So we have a quarterly set of questions that we take to maintain a education and a group of readings that we do to kind of continue our education and show that we are staying at that high standard required to be a board certified physician.

Dr. Undavia:

And you know, new research is happening all the time. You’re doing new treatments.

Dr. Smith:

Yeah, new medications come out, new procedures, new ways to treat things.

Dr. Reddy:

We’re constantly kind of trying to stay adept with the latest procedures. We just came back from San Diego for a conference on the latest in-office nasal procedures, for example. So we are constantly you know, just keeping up with the latest techniques. And that’s part of the whole learning process of practicing medicine, as Dr. Undavia kind of alluded to. Anything else? Yeah, I think we’ve covered everything. All right, very good. Yeah, let us know if you have any other questions.

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