After four years of college, you apply to medical school. If you are accepted, you're in a group of people who did well in college, and who plan on doing just as well in medical school. Doing well means getting into the specialty training in the field of your choice.

Ob-Gyn programs are generally quite hard to get into. If accepted, we do a year of internship (60-120 hours per week) and then three years of training just within Ob-Gyn (50-100 hr/wk). The progress of our knowledge is tested by yearly exams. At the end of these four years, we take the written board exam. If we pass, we then become "Board Eligible" and can practice in any community.

To become "Board Certified", or a Diplomat of the American College of Obstetrics and Gynecology (ACOG), you must practice long enough to collect a list of cases. This list must be broad based and diversified enough to demonstrate your ability to act as a consultant to physicians in other specialties. This list is submitted and reviewed by the ACOG. You then must go to Chicago to take an intensive four-hour oral examination covering the list's contents and also your management of some additional complex hypothetical patients.

Board certification used to be just an extra step, not taken by many. Currently, all of us try to do it because it has become a standard. There are some local Ob-Gyns that are not board certified.

I'm currently a "Board Certified" practitioner and so is other doctor with whom I share call coverage. I say currently because one must be re-tested every eight years to demonstrate that you are keeping up.