Let's look at an area where certification is well established: medicine.
New medical school graduates have to pass the test of the National
Board of Medical Examiners. Call that the doctor's CCNA. It's entry
level to internship.
Most physicians who do not further subspecialize will do 3-4 years of
combined internship/residency in an approved program. Depending on
the field, they complete an approved residency program and may take
tests to become "Board eligible". Board certification usually
requires some time in practice, and possibly case presentations as
well as tests. For internal medicine, the specialty board is the
American College of Physicians. "diplomates" are board-eligible,
while a board certified internest is a Fellow of the ACP (FACP).
Let's say you complete an internal medicine residency and want to
specialize further. You go on to a fellowship of several years, in
cardiology, infectious disease, gastroenterology, etc. Each of these
subspecialty boards has its own approved program of training and
certification. So, Dr. X goes through another several years and
meets the requirements of the American College of Cardiology. Dr. X
is now FACP, FACC, although most cardiologists would just write FACC.
Now, the good cardiologist wants to subspecialize even more. There
are higher-level fellowship programs, such as angioplasty,
electrophysiology, etc. While these "tertiary" specialties have
professional organizations, they don't typically have exams as such.
Instead, the control on practitioners is that you must have
demonstrate advanced training and a certain number of supervised
cases before a hospital will give you credentials to do the
procedures.
There are various interdisciplinary specialties, such as pediatric
general cardiology, where you might have a pediatrics and cardiology
certification.
My point here is that the more specialized physicians, such as
invasive cardiologists that limit their practice to angiography and
angioplasty remain busy full-time doing just that. The question
really comes up with respect to networking certification: who would
want someone who is a specialist in everything? At some point, you
need real experience, and typically in a specialty.
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