Background

Optometry residency training began 40 years ago and has grown such that today 25% of graduates, prior to entering practice, elect to serve a postgraduate residency (PG-1) in an optometry specialty of which the most popular is medical optometry. This is a significant shift towards postgraduate residency training and a sign the O.D. degree and license, while adequate to insure competence in general practice, can no longer insure competence in all areas of optometry practice. The profession of dentistry began to train and certify dental specialists prior to optometry. Medicine began to develop specialist residencies even earlier, about 90 years ago.

The movement towards optometry specialization began within the U.S. Department of Veterans Affairs in 1975 as an effort to prepare optometrists via residency training for practice within medical facilities in which they would encounter chiefly medical eye conditions, rather than refractive errors, and be trained to make appropriate referrals as required for surgical treatments while providing primary medical eye care.

The Association of Schools and Colleges of Optometry (ASCO) now lists 11 types of optometry specialty residency programs as well as a residency matching service and the Accreditation Council on Optometry Education accredits most optometry specialty residency programs.

At this time only the specialty of medical optometry has in place the accepted 3-step process to certify competence as a specialist required by Joint Commission accredited health care facilities and their credentialing committees. This recognition permits their credentialing as a specialist in medical optometry at accredited health care facilities and is the same as that required for medicine, osteopathy, dentistry, and podiatry specialists by credentialing committees at Joint Commission accredited health care facilities.

Such credentialing of specialists must be utilized for optometry specialists since optometrists are classified by the Centers for Medicare and Medicaid (CMS) as “physicians” for credentialing purposes and the Joint Commission requires this form of credentialing of all independently prescribing members of the medical staff which includes optometrists following a 1986 policy statement by the Joint Commission that authorized placing optometrists on the medical staff of accredited facilities and granting them clinical privileges.

Medicine, osteopathy, dentistry and podiatry have coordinating boards or committees that set the standards and requirements through which defined areas in their professions are recognized as specialties and by which its practitioners can become board certified specialists.

A key requirement of any profession’s specialty coordinating board is that it be free of real or apparent conflicts of interests with trade associations and all bodies responsible for accrediting residencies or preparing and administering specialty written examinations, in order to avoid “regulatory capture” and ensure autonomy of its actions. Such boards must also operate as a nonprofit corporation and have governance that includes representatives of the public.

Optometry has had no such coordinating board for optometry specialties to set the standards by which an optometry specialty is recognized and its practitioners are certified other than for the specialty of medical optometry whose specialty board is now recognized by credentialing committees at Joint Commission accredited health facilities and private practices. Specialty boards for the other optometry specialties have yet to be formed.

The US credentialing system of health care providers recognizes as specialists those practitioners of medicine, osteopathy, dentistry, optometry and podiatry who meet three requirements for recognition by credentialing committees at Joint Commission accredited health care facilities. These requirements are below:

Accepted Specialty Training, Testing and Certification Standards

1. Satisfactory completion of a postgraduate, accredited full-time clinical residency training program in a recognized specialty of the licensed profession
2. Passage of the standardized, national written examination in the specialty required by a specialty board of certification.
3. Certification of competence by a recognized specialty board.

This recognized, national 3-step process is commonly termed “board certification” and those holding such certifications are credentialed as board certified specialists within defined areas of their licensed profession by credentialing-licensing committees at Joint Commission health care facilities. Those completing the 3-step process may refer to themselves as “board certified” in their specialty.

Since specialists often practice within accredited health care organizations and private group practices having credentialing committees, it is highly advantageous to be board certified in one’s specialty.

The incorporators of ABOS believe all optometry specialties should have the same credentialing opportunities now available only to those completing residencies in medical optometry.

Purpose of ABOS

The current inequality of career opportunities to pursue one’s chosen specialty requires the establishment of additional specialty boards and written specialty examinations that meet the same high standards required of medical optometry specialists and those of recognized credentialing committees.

The American Board of Optometry Specialties (ABOS) has as its main mission, the encouragement, support and further development of optometry specialty boards and specialty examinations that meet, or exceed, the standards and expectations for acceptance recognition by credentialing committees at Joint Commission accredited health care systems as specialty boards.

To address the lack of specialty boards and written examinations for other optometry specialties ABOS will establish standards to be met by which ABOS will recognize a specialty, its residency programs and written specialty examination.

In addition, ABOS will, upon request, provide counsel, advice, and fiscal support to nascent optometry specialty boards and work with them to acquire ABOS recognition.