Licensure and Certification in the United States

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Abstract
LICENSURE and specialty board certification have changed substantially in the United States during the past decade. There are already signs of other important changes on the horizon. Some of the potential future changes are positive ones and deserve support from the medical profession; others, when viewed from the perspectives of the state licensing boards and the medical specialty boards with their responsibilities for assuring the competence of physicians, are alarming. PRESENT ACHIEVEMENTS What has been accomplished to date? Undoubtedly, the major advance is the progress of the Federated Licensing Examination (FLEX). The examination was offered for the first time in June 1968. At that time, 632 candidates from seven states took the complete examination. In June or December 1975, every state except Florida used FLEX as its licensing examination, and Florida recognized FLEX for endorsement. In addition, candidates were examined from the District of Columbia, Puerto Rico, the Canal Zone,

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