"Are You Board Certified?" Understanding Surgeon Credentials in Canada vs. The USA
This article is intended for Canadian residents only. Information provided on this site is for education and is not designed or intended to constitute medical advice, or to be used for diagnosis. Full Disclaimer information is available at on the Disclaimer and Copyright page
A common and very important question I receive from patients considering facial plastic surgery or rhinoplasty is, "Dr. Bonaparte, are you board certified?" This is an excellent question, as it shows patients are doing their due diligence. However, the term "board certified" primarily relates to the medical certification system in the United States, and its direct application in Canada can be misleading.
Let's clarify what credentials signify expertise in Canada, particularly for specialists like facial plastic and rhinoplasty surgeons.
"Board Certified": What it Means in the USA
In the United States, physicians and surgeons become "board certified" by specific member boards under the umbrella of the American Board of Medical Specialties (ABMS). This certification signifies that a physician has completed the required training and passed examinations in their chosen specialty. It's a crucial credential for practicing as a specialist in the USA.
Key Point: A Canadian physician cannot be formally "Board Certified" by an ABMS board for the purpose of practicing in Canada, unless they also intend to practice in the USA and maintain that specific US certification. Holding a US board certification does not, in itself, grant a license to practice in Canada, nor is it a Canadian requirement
The Gold Standard in Canada: FRCSC Designation
So, what is the equivalent mark of a highly qualified specialist in Canada?
In Canada, the path to becoming a certified specialist involves several rigorous steps:
Medical School: Completion of an accredited medical school program.
Residency (Specialty Training): An intensive, multi-year postgraduate training program in a specific medical or surgical specialty. For surgical specialties like Otolaryngology - Head and Neck Surgery (which is the foundational specialty for many facial plastic surgeons), this is typically a 5-year residency.
Royal College Certification: After completing residency, physicians must pass comprehensive, multi-day examinations administered by the Royal College of Physicians and Surgeons of Canada. Successfully passing these demanding exams allows a physician to become a Fellow of the Royal College of Physicians and Surgeons of Canada (FRCSC).
The FRCSC designation is the Canadian gold standard, equivalent to "Board Certification" in the USA. It signifies that a surgeon has met the highest national standards of training and competence in their specialty.
Provincial Licensing: The Next Step to Practice
In addition to Royal College certification (FRCSC), every physician in Canada must be licensed by the medical regulatory authority in the province(s) where they practice. In Ontario, this is the College of Physicians and Surgeons of Ontario (CPSO). The CPSO ensures that physicians meet the specific requirements to practice medicine safely and ethically within the province.
In summary, for a specialist surgeon to practice in Canada, they need:
Certification from the Royal College of Physicians and Surgeons of Canada (FRCSC).
A license from their provincial College (e.g., CPSO in Ontario).
A US "Board Certification" does not replace these Canadian requirements.
What About US-Based Fellowships and Examinations for Canadian Surgeons?
This is where further clarification is helpful, especially in highly specialized fields like Facial Plastic and Reconstructive Surgery.
Some Canadian specialists, after achieving their FRCSC, pursue additional, highly specialized training called fellowships. These fellowships can be in Canada, the USA, or internationally. If a fellowship is undertaken in the USA, it might be one recognized by American specialty boards.
For instance, in my field, Facial Plastic and Reconstructive Surgery:
After completing my 5-year Otolaryngology - Head and Neck Surgery residency and becoming an FRCSC, I pursued a dedicated fellowship in Facial Plastic and Reconstructive Surgery.
This fellowship was accredited by the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS).
Following this fellowship, I successfully passed the rigorous two-day examination administered by the American Board of Facial Plastic and Reconstructive Surgery (ABFPRS). This is the same examination that US surgeons take to become board-certified in this specific field in the United States.
So, while I practice exclusively in Ottawa, Canada, and my primary Canadian certification is FRCSC, I have successfully completed the training and examinations that would make one eligible for board certification in Facial Plastic and Reconstructive Surgery in the USA. I choose not to pay ongoing fees to maintain a formal US "Board Certified" status as it has no practical bearing on my license or ability to provide expert care here in Canada. My Canadian FRCSC and Ontario CPSO license are my credentials for practice in Ottawa.
What Canadian Patients Should Look For (and How to Verify):
When you see "make sure your doctor is board certified" online, remember this advice often originates from a US context. Here’s what to look for when choosing a surgeon in Canada:
FRCSC Designation: Ensure your surgeon is a Fellow of the Royal College of Physicians and Surgeons of Canada. This is your primary indicator of specialist qualification.
Provincial License: Verify their license to practice in your province. For Ontario, you can easily search for any physician on the College of Physicians and Surgeons of Ontario (CPSO) public register: https://doctors.cpso.on.ca/. This site lists their specialty and any conditions on their license.
Specialty-Specific Training: For procedures like rhinoplasty or other facial plastic surgeries, inquire about their foundational specialty (e.g., Otolaryngology - Head and Neck Surgery, or Plastic Surgery) and any additional fellowship training in Facial Plastic and Reconstructive Surgery.
Equivalent Qualifications: You can certainly ask your surgeon if they have completed training or examinations equivalent to those required for board certification in their specific area of focus in the USA (like the AAFPRS fellowship and ABFPRS exams for facial plastic surgery).
A Note on Canadian Standards: Canada has exceptionally strict regulations and rigorous training pathways for medical professionals. Any surgeon who has achieved FRCSC status and provincial licensing has undergone extensive training and multiple levels of examination, ensuring a high standard of care.
Conclusion: Clarity and Confidence in Your Choice
Understanding medical credentials can be complex, especially with information flowing across borders. For patients in Ottawa and across Canada, the FRCSC designation and a valid provincial medical license are the key indicators of a qualified specialist surgeon. Additional fellowships and successfully passed examinations (like those recognized by American boards) further underscore a surgeon's dedication to specialized expertise.
Don't hesitate to ask questions about a surgeon's qualifications during your consultation. An informed patient is an empowered patient.
