Importance Board certification is used as a marker of surgeon quality and professionalism. Although some research has linked certification in surgery to outcomes, more research is needed.

Objective To measure associations between surgeons obtaining American Board of Surgery (ABS) certification and examination performance with receiving future severe disciplinary actions against their medical licenses.

Design, Setting, and Participants Retrospective analysis of severe license action rates for surgeons who attempted ABS certification based on certification status and examination performance. Surgeons who attempted to become certified were classified as certified or failing to obtain certification. Additionally, groups were further categorized based on whether the surgeon had to repeat examinations and whether they ultimately passed. The study included surgeons who initially attempted certification between 1976 and 2017 (n = 44 290). Severe license actions from 1976 to 2018 were obtained from the Federation of State Medical Boards, and certification data were obtained from the ABS database. Data were analyzed between 1978 and 2008.

Main Outcomes and Measures Severe license action rates were analyzed across certified surgeons and those failing to obtain certification, as well as across examination performance groups.

Results The final dataset included 36 197 men (81.7%) and 8093 women (18.3%). The incidence of severe license actions was significantly greater for surgeons who attempted and failed to obtain certification (incidence rate per 1000 person-years = 2.49; 95% CI, 2.13-2.85) than surgeons who were certified (incidence rate per 1000 person years = 0.77; 95% CI, 0.71-0.83). Adjusting for sex and international medical graduate status, the risk of receiving a severe license action across time was also significantly greater for surgeons who failed to obtain certification. Surgeons who progressed further in the certification examination sequence and had fewer repeated examinations had a lower incidence and less risk over time of receiving severe license actions.

Conclusions and Relevance Obtaining board certification was associated with a lower rate of receiving severe license actions from a state medical board. Passing examinations in the certification examination process on the first attempt was also associated with lower severe license action rates. This study provides supporting evidence that board certification is 1 marker of surgeon quality and professionalism.

重要性 委员会认证被用作外科医生质量和专业水平的标志。尽管一些研究已将手术认证与结果联系起来，但仍需要更多研究。

目的 评估获得美国外科医师学会（ABS）认证的外科医生与未来根据其医疗执照受到的严厉纪律处分之间的关​​联。

设计，设置和参与者 根据认证状态和检查性能，对尝试ABS认证的外科医生的严格许可使用率进行回顾性分析。试图获得认证的外科医生被列为已认证或未获得认证。此外，根据外科医生是否必须重复检查以及他们是否最终通过检查，进一步将组分类。该研究包括最初尝试在1976年至2017年之间进行认证的外科医生（n = 44290）。1976年至2018年的严厉许可行动是从州医务委员会联合会获得的，认证数据是从ABS数据库获得的。分析了1978年至2008年之间的数据。

主要结果和措施 对获得认证的外科医生和未获得认证的外科医生以及检查表现组之间的严重执照采取率进行了分析。

结果 最终数据集包括36 197名男性（81.7％）和8093名女性（18.3％）。尝试和未获得认证的外科医生（每1000人年的发生率= 2.49； 95％CI，2.13-2.85）比经认证的外科医生（每1000人年的发生率= 0.77； 95％CI，0.71-0.83）。根据性别和国际医学毕业生的身份进行调整后，对于未能获得认证的外科医生，随着时间的流逝受到严厉许可行动的风险也大大增加。在认证检查顺序中进一步发展且重复检查较少的外科医生，随着时间的流逝，接受严格许可操作的风险也较低，风险也较小。

结论与相关性 获得委员会认证与从州医疗委员会接收严格许可行动的比率较低有关。首次尝试通过认证考试过程中的考试还与较低的严格许可操作率相关。这项研究提供了支持性证据，证明董事会认证是外科医生质量和专业水平的标志之一。