The National Board of Examiners in Optometry (NBEO) has announced the date for the 2026 Advanced Competence in Medical Optometry (ACMO) Exam – it will be administered at over 220 U.S. Pearson VUE Professional Centers on Friday, June 5, 2026.

• Overview, Fees and Tutorials
• Registration Dates (PDF)
• Test Center Information
• Register for the Exam

Important Notes

This exam is administered once per year.

Registration Opens: July 29, 2025
Registration Deadline: May 22, 2026
Extended Registration: May 23-29, 2026

The ACMO exam has a 2-tiered fee structure and there is a significantly reduced fee if you sit for the exam during the residency-year in which you complete your residency program. Exam Fees.

Since the availability of seats at some test centers may be limited, candidates are encouraged to register as soon as possible to reduce the likelihood of having to travel a long distance to the next available test center.

Register for the Exam

The Journal of Medical Optometry (JoMO) is supported by the American Board of Certification in Medical Optometry (ABCMO). The following is an excerpt from the journal’s first editorial. JoMO is freely available online here.

Welcome to the first edition of the Journal of Medical Optometry! JoMO is the official journal of the American Board of Certification in Medical Optometry and we are so proud to bring this publication to you. The genesis of this journal is the attempted solution to a problem: the dearth of journals designed for clinical optometrists. As an optometrist in a teaching hospital, each year I see colleagues and trainees come up with ideas for publication. And all too often I see them discouraged by the submission process. They see amazing cases which could be seen by eyecare providers everywhere and which could develop all of our knowledge; but this knowledge often goes unshared. This journal exists to be a platform where we can all come to learn and to share. Its audience is anyone who wants to learn about the medical-based problems (and solutions) that an eyecare provider might encounter on any given day… Read More

Journal of Medical Optometry, Issue 1 – May 2023

Three Articles from the First Edition
Subjective Dyschromatopsia as Presenting Symptom of Neovascular Age-Related Macular Degeneration
Conjunctivochalasis: A Report of Two Cases
Principles of Diabetic Care

Douglas J. Rett, O.D., FAAO
Editor-in-Chief, Journal of Medical Optometry
Secretary, ABCMO Board of Directors
Chief, Boston VA Optometry

ABCMO offers Board Certification in the Specialty of Medical Optometry which “encompasses the medical diagnosis, management and treatment of primary and secondary diseases and disorders of the human eye, adnexa and visual tracts.”

ABCMO is recognized at Joint Commission accredited medical facilities as issuing board certification in the Specialty of Medical Optometry. Those certified by ABCMO are eligible for credentialing at these facilities as specialists rather than general practice optometrists.

To apply for Specialty Certification in Medical Optometry an OD must:

1. Complete a full-time, ACOE (or equivalent) accredited, postgraduate clinical residency training program having its major emphasis on medical optometry at a health care facility accredited by The Joint Commission, such as a VA medical center.
2. Pass the Advanced Competence in Medical Optometry (ACMO) exam. This exam is significantly discounted for current Residents.
3. Meet additional requirements as outlined on the Certification Application.

For more information about specialty certifications at your medical facility, please talk with the residency supervisor where you are training.

You may send any application questions to info@abcmo.org

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About ABCMO

The American Board of Certification in Medical Optometry (ABCMO) is recognized at Joint Commission accredited medical facilities as issuing board certification in the Specialty of Medical Optometry. Those certified by ABCMO are eligible for credentialing at these facilities as specialists rather than general optometry practitioners.

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About The Joint Commission

The Joint Commission is the recognized agency that accredits federal, state, and local-chartered medical facilities. Over 127 Joint Commission accredited hospitals, clinics and teaching institutions now credential ABCMO Board Certified Optometrists as Specialists in Medical Optometry.

The following is a review of factors leading to enhanced programs to ensure Maintenance of Certification (MOC) of physician specialists. ABCMO requirements can be found in Article 19 of the ABCMO Bylaws and on the Maintenance of Certification webpage.

Background theory and general information

In 1999 some medical specialist boards still issued lifetime board certifications, while others required continuing education or training to renew the time-limited board certifications they issued. Medical specialist certifications are only earned after completing medical school and being issued an initial state license to practice medicine and they require residency training and passage of specialist examinations administered by specialist certifying boards.

Medical specialists had developed (the American Board of Ophthalmology was first, in 1930) prior to WWII and were supported by hospital organizations as medicine developed specialized, complex treatments necessarily best performed within hospitals. And because these procedures carried more risks, hospitals began to favor, and some to require, that medical specialists be board certified to join their medical staff. There are 24 recognized specialties in medicine governed by the American Board of Medical Specialists. Dentistry, podiatry and optometry only later developed specialties and certifying boards for them that, like medical specialties, require postgraduate clinical residency training and passage of specialty examinations.

The development of these specialties arose independently at the clinical level, begun by medical practitioners who sought to learn more about a particular aspect of medicine and traveled to spend time working with a known expert as a “resident”. They rapidly grew in numbers after WWII when returning veterans used GI benefits to seek additional training. By 1980 medical specialization had become the norm and today about 90% of medical school graduates become specialists by serving specialty residencies and most hospital higher risk procedures are performed or diagnosed by medical specialists.

In 1999, the Institute of Medicine (IOM), one of the National Academies, completed a study designed to recommend changes in American hospital care. The IOM study was one of many reactions to previous estimates that as many as 98,000 hospital patients died each year from medical errors. The estimates created such interest they raised the question whether lifelong specialty certifications should end and more rigorous standards be established for renewals of specialty certifications.

The IOM Committee on Quality of Health Care in American completed its study and published its recommendations in the book “To Err is Human: Building a Safer Health System”.

Among the IOM recommendations were these^

Health professional licensing bodies should:

1. Implement periodic re-examinations and re-licensing of doctors, nurses, and other key providers, based upon both competence and knowledge of safety practices; and
2. Work with certifying and credentialing organizations to develop more effective methods to identify unsafe providers and take action.

At about this time other similar studies were issued which also led to questioning the wisdom of issuing lifetime specialty board certifications.

Those studies produced a generally accepted consensus that medical specialty boards should:#,*

1. Issue initial board certifications not for life but carry expiration dates.
2. Renewal of expired board certifications should require evidence the specialist has undertaken steps to maintain their initial competence and keep pace with diagnostic and treatment developments.

References

To Err is Human: building a safer health system, Committee on Quality of Health Care in America, Institute of Medicine, The National Academies, June 2000, National Academy Press, 2101 Constitution Avenue, N.W., Washington, DC 20418. ISBN 0-309-06837-1. Full text available at www.nap.edu/readingroom. Report can be purchased at The National Academies Press.

^ It is important to note these recommendations were directed at board certified medical (allopathic and osteopathic) specialists holding hospital privileges and treating hospitalized patients since the reported deaths occurred within hospitals. The IOM made no recommendations for medical practitioners, whether board certified or not, treating patients within their private offices.

# No study or recommendations were made regarding dentists, optometrists and podiatrists although each profession has certifying boards for residency trained specialists. ABCMO is the only board certified optometry specialty at this time.

* Some optometry opinion makers believed the IOM study, insurance plans or Medicare regulations would soon require general practice optometrists become “board certified”. This created a “hot debate” within optometry, much angst and confusion, and led to formation of the American Board of Optometry that offers board certification to general practice optometrists as does a similar one for general practice dentists. About 4% and less than 1% respectively of general practice optometrists and dentistry hold these board certifications that are essentially additional CE in general practice.

The Board believes it vital to have independent, external advice and counsel of the highest quality and is pleased to announce Charles F. Mullen, O.D., has accepted the Board’s invitation to serve as Special Advisor.

Dr. Mullen brings an exceptional record of experience and leadership relevant to the ABCMO mission from having long been intimately involved in the integration of optometry into health care systems and building interdisciplinary delivery of eye care as demonstrated by his CV (PDF).

A graduate of the University of Virginia who served as an officer in the US Navy prior to entering the Massachusetts College of Optometry, his leadership qualities were so apparent he served as Special Assistant to the President for Clinical Development after graduation. During six years Dr. Mullen transformed the school’s clinical system by establishing interdisciplinary eye clinics at health clinics in the greater Boston area and reaching out to medical institutions.

He was recruited to be founding Executive Director of the Eye Institute in Philadelphia, the then new patient care and clinical education facility of the Pennsylvania College of Optometry from 1976 to 1990 and worked to integrate optometry within regional health systems and develop productive programs with medicine and ophthalmology.

In 1990 Dr. Mullen was recommended to, and selected by, the US Department of Veterans Affairs for appointment as Washington Director of its national Optometry Service, the largest optometry patient care and clinical teaching program in the country. In this position he was the highest ranking optometrist in federal service and worked with members of the US Congress and Executive Branch as well as leaders of medical education across the nation and was responsible for a staff of 260 optometrists at 159 medical facilities with 75 residents and 590 optometry students rotating per year.

In 1996 he was named President of the Illinois College of Optometry in Chicago where he led a transformation in its administrative and clinical programs, put the College’s financials on a sound base, created an affiliation with the University of Chicago and expanded student training sites from 9 to 144 sites while improving student retention to 99% before retiring in 2002.

Currently Dr. Mullen is co-founder and President of the American Board of Optometry Specialties that assists in the establishment of residency-based training programs in optometry specialties and their subsequent specialty and subspecialty certifications.

The Board believes Dr. Mullen’s experience will be invaluable to ABCMO and looks forward to working with him in the future.

Introduction

Until 1974 the Department of Veterans Affairs (DVA) lagged behind the Department of Defense in providing optometry care to its beneficiaries. But Congressional legislation, critical external reviews and the findings of a General Accounting Office investigation then set the stage for the development of a national DVA Optometry Service that now treats over one million unique patients per year utilizing some 700 optometry medical staff members while pioneering and now operating 81 optometry resident programs training 220 optometry residents each year in medical optometry, the only optometry specialty requiring postgraduate residency specialty training and passage of a national specialty examination that leads to national board certification in medical optometry.

The following article from the web-based textbook Optometric Care within the Public Health Community published in 2010 describes how those reforms in DVA optometry care mirrored those reforms used to achieve other signal improvements in DVA medical care.

Public Health and the Department of Veterans Affairs (This is the full article)

Development of Medical Optometry Within the VA (Pages 1-5 and 16-28 from above)

The author (Kenneth J. Myers, Ph.D., O.D.) served as founding director (emeritus) of the DVA optometry service, 1974-1989 and is founding director of the American Board of Certification in Medical Optometry.

Recognition of Medical Optometry

Formed in 2009, the American Board of Certification in Medical Optometry is now recognized by credentialing committees at over 100 Joint Commission accredited medical facilities across the nation that have appointed ABCMO certified optometrists as specialists in medical optometry rather than general practice.+ Specialists hold Level 2 credentials after completing an accredited specialty residency, passing a national specialty examination and certification by a recognized specialty board.

This acceptance of ABCMO certification established medical optometry as a recognized specialty and resulted from its adoption of specialty requirements analogous with those required of specialists in medicine, osteopathy, dentistry and podiatry.

Facilities Recognizing ABCMO Certification

Accredited medical facilities recognizing ABCMO specialty certification include:

1. Federal hospitals: Department of Veteran’s Affairs medical centers and clinics, Army-Navy-Air Force hospitals and clinics, Walter Reed Medical Center and Indian Health Service of the US Public Health Administration. (79 facilities to date)
2. State Licensed Hospitals: Notably the Mayo Clinic and University Hospitals. (24)
3. Credentialing documenters: CHG Healthcare, Air Force Centralized Credentials Verification Office, CVS, Valforce, VeriPoint, Merrit-Hawkins, Aperture. (7)
4. Private eye practices. (26)
5. Academic teaching facilities. (7)

ABCMO has now certified 418 optometrists to date, of which over half are members of the medical staff at accredited federal hospitals and clinics.

The typical ABCMO certified optometrist is an AOA member, Fellow or Section Diplomate of the American Academy of Optometry, faculty at an affiliated school of optometry and medical staff member at a Joint Commission accredited medical facility (federal and state).

Joint Commission accredited facilities conduct mandatory re-credentialing reviews of their medical staff and now require verification of ABCMO certification during credentialing reviews.+

With 24% of optometry school graduates completing specialty residencies other nascent specialties may soon seek recognition. The American Board of Optometry Specialties, sponsored by ABCMO, is prepared to assist in their development.

Note: While medical optometry residencies began at Veterans Affairs hospitals, optometrists completing accredited residency training in medical optometry at schools and non-VA facilities may apply for ABCMO certification. About 35% of ABCMO certified optometrists did not train, or practice at a federal medical facility. This percentage will continue to increase with the growth of non-VA medical optometry residencies.

VA Optometry Residencies

In 1946 the VA was first directed by Congress to establish medical residencies but VA optometry residencies for optometrists did not begin until 1975.

Congress realized in 1945 VA hospitals were ill prepared to care for the large numbers of WWII veterans and authorized building new VA hospitals affiliated with medical-dental-nursing schools, higher pay schedules and VA student intern and residency training programs for physicians, dentists and nurses. Today the VA is the largest component for training interns and residents in the country via its teaching affiliations.*

Unfortunately the 1946 VA modernization did not include optometry staff or affiliations with schools of optometry that continued to lack access to medical facilities, even at universities with medical and optometry schools and a nearby VA hospital.

To be fair, optometry’s isolation from hospital-based training was due to both its fear of being absorbed by medicine and a now expired AMA decree barring physicians from taking part in optometry training. In 1970 the VA still employed but 9 elderly Civil Service optometrists and had no optometry school affiliations but did have backlogs of veterans seeking eye care. Studies by schools of optometry, the American Optometric Association and the U.S. General Accounting Office documented VA lacked optometry staff, equipment, teaching affiliations and adequate salaries; the same conditions that had existed in 1945 for VA medical, dental and nursing care before VA modernization.

As in 1946, Congress responded to those findings by enacting legislation in 1976 that authorized a VA Optometry Service, transferred VA optometrists from Civil Service to the VA Medical-Dental salary scales and mandated optometry teaching affiliations; actions mirroring those of 1946 for VA medical, dental and nursing programs. As a result VA optometry care rapidly increased in quality and availability.

In 1975 the Kansas City VA hospital affiliated with the U. of California at Berkeley School of Optometry to create the first hospital optometry residency in the nation, training optometrists for hospital-based practice, a new area of optometry training.

That residency proved so effective other VAs developed optometry residencies and optometry student intern rotation programs expanded with them. (The first student rotations began in 1973 at the Birmingham VA hospital in affiliation with the University of Alabama, at Birmingham, School of Optometry.)

Today 70% of optometry students complete at least one VA rotation before graduation and the VA now has over 725 full-time optometrists on its medical staffs; operates 86 optometry residency programs training 215 optometry residents per year and VA optometry clinics have over 1.4 million unique patients enrolled.

NAVAO Calls for Specialty Exam

At its annual meeting in 1998 the National Association of VA Optometrists (NAVAO) decided a standardized examination to test the competency of those completing VA optometry medical optometry residencies was a high priority.

NAVAO believed this specialty examination would address concerns of the VA Office of Academic Affiliations that while VA residencies in medical optometry were popular and accredited, there was no quantitative measure to assess the competence of those completing them. And, after extensive meetings between NAVAO and the National Board of Examiners in Optometry (the profession’s independent testing body utilized by optometry schools and state licensing boards), a joint working committee developed the written specialty examination, “Advanced Competence in Medical Optometry” (ACMO), first administered in 2005 and thereafter annually.

The ACMO examination was the second step in developing medical optometry as a recognized specialty, and is a metric by which the VA, optometry schools, and ABCMO can assess medical optometry residency programs at VA and non-VA facilities.

While the majority of VA residency programs emphasize medical optometry, there are others that emphasize “low vision” and “vision rehabilitation” that can be expected to develop similar examinations and certifying boards in the future.

Establishing ABCMO

ABCMO organized in 2009 to certify optometrists who completed an accredited postgraduate medical optometry residency at an accredited medical facility, passed the ACMO examination and met other professional requirements. Establishing ABCMO allowed medical optometry to meet all three requirements of a recognized specialty—Specialty Residency, Specialty Examination, Specialty Board certification.

This process took 34 years and required close cooperation between the VA, the nation’s schools of optometry and the profession’s residency accrediting body.

While a slow process, thirty-four years was also typically the time required to establish specialties in medicine and dentistry.

In return for its support the VA has benefited from team delivery of eye care, better relations between medicine and optometry, reduced waiting times and creation of a national pool of hospital-trained optometrists from which it can recruit. A higher percentage of VA medical optometry residents practice in the VA than any other specialty. For example, the current national Director of the VA Optometry Service completed a VA residency, served as a VA staff optometrist and a VA Optometry Section Chief prior to appointment in Central Office.

Nature of Specialty Training and Certification

Specialty boards began to appear first in medicine as it broadened in scope to the extent a physician with an internship after graduation, could not be competent in all areas. The first specialty organized in 1930. With time, specialties formed coordinating bodies to develop uniform standards for residency training, specialty examinations and certification boards. Early boards had “grandfather clauses” to allow older practitioners to be certified without serving a residency; these usually expired within 5-years of the board’s creation. Certifications were life-long but today many certifications expire after 10 years with re-certification required via programs of Maintenance of Certification.

The system for training and certifying medical specialists developed at clinical facilities and arose sui generis, rather than by fiat from medical schools or state licensing bodies (the latter play no role in certifying specialists). The current coordinating body for allopathic physician specialists is the American Board of Medical Specialties (ABMS).

Credentialing of Medicare Physicians

Five prescribing health professions [allopathic-osteopathic Medical Doctors, Dentists, Optometrists and Podiatrists], are classified by the Centers for Medicare and Medicaid as “Medicare Physicians”.

This is the peer group into which optometry credentialing must be compatible with as federal medical agencies use one, standardized qualification credentialing form for them.

In this credentialing system Medicare Physicians holding a state license are credentialed as general practitioners of their profession [Level 1 credentials]; Specialists, by completing a postgraduate specialty residency, passing a specialty examination and being certified by a specialty board hold Level 2 credentials. Sub-specialists, have fellowship training within a sub-specialty recognized by their specialty board and hold Level 3 credentials.

Most (90%) allopathic and osteopathic physicians hold specialty certifications but considerably fewer of the other three Medicare Physician are specialists because their state licenses already limit their scope of practice. Optometry has one specialty board.

Requirements for Specialty Recognition

Medical and osteopathic physicians, dentists, podiatrists and optometrists have separate, independent governing bodies for their specialties but share in common these key requirements for recognizing specialists:

1. Hold a clinical doctoral-degree from an accredited medical, osteopathic, dental, or podiatry school.
2. Complete an accredited, postgraduate residency in a defined specialty.
3. Hold a letter of endorsement from the Chief of their residency program.
4. Acquire a state license to practice their profession while in residency.
5. Following residency, pass the standardized national examination testing competence in their specialty required by their specialty certification board.
6. Meet additional requirements for certification by their specialty board such as nature/site of residency training, numbers of patients seen, recommendations of former residency supervisors and evidence of high moral character.

At this time there are over 30 recognized specialty certifying boards for allopathic physicians, 18 for osteopathic physicians, 9 for dentistry, 1 for optometry and 6 for podiatry.

Sub-specialists are credentialed by the specialty board of which they are a certified specialist after serving a fellowship in the sub-specialty.

Optometry Specialties Slow to Develop

Optometry educators have identified areas suitable for specialization but only medical optometry has accredited residency programs, a standardized specialty examination (ACMO) and a specialty board recognized at Joint Commission accredited hospitals. Approximately 8% of optometrists practice within those accredited medical facilities.

While optometry’s legal and educational scope of practice have continued to widen, its national organization has seemed reluctant to endorse specialization although over 20% of graduates pursue specialty residency training. But specialization among the other licensed health professions has taken place with Pharmacy one example.#

In 1986 a committee of the American Optometric Association proposed guidelines by which a specialty could be recognized by nonprofit specialty boards external to the AOA. But its House of Delegates voted against approving this and the AOA still has no policy on optometry specialties. ABCMO choose to align with those AOA guidelines and those of recognized specialty boards in medicine, osteopathy, dentistry and podiatry.

Earlier, the American Academy of Optometry in 1984 had examined the issue of specialization and certification and its Executive Committee concluded “being a fellow in the Academy” or a “section diplomate” did not constitute certification of clinical competence as they were “knowledge based” rather than “competency” based.

ABCMO therefore has had to emerge independently (like early medical specialty boards) and establish recognition by its acceptance at Joint Commission accredited health facilities as a Level 2 credential within the “Medicare Physician” credentialing system.

In summary, the three levels of staff appointments made at Joint Commission accredited health facilities for “Medicare Physicians” are:

• Level 1: Degree and license to practice.
• Level 2: Level 1 + specialty residency + board certification.
• Level 3: Levels 1 and 2 + fellowship training within sub-specialty.

+ The Joint Commission (formerly Joint Commission on the Accreditation of Health Care Organizations) is the recognized gold standard of health care facility accreditation.

* The Dept. of Veterans Affairs and Department of Defense (DOD) are separate Federal Agencies. VA cares for those discharged from active duty while DOD health systems care for active duty personnel and dependents. Retired military personnel are eligible for care from the VA or DOD.

# Though not considered “Medicare Physicians”, the Board of Pharmacy Specialties was organized in 1976 as an independent agency of the American Pharmacists Association and it recognizes five areas of specialty pharmacy practice: Nuclear Pharmacy, Nutrition Support Pharmacy, Oncology Pharmacotherapy and Psychiatric Pharmacy.

Appendix

Background

The factors and legal background leading to the formation of ABCMO and its credentialing standards are detailed here:

1. Optometry Credentialing at Medical Facilities
2. Articles 2.1, 18.1, 18.2 and 18.3 of ABCMO Bylaws

These links provide perspective and supplemental material explaining the ABCMO mission, why VA pioneered medical optometry residencies and the agreement of ABCMO criteria with standards and requirements of specialty certifications in medicine, dentistry and podiatry.

The Role of State Licensing

The majority of optometrists are in private practice for which the legal requirements are an O.D. degree from an accredited school or college of optometry and valid, current state license to practice optometry. The states, not the Federal Government issue licenses to physicians, dentists, optometrists and podiatrists as well as to non-medical practitioners (insurance agents, realtors, barbers, brokers, opticians, beauticians, etc.) State licensing boards do not regulate specialists other than requiring them to hold a state license.

Advent of Medical Specialists

Prior to WWI the majority of physicians were in private practice and had completed a one-year internship. Their training was geared to the solo practice of general medicine. With the spread of hospitals and beginning development of medical specialties, some young physicians sought specialized training by spending time with a hospital-based mentor.

One of those physicians was W.J. Mayo of Rochester, Minnesota who set aside time each year to study with an expert in a specific area. In 1894 he visited the new school of medicine at Johns Hopkins University, in Baltimore, where he met Dr. William Osler. Johns Hopkins was held as an example of how modern medical schools should be organized and had adopted the German style of medical education where permanent “chiefs” ran specialty clinics at which recent medical school graduates “resided” to study a specialty.

Dr. Mayo, impressed by this system, joined others in endorsing the Johns Hopkins model and adopted it for what is now the respected Mayo Clinic System. From this developed the “residency” training model. The Mayo Clinical System was among the first to accept ABCMO certification.

These residency “rules” were first established at Johns Hopkins:

1. Specialty training is at the postgraduate level.
2. This training is conducted within an accredited hospital under a specialty “chief” who is usually a faculty member at an affiliated medical school.
3. Residency training centers on patients suffering from conditions upon which the “chief” is an acknowledged expert.
4. The residency training center has sufficient patient flow to practice its specialty full time.
5. Residents are given greater responsibility for patients in graduated steps.
6. Residents are, mentored, monitored and “tested” during training.
7. When the “chief” believes a resident is qualified to practice the specialty the resident is given a “voucher of competence”.

The “voucher of specialist competence” was a letter from the residency “chief” attesting to a resident’s competence which evolved into a specialty certification process.

The Move to Board Certification of Specialists

Medical doctors are free, once granted their medical degree and license (which requires serving an internship of 1-2 years after graduation) to establish the type of private medical practice they wish, without completing postgraduate training in a specialty. At one time most physicians did not specialize after their internship and established general practices (GP). Today 90% of medical and osteopathic physicians complete a specialty residency and general practice itself is a specialty.

Prior to about 1950 physicians who did not wish to be a GP would list their practice as “limited”. For example, “oculists” were physicians limiting their practice to the eye while others limited their practice to specific organ(s) or diseases. These physicians had not served specialty residencies but had usually stressed those areas while an intern.

After WWII large numbers of young M D.s who served in the armed forces, upon returning home took advantage of the new G.I. Bill to pursue a specialty residency (or attend medical school) and more hospitals began to be built and the country M.D. who once did surgery in the office (or patient’s home) were becoming the minority. Meanwhile early medical insurance plans were forming around larger cities and industrial concerns.

The first specialty to establish board certification after residency was ophthalmology in 1930 to distinguish its practitioners from G.P.s, oculists, EENT doctors, optometrists, opticians and “doctors” who at that time sold mail-order patent medicines that “dissolved cataracts” or “treated” eye weakness.

But until about 1980 the majority of physicians operated private, independent practices, while holding hospital privileges to admit patients for more complex conditions or procedures. In those times the primary purpose of specialty board certification was to signal to their colleagues their area of expertise to enable referrals.

Board Certifications Comes of Age

With the advent of vertical integrations of medical care, public media advertising of health care as a commodity delivered by “providers”, insurance panels, and patients being thought of as “customers” to which TV ads pitched cures, health care changed dramatically and became a fungible business commodity. Its delivery was concentrating around hospitals, HMOs and large group practices and new physicians were becoming employees of them. Growing numbers of specialty procedures became performed only at hospitals or large group practices. The public and insurers became malpractice sensitive, particularly hospitals which used credentialing and privileging for quality control.

Physicians who once had no difficulty in obtaining hospital privileges without being board certified are now often unable to receive privileges. The new specialty of “hospitalist” developed for physicians practicing only within a hospital have no private office but coordinate the care by other specialists within hospitals.

The prime drivers of board certification have become hospitals for quality control purposes while the general public is only vaguely aware of its meaning.

Impact on Optometrists

While board certification is almost mandatory for medical physicians, it is of lesser importance to dentists and optometrists in general practice for which state licensure is the main requirement and hospital privileges not needed.

Podiatrists are affected to the extent they increasingly need to admit patients to hospitals for surgical treatment of below-the-knee conditions and diagnostic scans and tests and have moved, beginning in the 1970s, towards requiring residency training for state licensure. Many of their residency programs also began within VA medical centers and clinics and their utilization within the VA medical system was expanded by the same legislative initiatives applied to optometry in 1976 and equally successful in improving VA care.

Dentists have continued to perform most of their surgical procedures within their private or group offices but have established specialties and board certification programs. Most dentists are in general practice however, have not served residencies and are not board certified in general dentistry.

The majority of optometrists, like dentists, remain in private general practice without need to admit patients to a hospital. The specialty of medical optometry is predominately practiced within accredited medical facilities, optometry-ophthalmology eye centers, group optometry practices and rural optometry practices.

General References

To Err is Human: Building a Safer Health System. Institute of Medicine, National Academy Press. Washington, D.C. ISBN 0-309-06837-1.

The Doctors Mayo, Garden City Publishing Co., Inc. Copyright 1941 by the University of Minnesota.

History of the American Academy of Optometry, James R Gregg. 1987.

Organizational Issues in Health Care Management, Alan Shelton. Spectrum Publications, Inc. 1975.

History of the VA Department of Medicine and Surgery. VA Central Office Library, Washington, D.C.

Bulletin from the Commission On Optometric Specialties, #106, May 29, 1986. AOA St. Louis Office.

Sample Application Form for “Medicare Physicians”

The American Board of Certification in Medical Optometry (ABCMO) confers a specialty board certification for optometrists who have completed an ACOE accredited residency in medical optometry, passed the advanced specialty examination “Advanced Competence in Medical Optometry” administered by the National Board of Examiners in Optometry and met additional requirements specified in the ABCMO Bylaws. It is the only optometry specialty board certification available and congruent with recognized specialty boards in medicine, osteopathy and dentistry.

The following medical facilities have utilized ABCMO to verify specialist status in medical optometry. However, this list should be viewed as a sample only because it does not include requests for verification of certification from private practice offices.

Department of Veterans Affairs Medical Facilities

DVA Birmingham, AL
DVA Fayetteville, AR
DVA Tucson, AZ
DVA Wilmington, DE
DVA West Palm Beach, FL
DVA Chicago, IL
DVA Honolulu, HI
DVA Baltimore, MA
DVA Detroit, MI
DVA Battle Creek, MI
DVA St. Louis, MO
DVA Salisbury, NC
DVA Manchester, NH
DVA East Orange, NJ
DVA North Las Vegas, NV
DVA Montrose, NY
DVA Oklahoma City, OK
DVA Roseburg, OR
DVA Columbia, SC
DVA Fort Meade, SC
DVA Memphis, TN
DVA White River Jct., VT
DVA Puget Sound, WA
DVA Walla Walla, WA
DVA Milwaukee, WI

Non-DVA Medical Facilities

South East Alaska Regional Health Consortium, AK
Indian Health Service, AZ
Indian Health Svc., Chinle, AZ
Indian Health Svc., NE Tribal Health, Sys., AZ
Indian Health Svc., Tuba City, AZ
Tuba City Regional Health Care, AZ
Indian Health Care, Inc., Banning, CA
Naval Hospital, Camp Pendleton, CA
Sanford Health Care, CA
U. of Iowa Hospitals and Clinics, IA
Wheaton Franciscan Healthcare, IA
Eye Specialists of Indiana Surgery Center, IN
Indiana U School of Optometry, Indianapolis Clinic, IN
Henry Ford Hospital System, Detroit, MI
Mayo Clinic, MN
Western Physicians Providers Inc (PHO), NE, SD, WY
Stony Brook Medicine, NY
Indian Health Svc., Lawton, OK
Northeastern State U College of Optometry, OK
Conemaugh Memorial Center, Johnstown, PA
Air Force Credentials Verification Office, TX
Gundersen Health Care, WI
Gunderson Lutheran Health Svc., WI

The Joint Commission is the recognized accrediting body for federal and state-chartered medical facilities.