Focused Practice Designation

Focused practice designation recognizes a specific area of practice within a medical specialty or subspecialty. Such areas develop as medical knowledge advances.  A focused practice is more narrow than a subspecialty and may concentrate on certain procedures while not requiring the breadth of training or clinical experience needed for a subspecialty certification.

In a focused practice, a board-certified physician or medical specialist may concentrate on specific patient populations, conditions, and/or procedures within the broader context of their specialty. For example, a physician with a specialty in Emergency Medicine from the American Board of Emergency Medicine may obtain a focused practice designation in Advanced Emergency Medicine Ultrasonography, recognizing their extensive experience and expertise in using ultrasound in the acute care setting.

Subspecialty certification is for a concentrated area of medical practice, within a specialty, in which a physician or medical specialist has expertise. In addition to the time required to obtain specialty certification, practice in a subspecialty follows additional special educational experience — an ACGME or equivalent-accredited training program. Focused practice is for even narrower areas within specialties or subspecialties that change as a physician or medical specialist gains experience or as medicine advances. See the Differences Between Subspecialty Certification and Focused Practice Designation^[PDF].

ABMS Member Boards can submit a proposal for focused practice designation to the American Board of Medical Specialties (ABMS). The proposals must meet ABMS standards and include eligibility criteria including clinical practice experience, training (if required), and the assessment process for maintaining the designation. The proposal goes through a thorough review and approval process by the ABMS Committee on Certification and Board of Directors.

Physicians and medical specialists who are already certified in a specialty or subspecialty can apply for focused practice designation through the relevant ABMS Member Board. They need to meet the criteria, including the amount of time they’ve spent in the specific area and the number of patients they’ve treated or procedures they’ve performed. Sometimes, formal training is also required.

To keep their focused practice designation, physicians and medical specialists must meet all the requirements for continuing their certification in their primary area of practice (i.e., specialty and/or subspecialty certification as per the Member Board requirements). They must also complete the focused practice requirements which may count toward maintaining their primary specialty or subspecialty certification. We recommend physicians and medical specialists check with their primary board so they are aware of the requirements to continue their Focused Practice Designation.

No. A physician or medical specialist may continue to meet their specialty or subspecialty certificate requirements without also continuing to meet the focused practice requirements, in which case only the designation lapses. Eligibility to resume the designation may be possible by again meeting the Member Board’s requirements for it, but the primary specialty or subspecialty certificate must continue to be kept up to date.

Yes, board certified physicians and medical specialists will have their focused practice designation displayed as part of their active certification on the ABMS Board Certification credentials profile; lapsed designations are not recognized on the profile.

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