While licensure by the individual states sets the minimum competency requirements to practice medicine, it is not specialty specific. Board certification is a voluntary program in which specialists seek to improve their performance and demonstrate a commitment to their profession.

The path for an otolaryngologist-head and neck surgeon to become certified by the American Board of Otolaryngology (ABOto) is long and complex. First, an individual must graduate from college and medical school which normally takes eight years. After completing a five year residency in otolaryngology-head and neck surgery and with the approval of the training Program Director, an individual can apply to take the certification examinations. The ABOto's examination consists of two parts. An all-day written examination qualifies the individual to sit for the oral examination which consists of a half-day examination with four examiners involving 16 actual patient scenarios. Only after passing both of these examinations is the individual certified and are referred to as ABOto diplomate.

Beginning in 2002, all ABOto diplomates must participate in Maintenance of Certification (MOC) which was developed to assist our diplomates with staying up-to-date in their specialty. The MOC program, when fully implemented, is a ten year cycle which involves annual updates on the individual diplomate, self-assessment, evaluation of performance in practice, and an examination the diplomate must pass to renew his/her certificate.