Board certification demonstrates that physicians have met vigorous standards through intensive study, self-assessment and evaluation. Additionally, Certification encompasses the six areas established by the Accreditation Council on Graduate Medical Education (ACGME) and sets the stage for continual professional development through values centered on lifelong learning. In order to be certified, a physician must: 1. Complete the requisite predoctoral medical education 2. Meet the training requirements 3. Meet the licensure requirements and procedural requirements 4. Pass a Certification examination *Maintenance of Certification promotes lifelong learning and the enhancement of the clinical judgement and skills essential for high quality patient care. Every 10 years, internists and subspecialists certified in or after 1990 renew their certificates through ABIM's Maintenance of Certification program. Those certified prior to that date are strongly urged to participate since the program helps improve the quality of care delivered to patients.