Our goals were to estimate how many physicians who were enrolled in a physical medicine and rehabilitation residency program are licensed to practice medicine without American Board of Physical Medicine and Rehabilitation board certification and to compare risk of state medical board disciplinary action with those who are board certified.

We matched physicians who completed training in physical medicine and rehabilitation before 2019 with the Federation of State Medical Boards database. We compared certified versus noncertified physicians registered with Federation of State Medical Boards and frequencies of disciplinary action.

There were 14,729 physicians with matched American Board of Physical Medicine and Rehabilitation and Federation of State Medical Boards data. Of these, 13,707 (93.1%) had attained initial American Board of Physical Medicine and Rehabilitation certification and 1022 (6.9%) had not. Certification status predicted a disciplinary action (odds ratio = 2.76; 95% confidence interval = 2.202–3.463; P < 0.001). Compared with the board-certified physicians, those who never passed part I (attempted once or more) were 4.68 times more likely to have a disciplinary action (P < 0.001), and those who passed part I with multiple attempts but failed part II (1 or more times) were 3.26 times more likely to have a disciplinary action (P = 0.013).

Absence of American Board of Physical Medicine and Rehabilitation certification is noted in approximately 7% of physicians who undertook physical medicine and rehabilitation residency training and obtained medical licensure. These individuals are at higher risk for state medical board disciplinary action.