Paul passed the certifying examination of the American Board of Ophthalmology in 1995, entitling him to describe himself for 10 years as a "board-certified" ophthalmologist. In 1992, the century-old American Board of Ophthalmology, which in 2010 listed 16,000 ophthalmologists on its rolls, had begun requiring physicians to recertify every 10 years; prior to that, no limits had been placed on duration of certification.[24] In 1997, in protest of the American Board of Ophthalmology's decision to grandfather in older ophthalmologists and not require them to periodically recertify in order to maintain their status as board-certified practitioners, Paul, along with 200 other ophthalmologists formed the National Board of Ophthalmology to offer an alternative ophthalmology certification system.[25] The National Board of Ophthalmology was incorporated in 1999, but Paul allowed it to be dissolved in 2000 after failing to file required paperwork with the Kentucky Secretary of State's office for the organization to continue to operate. Paul later recreated the board in September 2005, three months before his original 10-year certification from the American Board of Ophthalmology lapsed.[20] Since then, Paul has been certified by the National Board of Ophthalmology, with himself as the organization's president, his wife as vice-president, and his father-in-law as secretary.[24] The National Board of Ophthalmology is not recognized by the American Board of Medical Specialties, the American Medical Association,[24][26] or the Kentucky Board of Medical Licensure.
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