Certification is a voluntary process through which a physician may prove his competence by meeting certain performance qualifications. These qualifications have been specifically designed to probe the level of the applicants' knowledge and skills. To achieve certification through the ABLES, a physician must meet the ABLES' published eligibility requirements, successfully complete the ABLES' written certification examination, and earn favorable critique on seventy-five documented, prior surgical cases of a diverse nature. These cases are evaluated for the quality and thoroughness of the documentation, appropriateness of treatment, clinical judgment, and treatment outcome.