According to Wiki, because the original sanctioning board changed the system so those who had qualified before were grandfathered into a system where they never had to recertify while new applicants had to recertify at substantial personal cost every ten years. That struck the good doctor as unfair so he started his own board with an open book test he wrote himself. As I said above, it is quite sketchy and incestuous, but by the few accounts I have read it was because of money not because of competence.
Wiki is not exactly the gold standard of information, but the other sources I read said essentially the same thing, here is the text:
In 1995, Paul was certified to practice by the American Board of Ophthalmology (ABO).[27] Three years earlier, the ABO had changed its certification program, which previously awarded lifetime certifications, and required ophthalmologists to recertify every 10 years, while those who had already been given lifetime certification were not required to recertify. Paul felt this was unfair and began an aggressive campaign to have all ophthalmologists recertify every ten years. In 1997 he set up the National Board of Ophthalmology (NBO) to offer an alternative certification system, at a cost substantially lower than that of the ABO.[28][29][30] Its certification exam, which Paul completed for his own certification, was an open book take-home test that Paul helped write.[28] Paul appointed exclusively his own family members to the board of directors and registered the Board to an incorrect address.[28]
No one anywhere that I read denied that he graduated from Duke University School of Medicine. I also read that he did pass the previously existing board (the American Board of Ophthalmology or ABO) but was pissed about having to recertify every ten years at personal expense while older members were not required to recertify. When he was not able to effect those who were grandfathered in, he started his own board (the National Board of Ophthalmology or NBO). As I readily admit, it seems sketch and wholly insubstantial.
To summarize, he DOES have training, he graduated from a genuine medical school. According to what I have seen, he was sanctioned through the original ABO before throwing a temper tantrum, quitting, and then launching his own organization (the NBO). I assume as a doctor, he also holds some sort of license to practice issued by the state. (And I am pretty damn sure he does not get to have input into his own state licensing – that would be up to the state itself despite his role in the federal government.)
Listen, no one dislikes Rand Paul more than I do. But as bad as he may be at it, he is a real doctor with a real degree from a real medical school. It seems he passed the “real” certification exam before he created his dodgy board with its open book, take home test that anyone of us could pass without any training.
Now, I happen to believe he is completely full of shit and is trying desperately to discredit Fauci for purely personal or political reasons. But saying he is not a real doctor just makes us look as stupid and partisan as the other side. Show me some authoritative source that says he never graduated from Duke Medical, or that he does not hold (and has never held) a license to practice medicine and I will dance under a full moon with you over it. But don’t believe something just because you want it to be true. If I did that I would still be a Republican like all my family and neighbors and I would be as wrong as they are.
Now I am sorry for this distraction, it has little to do with mask mandates but it does demonstrate just how dysfunctional the Republican Party is on this issue (and dozens of others too). It is mostly because they are:
- A personality cult
- Far, far too committed to an ideology (and one that defies any logic I can detect)
- Completely devoid of decency or humanity or sense of statesmanship or even fairness
- Obsessed with destroying the opposition with a profound fear of their ideas,
- Convinced they are the army of (the One True) God doing divine work, and lastly
- Incapable of reasonable thought (or real life, or real life consequences – reality I guess)