Rand Paul opposed Opthalmology Certification process so started his own Board:

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Rand Paul's Upstart Ophthalmology Group Leaves Little Mark
Zachary Roth | May 27, 2010, 11:26AM

Rand Paul's reputation for marching to his own drummer may extend to his medical career. The GOP Senate candidate is the founder and president of a certifying board for eye doctors, which he appears to have set up as a rival to the existing certification board. But his organization has left little public record, and the legitimacy with which it's viewed remains unclear at best.

In 1999, Paul created a new non-profit organization, the National Board of Ophthalmology (NBO), headquartered at his home in Bowling Green, Kentucky, in order to "provide information to the public concerning physicians with exemplary qualifications in the medical specialty of ophthalmology," according to the organization's founding document, filed online with the Kentucky Secretary of State's office.
"It was a certifying board," Beth Ann Slembarski, the administrator of the major existing ophthalmology certifying board, the American Board of Ophthalmology (ABO), told TPMmuckraker.

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Officials for two other eye-doctor groups -- the American Academy of Ophthalmology and the American Society of Cataract and Refractive Surgery -- told TPMmuckraker they'd never heard of Paul's group. "I think it's fair to say that we would have heard of most organizations involved in ophthalmology in the US," said John Ciccone of ASCRS.

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About 96 percent of American ophthalmologists are certified through ABO, the established group, Slembarski said. But Paul himself is not. He was certified from 1995 until 2005, when his certification lapsed.

http://tpmmuckraker.talkingpointsmemo.com/2010/05/rand_pauls_upstart_ophthalmology_group_leaves_litt.php?ref=fpa