Hollowed out and not finished on the back. The diamond weight seems a bit doubtful as they are barely visible and there is no real sparkle seen. I think it looks more like a diamond accent piece, which would be less than the advertised 1/10 TDW. Generally nice, but very over-priced for what you get even considering the price of gold today. I like the ease of the lobster-claw clasp for attachment to a charm bracelet. Generally a fair detailed charm for anyone in the registered nursing profession.