Physician Resources

ABMS NEUROCRITICAL CARE MULTIDISCIPLINARY SUBSPECIALTY

The American Board of Medical Specialties (ABMS) adopted a new Neurocritical Care (NCC) Subspecialty involving the American Board of Psychiatry and Neurology (ABPN), American Board of Anesthesia (ABA), American Board of Emergency Medicine (ABEM) and American Board of Neurosurgery (ABNS). The new NCC subspecialty will allow for uniformity in the training and skill sets of neurointensivists through ACGME-accredited fellowship training.

FREQUENTLY ASKED QUESTIONS (FAQs)

Download a copy of this FAQ here.
Download the UCNS FAQ here.  

1. How did this certification come about?

The NCS first reached out to the ABPN in late 2016 about the possibility of starting an ABMS Member Board subspecialty in Neurocritical Care. Due to their aligned goals, the NCS worked closely with the AAN to submit a preliminary application to the ABPN in May 2017 and the final application in November 2017. The ABMS Board of Directors approved the application at their June 2018 board meeting.

2. What is the value of this subspecialty certification?

It standardizes training programs in addition to certifying individuals with expertise and competency in bodies of knowledge of not only general critical care medicine but the unique population of those critically ill with neurological illness. Most specifically, it should ensure uniformity in the training and skill sets of neurointensivists through the Accreditation Council for Graduate Medical Education (ACGME)-accredited fellowship training.

3. Now that the NCC subspecialty application was approved by the ABMS, what are the next steps and how will the examination be created?

The sponsoring Boards (ABPN, ABNS, ABA and ABEM) will develop an agreement of how the Boards will work together. Thereafter, they will appoint a multispecialty examination committee to develop a Content Outline and write questions. Additionally, the ACGME will be asked to develop training guidelines and requirements for the NCC subspecialty fellowship programs. Eventually, the ACGME will review applications for training programs seeking accreditation.

4. What is the connection between the ACGME and the ABMS?

The ACGME is responsible for setting criteria for residency and fellowship training programs and for accrediting training programs. There is no direct connection between the ABMS boards and the ACGME, but individual Boards (ie, the ABPN) do pay some attention to what the ACGME Residency Review Committees publish as requirements. Therefore, the ACGME will determine what is required for NCC fellowships training programs to be accredited..

5. I am due to renew my UCNS certification later this year. Due to the ABMS subspecialty approval, should I hold off on taking the UCNS exam this year?

Since the process of writing the NCC examination through collaboration of the ABPN and other sponsoring Boards (ABNS, ABEM and ABA) will take time, if you are UNCS or CAST certified, you should continue to maintain your current certification. The ABMS practice track will allow you to take the certifying examination if your UCNS or CAST certification is current.

6. I am not a diplomate of one of the sponsoring Boards for NCC, (i.e., ABPN, ABNS, ABEM, and ABA); will I be eligible for the ABMS NCC certification?

No, you will not. When NCC was proposed as an ABMS subspecialty, the ABMS process is to ask all the member boards if they are willing to sponsor the new subspecialty. NCC leadership was aware that the ABIM, ABS and ABP have diplomats that are UCNS-certified in NCC. The leadership of the non-sponsoring Boards were approached and chose not to sign on at this time. The process also allows them to sign on later. If you are a diplomate of one of these Boards, we would recommend that you petition your ABMS member board to sign on as a sponsoring Board.

7. When will the first board certification exam be offered that meets ABMS criteria?

It is anticipated that the first board certification exam that is recognized through the ABMS process will be offered in 2020 or 2021.

8. Who will the administer subspecialty board certificate?

It will be administered by the ABPN and will be offered to eligible diplomates of the ABPN, American Board of Anesthesiology, American Board of Emergency Medicine and American Board of Neurological Surgery.

9. What is the subspecialty’s practice pathway?

There will be a six year practice pathway for neurologists, neurosurgeons, anesthesiologists, and emergency medicine physicians who are certified in Neurocritical Care by the UCNS or CAST, have completed a “fellowship” in Neurocritical Care (UCNS, CAST, or other non-accredited fellowship), or who document required practice experiences. Please click here for access to the FAQs on UNCS Certification/Accreditation for Neurocritical Care.

10. When will the practice pathway begin?

The practice pathway will start when the first exam is offered.

MOC RESOURCES

Don't Sweat the MOC: Maintenance of Certification for Neurology Decoded

By Jennifer Frontera, MD, FNCS

NCS MOC PIP tools are APBN approved and now available on our website!

Back in the olden days (prior to 1994), those who were ABPN certified in neurology were granted lifetime certificates. Then in 1994 the ABPN changed to a 10 year recertification model, which required passing a standardized exam. Beginning in January 2012 the ABPN began requiring maintenance of certification (MOC) every three years along with an exam every 10 years. MOC includes: 1) Category 1 CME credits, 2) Self-assessment credits (also known as SAE or self-assessment exams), which consist of educational material with practice questions, and 3) PIP (performance in practice) modules consisting of clinical modules demonstrating your practice abilities and feedback modules from both patients/families and peers.

Tools to earn SAE and PIP credits must be approved by the ABPN as of 2014. A list of currently approved tools can be found at www.abpn.com/moc. However, there are few tools which apply to the daily practice of neurointensivists. To solve this problem, the NCS has devised PIP modules for approval by the ABPN. Once approved, PIP modules will be available on the NCS website for all members including: 1) forms for peer feedback 2) forms for family or patient feedback and 3) clinical modules. Clinical modules will be geared toward the everyday work you do in the neuro-ICU. The NCS is developing two clinical modules, one on subarachnoid hemorrhage and one on intracerebral hemorrhage, which are designed to evaluate adherence to quality measures as outlined in NCS and AHA guidelines. The history and physical examination from 5 patients would be reviewed by a colleague using an approved form. For example, the review form would assess inclusion of a discussion of blood pressure management, glucose control, and deep vein thrombosis prophylaxis among other items. Submission of history and physical examinations of another 5 patients within the next 2 years is required for completion of the PIP clinical module. Completion of evaluation these 10 patients could then be self-reported on the APBN physician Folio website. Your ABPN physician Folio also compiles your CME and SAE credit and must be updated annually as you complete MOC items. The ABPN may audit your CME, SAE, and PIP records during the continuous MOC process, but no actual patient documents need be submitted to the ABPN. This entire MOC process is repeated every 3 years, leading up to the next cognitive examination in the 10th year.

For those who have taken an ASPN computer-based cognitive examination since 2012, You are enrolled in continulous MOD, and participation includes the elements listed in Table 1.

table_1.jpg

For those who have not taken an examination since 2012, you are still in the traditional MOC program. Your specific year-to-year requirements are individualized in your folio account, but are summarized in Table 2.

table_2.jpg

Additionally, NCS is planning to develop ABPN approved self-assessment CME modules. Stay tuned!
Acknowledgements: I would like to thank Dr. Kerry Levin, neurology director and chairman, MOC committee, APBN for reviewing this article for accuracy.

NCS MOC PIP Tools