September! This is a month of academic renewal and changing seasons. In this time of seasonal change, we take a moment to reflect on our year-long progress to discover beyond the horizon.

In the past year, we have addressed some important opportunities for advancing the mission of the NCS. The first opportunity involved our guidelines. Guidelines are an important aspect of the NCS and have broad impact on both patients and practitioners. Many societies write guidelines and use a variety of approaches in the process. The NCS has endeavored to meet rigorous standards for our guidelines using the GRADE approach. In being rigorous, we have revealed a fundamental deficit in our field, namely, the paucity of scientific evidence to drive the recommendations in guidelines. The NCS understands that more research is needed to provide high levels of scientific evidence which in turn can be used to develop more informative guidelines. This need for better science has served as one of our primary strategic drivers in the last few years. The NCS has a long-term mission to ‘drive the science’ for our field and NCS has made concerted investments in driving the science including sponsoring two distinct research grants, offering a Research Catalyst Mentorship Program for early career investigators, presenting late breaking science at the annual meeting, and the Curing Coma Campaign. The Curing Coma Campaign now includes over 400 collaborators and has published over 40 primary papers and been cited in nearly 100 other publications. As part of the ‘driving the science’ focus, the NCS also created the Neurocritical Care Foundation (NCCF). The NCCF has the goal to raise philanthropic funds for research. In order to enhance the success of the NCCF, the NCS welcomes a new Director of Development, Steve Hartley. Steve will lead all development activities for the NCS and the NCCF. The NCS plans to embrace our corporate and philanthropic sponsors in an active campaign in the coming months to enhance funding for neurocritical care research. Our sponsors look forward to engaging with leadership and all members at the upcoming annual meeting. We are excited for the membership, our sponsors, and our scientific partners to meet Steve Hartley and begin considering how best to support funding scientific discovery.

An example of how guidelines impact neurocritical care is the recently published AAN Brain Death Determination (BDD) Guidelines. The BDD guidelines provide practitioners with very specific guidance on how to conduct the BDD. Implementation and application of the BDD guidelines has generated considerable interest, some controversy and spirited debate, and enhanced public interest in end-of-life considerations in neurocritical care. Given the interest and enhanced scrutiny surrounding BDD, the NCS recognizes the need for training of clinicians to properly apply the BDD guidelines. NCS recognizes neurocritical practitioners’ central role in BDD and is taking action. The NCS has recently revised and updated the NCS BDD certification course, which is available on-line, and will very soon be implementing a hands-on teaching course. We anticipate that there will be increased interest in BDD in the coming years and the NCS is committed to enhance the process and policies surrounding BDD.

An emerging opportunity in Neurocritical Care is enhancements in training in neurocritical care. The ACGME published revised fellowship training requirements in 2024. These changes were very welcome, and we applaud the ACGME. The NCS is very motivated to maintain standards for accreditation and certification so that our graduates are seen and respected as fully qualitied intensivists.  In concert, there has been continued growth in ACGME accredited fellowship programs and an increased number of fellowship positions.  All of this is very positive. However, the number of fellowship applicants has dipped in recent years, and this is reflective of a similar dip in interest among other critical care fellowships in anesthesia, surgery and medical critical care. The NCS will soon be addressing longer range efforts to sustain and boost interest in neurocritical care and to consolidate efforts to attract practitioners to the field of neurocritical care. As part of this effort, the NCS will be addressing workforce and staffing needs in neurocritical care and exploring how collaborative and multidisciplinary teams can meet the workforce demands to achieve excellence in patient care. The horizon of future trainees depends on a concerted effort in this domain.

Finally, NCS leaders have identified an opportunity to enhance our collaboration and interactions with our global partners to enhance patient care worldwide. As we emerge from the isolation of the pandemic, we focus on re-affirming our contacts with our international partners. The NCS has enhanced representation of our global partners through creation of an International Council. The NCS has continued to grow the delivery of educational courses in international settings and has increased financial support for international speakers at the Annual Meeting. The NCS envisions being the Educator of Choice in Neurocritical Care, and this applies to our international audience as well. We look forward to our 2025 annual meeting Montreal, as well as the upcoming regional chapter meetings: South America 2024 in Buenos Aires (November 29-30, 2024) MENA 2025 in Kuwait (Feb 1-3, 2025); South America 2025 in Medellin, Columbia (May 28-30, 2025, and ASIA-Oceana 2025 in South Korea (TBD).