By Michael L. “Luke” James, MD
Since 2007, the United Council for Neurologic Subspecialties (UCNS) has been the recognized certification and accreditation body for Neurocritical Care (NCC). UCNS now accredits 69 NCC training programs and certifies 1,337 diplomates. The measures of expertise for certification of the diplomates and the standards for training program excellence have been established by respected representatives nominated by the sponsoring organizations: the Neurocritical Care Society and the American Academy of Neurology’s Critical Care & Emergency Neurology (CCEN) section.
The NCC sponsoring organizations also have a voice on the UCNS Board of Directors, and I have served as the NCC representative on the UCNS Board since 2017. I have found my time serving on the board of directors beneficial, as I have participated by representing the NCC community in decisions made effecting the subspecialties recognized by UCNS. One issue impacting neurology subspecialties is recognition of subspecialties within hospitals. UCNS has assisted with recognition by the Leap Frog Group and, most recently, with the National Uniform Claim Committee in securing a taxonomy code.
Like you, I have been attentively monitoring progress of other possible NCC certification routes outside of UCNS. In 2018, the American Board of Psychiatry & Neurology (ABPN) announced it received approval of its application to the American Board of Medical Specialties (ABMS) to offer a certificate in the subspecialty of NCC. Further, the ABMS has released its initial requirements for certification through “practice track” pathways that intend to begin granting NCC certifications as early as the next three years. Despite this, with a 12-year history of supporting NCC, the UCNS has stated its commitment to the continued support of this multidisciplinary subspecialty, the NCC UCNS-certified diplomates and NCC UCNS-accredited programs. The availability of the NCC certification through ABPN does not invalidate UCNS certification or accreditation.
The UCNS will offer the 2019 NCC initial certification examination as previously scheduled, providing an opportunity for interested physicians to certify and then to continue certification through the UCNS. The NCC certification examinations will continue to be developed by the subject matter experts nominated by NCS and AAN’s CCEN to serve on the examination committee. UCNS diplomates who choose to pursue the ABMS certification will need to take the examination being developed and administered by the ABPN, as outlined in their requirements.
Committed to supporting NCC, the UCNS remains responsive to the needs of physicians in practice. Hearing dissatisfaction with maintenance of certification, the UCNS Board of Directors asked the Certification Council to develop a new method for recertification. All UCNS diplomates, including NCC, will have the opportunity to continue their certification through the new UCNS continuous-certification (C-cert) process that will launch in 2020. With the new C-cert process, UCNS diplomates will no longer be required to take a high-stakes recertification examination to maintain their certification. Instead, all diplomates will be transitioned to C-cert. C-cert participants will complete short annual assessment quizzes that promote lifelong learning relevant to the subspecialty. The NCC sponsoring organizations and diplomates will be involved in identifying the developments and topics of importance to life-long learning in NCC. Certificates will not expire if the annual C-cert requirements are met. Additional details about the UCNS C-cert transition and requirements will be forthcoming in the spring of 2019.
While the Accreditation Council for Graduate Medical Education (ACGME) is exploring options for NCC program accreditation, the UCNS will remain the sole accreditor of NCC training programs. Accreditation, like certification, is a voluntary process. UCNS-accredited NCC training programs may continue their accreditation through the UCNS and applications for new programs may be submitted by either annual deadline date, June 1 or Dec. 1. The UCNS accreditation process is modeled after the ACGME process, including development of training milestones for NCC. UCNS secured permission from ACGME to follow its milestones format, and the NCC milestones were drafted by a work group nominated by the subspecialty’s sponsoring organizations.
Additional information is available in a Neurocritical Care Certification FAQ document on the NCC certification examination page at the UCNS website (www.ucns.org). There are also certification recognition resources available on their website to help promote UCNS certification and educate institutions about the value of the certification.
While this is a time of change within NCC certification, I will continue to work directly with NCS leadership to provide a voice for the subspecialty, as the representative for NCC on the UCNS Board of Directors. Should you have any questions or concerns, please feel free to email me at firstname.lastname@example.org.