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June 2022 President's Update

By Currents Editor posted 06-03-2022 08:32

Have you planned for your summer vacations? Well, some will say “we prefer snow skiing in the winter”, but I bet that most of you will take some days off to visit a beach, a lake, have a boat-trip. A summer vacation.

NCS does not take vacations. It was a busy month for the Society, and June will be similar. There have been new developments on several fronts:

NCS has collaborated with our management partner, Smithbucklin, on the pathway to identify our new Executive Director. We have already started the process of interviewing candidates and we will continue. The interim leadership plan designed by staff and Smithbucklin leadership has been smooth and we have not experienced any hiccups.

Registration for the NCS 20th Annual Meeting has also opened. We have had several discussions with the Inclusion in Neurocritical Care Committee (INCC) about placing a statement on the webpage regarding the restrictive legislation that Texas has recently passed affecting gender equality and physician-patient relationships. Because NCS has an IRS non-profit (501c3) status, there are limitations on what can be stated and, even more importantly, on the links that one can open through clicking our website. We sought legal advice from NCS counsel and the final product reflected this collaborative effort and review. NCS has begun a process to address requests for statements regarding current and future issues, from war conflicts to restrictive health care legislations. We need to prioritize what is important for an international medical Society like ours, which lives and breathes within a much grander mosaic of opinions, within different cultures, countries and the World. We want to do the right thing: to continue supporting diversity, inclusivity, address medical or neurocritical care issues and at the same time balance risks for the future of the Society.

After going back and forth with ACGME, on May 18th we received a letter from them affirming that 1) they will not change the verbiage to the previously proposed “neurologist or neurosurgeon” but will keep the current “neurologist and neurosurgeon” requirement for Program Core Faculty and 2) there will be a “grace period” until 2026 for Programs to apply for Fellowship accreditation even though they may not have as Core Faculty a NCC-certified neurosurgeon. However, after July 1, 2026, all neurosurgeons serving as Core Faculty should have Recognition of Focus Practice in NCC. The ABNS has published specific paths for them to achieve that. Although it is not clear what will happen to Programs that will not achieve this by the deadline (losing their accreditation? unable to renew it?), it is reasonable for all current UCNS Programs that wish to also become ACGME-accredited to apply now and in parallel explore with their neurosurgery colleagues paths to achieve NCC RFPs before 2026.

Another unclear statement in this same ACGME letter was the reference to the IMG colleagues requiring J-1 visas. ACGME is developing a guidance for sunsetting the Non-Standard Training Programs designation, currently used to sponsor J-1 visas through ECGME. For colleagues starting this July, there is no question, this will continue until they complete their training. For those starting in 2023, this is also true based on an email by ECGMG we received on May 21st. Therefore, there is no reason to panic or, even worse, to withdraw or make “deals” outside the SF Match.

The majority of Officers represented NCS to the 18th Emirates Critical Care Conference (ECCC) in Dubai in mid-May. If you have never been in that area of the world, you may consider visiting: tourism is one of the goals they have put afront to enable them to switch from a purely oil-based economy and it seems they have been successful. This is one of the fastest growing areas in Middle East, with an amazing skyline of ultra-modern buildings and the tallest skyscraper in the world. The Conference was well-attended with record interest in NCC based on the attendance to the ENLS and the other neuro-related courses. We had also an opportunity to connect with colleagues from other underrepresented countries such as Nigeria, Sudan, Saudi Arabia etc., and also initiate a dialogue with our Emirates colleagues to provide training for Brain Death. I must recognize the contribution of Yasser Abulhasan and Jamil Dibu for connecting NCS with the right stakeholders and also of recurrent ECCC attendees, such as Tamer Abdelhak, Katja Wartenberg and Gene Sung for introducing us to the critical care local leaders. Overall, a successful NCS presence with great potential for future collaborations.

Hesiod was the second greatest poet of the pre-classic period. He was compared to Homer and apparently, he had won a poetic competition against him! Two oeuvres have been saved “Theogony” where he coins the myths to the Gods and “Works and Days” about the peasant life of this bygone era. It is on the latter where he states “Μέτρα φυλάσσεσθαι, καιρός δ’ επί πάσιν άριστος” Keep due measure. There is time for everything (or there is a right time for everything). This is close noematically to one of the most famous quotes in antiquity by Cleobulus of Lindos. He was another venerated poet of the 6th century BC, who is considered one of the seven sages of ancient Greek world, and who said “Πάν μέτρον άριστον” Moderation is the best thing. We live in a world of extremes. Fast paced, constantly changing. Life has been extended by modern Medicine, but does not last forever. There is an urge to live the moment at its most extreme, at the most pleasure it can provide. Like there is no tomorrow. Sometimes, however, we encounter this tomorrow in our Neuro-ICUs. The tomorrow of heavy smoking, heavy drinking, heavy eating, heavy risk taking. Have you ever asked your patients had they known the present in the past, would had they chosen the same un-moderate habits? I bet many wouldn’t have budged, but many would have had regrets. This would probably be a yes or no answer, binary, no moderation, no in-between...

Panayiotis (Panos) N. Varelas, MD, PhD, FAAN, FNCS
President, NCS Board of Directors
Professor of Neurology and Chairman, Department of Neurology
Albany Medical College

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