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October will be a very important month for all of us. We are coming close to the NCS Annual Meeting in San Antonio. I believe most of you are planning to attend in-person. Not a surprise here. We are social animals (sometimes with anti-social behaviors, for sure) and living during COVID-19 made our brains re-adjust to a different reality than the 300,000 years of homo sapiens evolution has led us to. And we were not happy. Last year with the first hybrid meeting, uniformly all attendees (including exhibitors!) agreed that the experience was much better than the year before, when everything was 2-D on the screen.

But October is also an important month for me personally, because at the Annual Meeting I will complete my term as President of the Society and pass the baton to Sarah Livesay. Therefore, this is my last letter to you as President of NCS. It feels like yesterday! And it was not an easy year. Yes, COVID has settled into a more endemic form and the infection has become milder for all of us who have been vaccinated and boosted. However, it is still out there waiting to hop to the next Greek alphabet letter. The economy had its ups and downs and the war in Ukraine did not help with the recovery. More and more academic hospitals and health systems felt the economic pressures from the staff shortages and are asking the providers to focus more on clinical productivity rather than research or education. All these external pressures and challenges have disturbed the Society beyond the expected turbulence. For example, we have seen some non-operational losses in our investments with the market’s fluctuation. However, due to years of good planning and strong past performance, we still remain financially solid and able to fulfill our mission. 

Looking back at the year past, I cannot restrain myself but to view the challenges and accomplishments through a critical lens. What did we do well and what not so well? How will all these affect the future? Here is a long list of them (and I am sure I forgot some):

• The first ACGME NCC exam was held last October and many colleagues got certified. But this exhilaration did not last long because we soon learned about the Program Requirements, which came as a surprise, as different to what had been agreed before and as unattainable. We launched a survey of the existing UCNS-accredited Programs which proved this very point and now serves as a basis for monitoring future trends. We spent multiple days trying to solve the issue through ACGME and ECFMG and with the help of the AAN, the ABPN and an army of dedicated NCS colleagues, we were able to secure a “grace period” for Program application until July 2026. But beyond that date every Program will be at risk for losing accreditation if not all programmatic requirements are met. The fight to address this crucial issue with ACGME is far from over and I can assure you we will continues to work diligently on resolving it.
• A second major challenge we faced this year was the leadership transition in our Executive Director, when Sharon Smith-Terry unexpectedly left Smithbucklin. With our partners’ assistance we were able continue business as usual and to find and secure her replacement within couple of months. Mindy Saraco, our new ED, has valuable previous experience and has already proven to be on an NCS-fast-learning trajectory.
• A very positive development on the other hand was the highest number of members that the Society has ever seen. We surpassed the 3,000 target! This confirms that our branding efforts and the value we bring to our members have not passed unnoticed.
• We are heading towards the end of the previous Strategic plan in the end of this year. I am happy to report that the vast majority in this long list of objectives and actions have been completed successfully. In March, we started the 4-phase development of the next 3-year Strategic Plan. This crucial task will be completed before the end of this year and will be the next roadmap for our Society.
• The Curing Coma® Campaign is not only meeting the set deadlines but is also extremely successful. The 2nd World Coma Day participation increased by 27 percent and with more than 1,500 registrants from 100 countries.
• The Neurocritical Care Foundation, which was launched last year as a separate entity from NCS faced some unexpected challenges, which can be viewed as part of the maturity process of a newborn. As the roadblocks have been removed, we are expecting the Foundation to fulfill its fundraising goals in the near future.
• We created a task force to address the ever-growing need for public commentaries. As more and more requests for comments or support from the Society on issues relevant to health care or beyond were landing to our shores, this had to be addressed. This task force is working diligently to create a process for sorting out the requests and for using appropriate language when responding. Another task force was also created to develop a memorandum of understanding between NCS and the Foundation to clean and polish the communication lines between the two.
• The yearly financial audit was completed and, as expected, we passed with “honors.”
• A salary survey was completed in partnership with MGMA and we do have now a basis for future comparisons.
• ENLS 5.0® was launched with a simulation component and other significant enhancements. Other educational products under development, such as the Basic Emergency Neurological Evaluation (BENEfit) may expand the knowledge on how to deal with neurological. emergencies to the non-health care professionals or lay persons
• We partnered with the American Epilepsy Society on the new Status Epilepticus Guideline. We also partnered with the SCCM on a new Anticoagulation Reversal Guideline.
• We represented the Society in multiple national and international meetings. One of the most successful was the Emirates Critical Care Conference in Dubai, where we were able to explore educational collaborations with our Emirati colleagues and developed communication lines with colleagues from few African countries. If you remember one of my ambitions when I started my presidency was to expand NCC to this vast continent. I am very pleased to report we are moving towards that direction.

I could go on and on, but I would like to finish by emphasizing one more time how much work is done within our Society, especially under the surface. By you, members. By you, volunteers! And with the assistance and guidance from our partner Smithbucklin. Without this partnership, this Society would had not grown exponentially and would had not achieved the financial stability it needs to fulfill its mission. Because of you, NCS remains a multidisciplinary, open and transparent, international Society, one with a great potential, 20 years after our inaugural meeting in Phoenix. One that I am proud of! 

As the curtains fall, I have to tell you one more: for the last year, I had the honor and the privilege to serve you as President and I am extremely grateful to all of you for giving me this once-in-a-lifetime opportunity…

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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