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III. Requirements for Initial Application:
Candidates wishing to become Diplomates of the Board must complete a formal written application, which will be furnished by the ABNM on the ABNM website. To apply, a candidate must provide and meet ALL the following requirements:
(1) A complete, up to date curriculum vitae or resume.
(2) Possess a minimum of an earned doctoral degree in a physical science, life science or clinical allied health profession, restricted to the following degrees: Ph.D., M.D., D.O., D.C., Au.D. and D.Pt., conferred by an accredited institution recognized by the U.S. Department of Education or, in the case of foreign medical graduates, the World Health Organization. Furthermore, the ABNM requires applicants with foreign Medical or foreign Doctoral degrees to have provided documentation of US education equivalence. The ABNM considers degrees to be foreign if not originating from approved institutions in either the USA or Canada. Applicants holding foreign Medical or Doctoral degrees (as appropriate) must provide documentation such as a Certificate of the USMLE Step 1, or, a Certificate of primary-source credential verification such as provided by the EICS (ECFMG International Credentialing Services), or, a certified Evaluation of a foreign educational program such as provided by the AACRAO (American Association of Collegiate Registrars and Admissions Officers), or, documentation from an equivalent verification service, that validates the foreign Doctoral degree program as having met equivalent standards and curriculum content compared to the USA. Applicants with a foreign medical doctoral degree must provide documentation showing that medical school where the degree was obtained is on the WHO list of medical schools - http://avicenna.ku.dk/database/medicine. On-line doctoral degrees will not be accepted. Proof of the degree i.e., a copy of the original degree or diploma, must be provided with the application.
(3) Licensed physicians (MD, DO or equivalent), who use or direct intraoperative neurophysiologic monitoring as part of their clinical care may apply as candidates for DABNM provided they fulfill the following criteria:
- Completion of an accredited post-doctoral program of training of at least 2 years duration
- Specific training in IONM from a neurophysiologist qualified under current standards (ABNM, ABCN, or ABPN certified)
- Licensed to practice as a physician in the location in which the IONM training is performed
- Basic technical competence should be demonstrated through:
- Direct observation of the set-up of monitoring for 25 spine and 25 non-spine cases – to include elements of electrode placement, setting stimulation parameters, as well as acquisition and optimization and interpretation of baseline recordings.
- In 10 of each of the above cases, candidates must acquire and optimize baseline recordings by running the IONM equipment.
- A minimum of 5 hours of CME covering the technical cognitive components of IONM. Items to be covered include filters, signal digitization, noise reduction strategies, electrical safety and troubleshooting.
- Technical competence during training will need to be substantiated by documenting 100 cases done under personal supervision of a training neurophysiologist and logged in the “Section 5. Training case Log” that will include the signed attestation of the Training Neurophysiologist.
- The training neurophysiologist must be qualified under current standards (ABNM, ABCN, or ABPN certified)
- A minimum of 5 hours of IONM CME/year for each of the 3 years of experience with the primary responsibility for supervision and professional interpretation of IONM.
(4) Successful completion of two separate graduate level courses, one in neuroanatomy and one in neurophysiology, from an accredited institution with a passing grade. All ABNM required coursework must be taken in class or as an ABNM-approved distance learning course. At time of this version, there are no ABNM approved distance learning courses. Evidence of this information in the form of an original official transcript from the issuing institution must be provided with each application. The transcript must identify each course by name as neuroanatomy and neurophysiology. In the case of courses that have a different name, the applicant must complete a request for course equivalence that is a component of the ABNM application checklist and provide the required documentation of the course number and title, the complete course syllabus, complete class schedule, number of academic credits and course faculty. This required documentation must be in print form and if not originally in English must include the original documentation AND an official translation of all original material into English provided by an official translation company. All material included in the application packet must be received at PTC by the application deadline.
(5) Submit 2 case logs (Case Log I and Case Log II) each as an EXCEL Spreadsheet that log a minimum of 300 cases monitored where the applicant had primary responsibility for professional interpretation of data and technical supervision. Of these 300 logged cases:-
Case Log I.
- A minimum of 300 total cases must be logged in CASE LOG I.
- A minimum of 36 months must be logged with at least one case logged per month.
- The Case Log I must contain the date of each procedure, the type of surgery, the name of the responsible surgeon and the hospital where each procedure was undertaken.
- Months need not be contiguous.
- There is no limit to the number of cases that may be logged for each month.
- Months must be ordered consecutively starting with Month # 1, progressing through Month #36 and must end with at least Month #36. Additional months beyond the required 36 months may be added as necessary.
- The Case Category must be identified for all cases that are defined in the Table below and left blank for cases that are not defined in this Table.
- A minimum of 100 cases in which the applicant physically performed the majority of the technical aspects of monitoring must be logged.
- The log must indicate which cases were physically performed.
- Logs submitted with any patient identifiers included will be immediately disqualified.
Case Log II.
- From the cases that are logged in CASE LOG I, a minimum of 165 total cases must be logged in CASE LOG II distributed across six case categories, with the minimum numbers of cases logged by category, as follows:
# Code Category minimum # of cases
- SPN Spine minimum of 45 cases.
- STL Spine Tumors and Lesions minimum of 15 cases
- CTL Cranial Tumors and Non-Vascular Lesions minimum of 45 cases.
- INP Interventional Neurophysiology minimum of 10 cases.
- VAS Vascular minimum of 45 cases.
- ENT ENT minimum of 5 cases.
- To arrive at a total of 300 cases, the balance of 135 cases (in addition to these 165 cases) may be listed under any case category or be any case with IONM.
- Case Log II must not provide any case details and is to be used to total the numbers of logged case by case category.
- Within each case category (I through VI), several sub-categories are listed. For the required 165 cases, only cases specified in this Table may be included in the case log.
- The required number of cases in each category may comprise cases listed combined from all subcategories, or, from only a single sub-category. For example, the 10 required cases in Category IV. Interventional Neurophysiology (INP) may be drawn from only one sub-category or from a mixture of any of the nine sub-categories.
Case Log II – continued.
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ABNM CASE LOG |
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Six case Categories with list of qualifying cases in each category and minimum numbers of cases that must be included in the official case log: |
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Category |
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Surgical Procedure |
Minimum # of Cases |
I. |
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Spine |
45 |
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1. |
Anterior Cervical Decompression/Fusion |
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2. |
Posterior Cervical Decompression/Fusion |
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3. |
Thoracic Spine Decompression/Fusion/Correction |
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4. |
Lumbar-sacral Spine Decompression/Fusion/Correction |
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II. |
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Spine Tumors and Lesions |
15 |
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1. |
Spinal cord – Extramedullary tumor/lesion |
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2. |
Spinal cord – Intramedullary tumor/lesion |
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3. |
Resection of Bone Tumors/Fusion/Correction |
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4. |
Release of Tethered Cord |
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III. |
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Cranial Tumors and Non-Vascular Lesions |
45 |
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1. |
Cerebral Cortex Convexity and/or Deep parenchymal tumor resection |
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2. |
Skull base and/or CP angle/post fossa (involving IOM of long tract pathways, cranial motor and cranial sensory nerves) |
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3. |
Chiarri Malformation |
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4. |
Micro-Vascular Decompression of Cranial Nerves V, IX and/or X |
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IV. |
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Interventional Neurophysiology |
10 |
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1. |
Peripheral nerve – CNAP studies. (in person) |
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2. |
Brachial plexus mapping (in person) |
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3. |
Epilepsy/ ECoG (in person) |
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4. |
Micro-Vascular Decompression of Facial Nerve involving triggered EMG of “Lateral Spread” |
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5. |
Cerebral Cortex with direct cortical recording of SSEP Phase-Reversal |
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6. |
Cerebral Cortex with direct cortical surface motor mapping |
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7. |
Cerebral Cortex with direct cortical surface language mapping: Awake patient (in person) |
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8. |
Spinal cord stimulator in the cervical spine documented to involve spinal mapping with EMG and/or SSEP collision testing |
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9. |
Micro-Electrode Recording (in person) |
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V. |
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Vascular |
45 |
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1. |
Carotid Endarterectomy |
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2. |
Cerebral Aneurysm – open craniotomy |
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3. |
Cerebral Aneurysm – endovascular approach |
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4. |
Resection of spinal or cranial AVM |
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5. |
Cardio-Thoracic aortic aneurysm/dissection/grafting |
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VI. |
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ENT |
5 |
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1. |
Thyroidectomy with IONM of CN X (free run and triggered EMG.) |
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2. |
Tympano/Mastoidectomy with IONM of CN VII (free run and triggered EMG.) |
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3. |
Implantation of Cochlear Implant. |
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4. |
Parotidectomy |
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5. |
Neck Dissection with IONM of sensory & motor CN's (free run and triggered EMG.) |
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Total minimum number of required cases in categories I-VI: |
165 |
(6) Have at least thirty six months experience in the field of neurophysiologic monitoring as documented in CASE LOG I; the dates of the log must reflect work performed over a minimum of any 36 months with at least 1 case being monitored per month.
(7) Provide statements from two attending surgeons capable of attesting to the applicant’s experience and expertise. The Review Committee of the Board, at its discretion, may require additional letters of support.
(8) Provide a completed and signed statement from a qualifying, Training Neurophysiologist describing the training in the interpretation of neurophysiological data provided to the applicant during the applicant’s three years’ experience, or, the required 300 cases.
- For USA/Canada trained applicants, a qualifying Training Neurophysiologist is either an individual with Board Certification from the American Board of Neurophysiologic Monitoring (ABNM) or, a licensed physician who is Board Certified in Neurology (ABPN) or Clinical Neurophysiology (ABCN) or, by another medical Board specialty deemed appropriate by this board. A licensed physician who is Board certified in Neurology or Clinical Neurophysiology must submit their Curriculum Vitae and proof of Board Certification with the statement. A licensed physician certified by a Board other than Neurology or Clinical Neurophysiology, may be considered to be eligible to qualify as a Training Neurophysiologist by submitting their Curriculum Vitae, proof of Board Certification, and documentation of their training and experience in clinical neurophysiology, with the Statement.
- For foreign (i.e., non USA/Canada) trained applicants, a qualifying Training Neurophysiologist is either an individual with Board Certification from the American Board of Neurophysiologic Monitoring (ABNM) or, a neurophysiologist with a Ph.D. degree, or, a licensed physician who is Board Certified in their home country in a sub-specialty that is approved and recognized to provide interpretation of clinical neurophysiological data in the applicant’s country. Examples may involve sub-specializing in Neurology or Clinical Neurophysiology, by another medical Board specialty deemed appropriate by the ABNM. In all cases, the proposed Training Neurophysiologist must submit a Curriculum Vitae, proof of Board Certification where appropriate, documentation of who trained them and documentation of their training and experience in clinical neurophysiology, with the Statement. The ABNM requests the submission of documentation that is as complete and comprehensive as possible. The ABNM reserves the right to verify all information provided and to reject applications that fail to fulfill the Board’s requirement of an appropriate and qualified Training Neurophysiologist.
In all cases, the Training Neurophysiologist must provide evidence of a minimum of 5 years’ experience in intraoperative neurophysiological monitoring (IONM) including at least 2 years of supervisory experience in IONM. An individual who functions in the capacity of a “reading neurologist”, or “billing provider” or “remote neurologist” or any similar capacity and who otherwise has not provided training to the applicant in the interpretation of neurophysiological data, does not qualify to be the applicant’s Training Neurophysiologist.
Finally, the statement from the Training Neurophysiologist must attest to the fact, and provide documentation of, at least 25 monitored cases in which training was provided by the Training Neurophysiologist, where the Training Neurophysiologist conducted training of the applicant in person and on-site together with the applicant/trainee, either together in the operating room or together at a site providing remote IONM services. This period of direct, in-person training must occur over a minimum term of 10 business days. None of the required training between trainer and trainee for these 25 cases may be provided either indirectly or remotely or on-line. The form to be used for this statement from a qualifying, Training Neurophysiologist is provided with the application form and must be wholly completed by the Training Neurophysiologist and returned directly to the applicant and included in the application packet submitted to the testing service by the application deadline. Acceptance of the Training Neurophysiologist’s statement will be at the discretion of the Board and must occur for the applicant’s application to be deemed complete. Applicants may provide official statements from multiple Training Neurophysiologists. The ABNM reserves the right to verify all information provided.
(9) The current application and examination fee.
(10) A completed ABNM application checklist (in Application Materials) signed and dated by the applicant.
(11) Be in good standing with the ABNM and in compliance with all ABNM Policies and Procedures for Ethics and Professionalism.
Notes:
Incomplete application packets that may include incomplete forms will be returned. All material submitted with every complete application packet will be formally reviewed by the Review Committee and a recommendation concerning eligibility made to the Chairman of the Board.
There were specific reasons for each of these required criteria that revolved around aspects of professional development and experience. The acquisition of an advanced doctoral degree indicates the demonstration of cognitive, analytic and data interpretational skills and the mastery of an advanced knowledge base that distinguishes the individual at a professional level. Since some candidates may not have completed a recognizable training program in neurophysiological monitoring that can certify the individual's competence in the field, the criteria developed for the Training Neurophysiologist will serve as a substitute (i.e. direct and on-site training by a qualified and experienced Training Neurophysiologist as well as peer recognition of competence through participation in monitoring teams). The Board decided to approach this peer recognition using documentation of substantial experience in monitoring with the recognition that a sufficient and varied case load with minimum numbers of required cases in each of six surgical categories should signal professional growth and maturation in the skills necessary for the comprehensive practice of IONM. The attestation statement of two surgeons is used to confirm the level of professional maturation by this experience. This is congruent with the only published evidence that relates to competency that shows case experience correlates positively with patient outcome. As such, a minimum of 300 cases for which they had personally interpreted neurophysiological data is required with the additional requirement that their experience extended over a minimum of thirty six months. The Board’s requirement for in person training by a qualified and experienced training neurophysiologist is intended to facilitate interaction, training, education and mentorship to assure that some component of the applicant’s professional training was received from a qualified individual.
Upon acceptance of a candidate's application to become a Diplomate of the Board, the Board or its authorized agent will notify the candidate that their application has been approved and if requested, furnish a list of the times and places of the next scheduled ABNM Part I-Written examination. Proof of such approval shall be required for the candidate to register to sit for the examination. Any and all questions concerning eligibility should be made directly to the Chairman of the ABNM Board, or via the email link (info@abnm.info) at the ABNM website. |
