Perhaps I am being a bit lazy, but:
What are the limitations to credentialing in neurocritical care?
Currently EM grads can only take the boards in Europe for general CCM.
How about neurocritical care?
Does it matter?...in these terms: IM CCM is an actual board, whereas CCM in anesthesiology and surgery is just a specialization without board.
What about neurocritical care?
HH
In terms of hospital credentialing, lack of traditional board certification (ABMS) does currently make a difference and will very likely continue to make a difference in the future, especially if ABMS allows ABEM to co-sponsor the ABIM CCM exam. In the past and present, given the lack of access to ABMS certification in CCM, EM intensivists used a few work arounds to satisfy hospital credentialing committees via alternative boards.
Many completed the written and oral CC boards in Europe (
EUROPEAN DIPLOMA IN INTENSIVE CARE MEDICINE (EDIC, http://www.esicm.org/Data/ModuleGestionDeContenu/PagesGenerees/03-education/0A-european-diploma/11.asp). This exam is open to EM physicians. Some hospitals and academic medical centers will accept this as CC board certification for EM physicians.
Some used their CC fellowship time and/or actual post-fellowship practice time to apply for board certification in neurocritical care via the United Council for Neurologic Subspecialties (UCNS).
The UCNS is a US organization that accredits fellowships and provides certification in various non-ACGME accredited programs/non-ABMS neuro subspecialties. EM intensivists could apply via the "practice track pathway" and sit for the UCNS neurocritical care exam (
http://www.ucns.org/go/subspecialty/neurocritical/certification). To some extent, this may restrict one's hospital privileges/scope of practice, but it helps satisfy the need for some type of recognized board certification that is open to EM physicians. However, the practice track pathway will be closing soon.
Some recent EM residents have chosen specifically to go into UCNS accredited neurocritical care fellowships because the UCNS exam is open to EM physicians. Univ of Cincinnati EM has sent several recent graduates into the Univ of Cincinnati neurocritical care program. These folks have been able to take the UCNS neurocritical care boards and work in the neuroICU.
Comparing UCNS neurocritical care certification to ABMS recognized CC certification (via ABIM, ABS, ABA) is not totally analogous due to the simple fact that UCNS is not part of the ABMS system. However, the UCNS neurocritical care exam is definitely open at this time to EM trained candidates who meet the practice track or neurocritical care fellowship training requirements. In addition, the UCNS neurocritical care certification is recognized within many university hospitals and in the realm of US academic neurology.
Potential drawbacks include restriction of scope of practice to the neuroICU. In some hospital credentialing settings where US certification in CC is required for privileges, UCNS certification may get your foot through the door even when EDIC falls short. Whether you are allowed to attend in non-neuroICUs will likely depend greatly on individual and institutional factors (local staffing needs/patterns, person known to relevant dept., specific training background, etc.).
