Continuous Certification
The ABNS Continuous Certification (CC) Program documents a neurosurgeon's ongoing commitment to professionalism, lifelong learning, and practice improvement following initial board certification. This program has been designed to provide flexible, high-quality, practice-related learning and assessment to support neurosurgeons in keeping with the ABNS’ mission. CC also provides assurance to patients and their families, payors and funding agencies and the public that ABNS diplomates maintain and continually improve their knowledge and practice.
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All Diplomates who were Certified by the ABNS in 1999 or later are required to participate in CC to maintain their Certification. Both CC and annual dues payment must be completed each year. A new time-limited certification is awarded to Diplomates at the end of the 10th year after successfully completing all CC requirements annually and paying all annual dues.
New 10-year certificates will be mailed towards the end of December for Diplomates who have completed the annual CC requirements, paid dues, and are at the end of a 10-year cycle. However, Certificates may be subject to forfeit (and Diplomates may lose their Certified status at any time) if a Diplomate fails to annually complete all elements of CC each year during the 10 year cycle (subject to certain grace periods discussed below).
Diplomates certified prior to 1999 may have a “non time-limited certificate.” These Diplomates may voluntarily participate in CC at any time and are highly encouraged to do so. These Diplomates will not lose certification if they subsequently drop out of the CC process. However, Non-Time-Limited Certificate holders with a Recognition of Focused Practice (RFP) Certificate must participate in CC annually (see Diplomates with RFP section).
To sign up for CC, please send an email request to abns.cc@abns.org
All Diplomates (whether time-limited or non-time limited) who have a Recognition of Focused Practice (RFP) from the ABNS must participate in CC annually and pay dues. In addition, the RFP-specific ABNS learning tool must also be completed.
All candidates who complete neurosurgery residency since June 2021 are assigned by ABNS staff to participate in CC. In order for a candidate to be considered "tracking toward Certification" (also referred to as "Board Eligible"), and be permitted to hold themselves out to the public as such, candidates must commence participating in CC beginning January 1 following the completion of residency and remain current at all times on all annual requirements for participation in Continuous Certification. Note that candidates are not required to pay ABNS annual dues.
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Professionalism and Professional Standing (ABMS Part I): Chief of Staff Questionnaire
The Chief of Staff questionnaire requests attestation of the following:
- Member of good standing on the active medical staff without any disciplinary or clinical practice restrictive actions
- Unrestricted privileges for the practice of neurological surgery at their primary hospital.
- Unrestricted medical license
If the chief of staff is not available for attestation, a department chair, division head or other suitable physician administrator may provide this attestation.
Lifelong Learning and Self-Assessment (ABMS Part II)
CME (continuing medical education) - diplomates must report at least 20 AMA PRA Category 1 Credits™ in neurosurgery annually. CME credits cannot be carried over from prior years to satisfy this annual 20 CME credit requirement. Documentation of the earned credits is preferable, but attestation is acceptable. However, attestation without documentation may subject the neurological surgeon to the possibility of random auditing.
Assessment Of Knowledge, Judgment, and Skills: Adaptive Learning Tool (ABMS Part III)
The ABNS Adaptive Learning Tool links to scientific articles pertinent to the practice of neurological surgery and multiple-choice questions based on the articles. The Adaptive Learning Tool can be accessed on-line https://abnslearning.com/#/login and must be completed annually. For RFP credential holders, additional modules in Pediatrics, Neurocritical care and CNS Endovascular are required. The Adaptive Learning Tool is tailored to update “core neurological surgery” knowledge by focusing on new evidence-based concepts most critical to providing emergency, urgent or critical care for the those in the diplomate’s communities, ultimately enhancing public safety. If the question is answered incorrectly, the learner reviews the associated, peer-reviewed articles again. The question can then be answered again ensuring real-time education and mastery, before proceeding to the next question.
Improvement In Medical Practice (ABMS Part IV)
Each year, the Diplomate (or candidate) must participate actively in the Morbidity and Mortality Conferences (M&M) and/or Quality Assurance/Improvement Conferences (QA/QI) at least quarterly in which the neurological surgeon discusses some of his/her cases to improve his/her practice. Given the variability of neurological surgery practice today the ABNS does not believe that “one size fits all” in terms of a particular conference structure. It is up to the Diplomate (or candidate) to develop a meaningful conference structure with their colleagues, specifically one that includes an analysis of cases for future safety and quality improvement opportunities. The ABNS will provide a confidential outline/protocol for neurological surgeons who would like to use the ABNS format. Click here for the ABNS M & M conference format template
Neurological surgeons who do not have access to traditional hospital M&M or QA/QI Conferences at their institutions may fulfill this requirement by attending four (4) regional or national M&M or A/QI conferences (quarterly conferences) annually and having their respective institution leadership attest as such. The hospital’s Chief of Staff, a Department Chair or other suitable physician administrator (as part of the Chief of Staff Questionnaire) must verify annually that the Diplomate (or candidate) attended such the conferences at least quarterly and meaningfully participated by reviewing their complications.
Please note that most State laws provide a “peer review privilege” that prohibits malpractice plaintiffs and others from gaining access to materials and discussions undertaken in connection with certain legitimate peer review activities, particularly those conducted at hospitals. The scope of this privilege varies from State to State, so Diplomates are encouraged to consult with the own (or their institution’s) legal counsel for guidance as to whether a Diplomate’s contemplated M&M activity, especially any such contemplated activity in a non-hospital setting, will be covered by the privilege.
A Diplomate with a time-limited Certificate will lose Certified status upon failing to annually complete all CC requirements, including payment of annual dues, but subject to the grace periods described below.
Candidates who fail to annually complete all CC requirements will lose their status as “tracking toward Certification in good standing" (i.e., “Board Eligible”), and are not subject to grace periods. Note: Candidates are not required to pay annual dues.
Both Diplomates and Candidates are therefore strongly encouraged to timely complete all elements of CC annually and to keep track of their status towards completion. The ABNS continues to strive to make CC less onerous and more relevant to neurosurgical practice.
Information on reentry to certification can be found here: https://www.abns.org/re-entry-certification/
A Diplomate who is delinquent in some or all of the components of CC for any year will receive notice of that fact and will be given until the end of the following year (i.e., a one-year “grace period”) to complete all CC requirements for the year missed. The annual CC requirements for the following year must also be completed in full and a late fee paid. The same grace period and fees also apply to those Diplomates who are delinquent in some or all of the additional CC requirements for continued Recognition of Focused Practice.
For a Diplomate with a time-limited Certificate to maintain his or her Certificate (and/or his or her Recognition of Focused Practice credential), this failure to timely complete all annual requirements may occur only twice in each 10-year Certification period and not in consecutive years.
A Diplomate with a time-limited Certificate will immediately lose his or her Certified status upon failing to timely complete all annual CC requirements more than two years in any 10-year Certification period, or upon failing to timely complete all annual CC requirements in any two consecutive years, or upon failing to complete all delinquent CC requirements for any year during the one-year grace period.
Similarly, any Diplomate with an RFP will immediately lose his or her focused practice credential upon failing to timely complete all additional CC requirements for that RFP more than two years in any 10-year Certification period, or upon failing to timely complete all such additional annual CC requirements in any two consecutive years, or upon failing complete all such additional CC requirements for that RFP for any year during the one-year grace period.
If a Diplomate loses his or her Certificate (and Diplomate status) for failing to timely complete annual CC requirements), the Reentry Process is as follows. The former Diplomate must:
- Commence reinstatement activities by notifying the ABNS that he or she wishes to do so within two (2) years of the date he or she lost his or her Certified status, as well as pay a reentry fee established by the Board which is not subject to refund regardless of the individual successfully completing the reinstatement process.
- Submit 75 consecutive surgical cases performed during the immediately preceding three years through ABNS POST. The cases must be submitted within one year of commencing the reinstatement process and are subject to audit to confirm that they are consecutive.
Once the the Reentry processcase commences, the former Diplomate may begin referring to himself/herself as “tracking toward Certification” or “Board Eligible.”
Based on the case submission, the ABNS will take one of three actions: (i) If the case submission raises few if any issues and no safety concerns, the individual’s Diplomate status may be re-instated based on the case submission alone; or (ii) if the case submission raises some concerns, the individual may be required to take a reentry oral exam in the same oral exam format as for initial certification; or (iii) if the case submission raises serious concerns regarding safety, competence, judgement, professionalism or ethics, a hearing may be convened to determine whether the candidate for re-instatement meets the requirements for oral examination.
Neurosurgeons who have lost Board Certification and who have not reentered the certification process within two years of losing ABNS Certified status must commence the entire Certification process anew, including passing the primary exam. More information can be found here or please email the ABNS at abns@abns.org
For more detail on the process, please see the ABNS Rules and Regulations https://abns.org/governance/.
Candidates who cease to be tracking toward Certification/Board Eligible due to failure to annually complete all required elements of CC will be able to reenter the process by:
- Coming into compliance (re-commencing participation in Continuous Certification)
- Paying such fine as may be established by the Board from time to time.
Individuals must complete the reentry process within six (6) months of the date they initially cease to be tracking toward Certification/Board Eligible. Failure to do so will require the candidate to commence the entire Certification process anew, beginning with passing the primary exam.
More information on reentry can be found here:https://www.abns.org/re-entry-certification/
Correcting Delinquency in CC
The ABNS allows a one-year grace period to complete the four parts of Continuing Certification, subject to limitations described above under “Grace Periods”. However, all annual dues must be paid on time.
Correcting Delinquency in Dues
Delinquent dues must be immediately paid. There is no grace period.
Request for Extension
If a Diplomate or candidate wishes to request an extension or exemption from CC for compelling circumstances, an email may be sent to abns.cc@abns.org. However, exceptions and extensions will only be granted in rare cases for demonstrated good cause. Some individuals may be granted exemptions from certain parts, but not all, of CC. For example, “Inactive” Diplomates who are not currently practicing may be granted exemption from the Chief of Staff Questionnaire and possibly M&M Conferences but not the Adaptive Learning Tool or CME.
Voluntary Participation in CC
For those Diplomates with non-time-limited Certificates who wish to (and all are strongly encouraged to) participate in CC, please email abns.cc@abns.org with your request.