How does the individual case minimums impact a candidates ability to become board certified by the ABNS?

The ABNS will review an individual resident’s case log numbers and use it with everything else we look at – to decide whether the candidate is cleared to take the oral exam. The ABNS credentials committee looks at the residency program completion, primary exam passing, 6 to 8 letters of reference, malpractice history, their website, their POST case log and a few other things. The resident’s individual case log will just be another piece of data reviewed.

If a candidate missed on a few of the case minimum categories, the ABNS would probably not make an issue of it and would let the person sit for the oral exam. However, if the candidate’s cases were hopelessly inadequate in multiple areas, the ABNS would likely focus heavily on the 125 cases entered into POST. If the candidate’s POST case log was excellent, we would let them proceed to the oral exam. If there were issues with POST, we may require the candidate to come in for a hearing or enter additional cases into POST.

We do not intend for the ABNS individual case minimums to be a “hard stop” in the board certification. It is just another piece of information we will look at.

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As a resident, what needs to be done if I want to complete a rotation away from my primary program?

Rotations away from your parent program must receive prior written consent from the ABNS. If credit is expected for any type of outside rotation, including research, your Program Director must write prospectively to the Board requesting approval for the rotation, whether it is clinical or non-clinical. The letter must give brief details of the educational experience, where it will take place, under whom, and the time frame. Once the rotation is complete, please submit to the Board a written evaluation of the training and how it contributed to your career goals.

  • 6-12 months of neurosurgery credit may be granted if it is neurosurgery or a subspecialty at another ACGME accredited program.
  • If the program is not ACGME accredited elective credit will be given.
  • Rotations of less than three months are of questionable educational value and most likely will not be approved.

Send written request to

A request needs to be sent to the ACGME/RC, specifically Corey Parker if the program is also seeking credit approval.

Send written request to ACGME/RC

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As a resident, what steps need to be completed to get credit for prior education?

Up to 30 months of elective credit may be requested by a Program Director for prior educational experiences, such as a PhD degree in a relevant subject, clinical rotations (other than fellowships) obtained at an ACGME accredited programs, and neurosurgical training completed outside of the U.S., particularly if the resident is certified in that country.

Written requests submitted by the Program Director to the ABNS. The request  must include a complete description of the experience and justification for the request.

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What is the pass rate for residents taking Primary Examination?

In March 2021, the primary exam was taken for credit by 232 examinees and by 605 examinees for self-assessment. The passing score was 335 which is a pass rate of 97.8%

In May of 2020 (delayed due to COVID 19), the was taken by 585 examinees for self-assessment and 270 examinees for credit. The passing score was 335 which is a pass rate of 97%

In March 2019, the exam was taken by 204 examinees for credit and 606 took it for self-assessment.  The minimum passing score is 335.

In 2018, the exam was taken by 219 examinees for credit with a pass rate of 90.86% and 91% for residents taking the primary exam for the first time. The minimum passing score was 335.

Previous pass rates were 99% in 2017, 89.9% 2016, 92.6% in 2015, 91.9% in 2014, and 93.5% in 2013. The minimum passing score was 311.

The exam consists of 375 questions with 60% of the questions being new, rewritten or revised annually.

The relative merits of an NBME style summative exam versus a formative or Mastery Exam continues to be a topic of conversation, the ABNS is considering changing to a Mastery exam format for the 2022 primary exam.

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What is the pass rate for the Oral Examination?

In November 2019, 137 physicians took the ABNS oral exam, 113 became certified (82.5% pass rate).

In May 2019, 122 physicians took the ABNS oral exam, 99 became certified (81% pass rate).

In November 2018, 154 physicians took the ABNS exam with 131 becoming certified (85% pass rate).

In May 2018, 112 physicians took the ABNS exam with 93 becoming certified (83% pass rate).

In November 2017, 93 physicians took the ABNS exam with 75 becoming certified (81% pass rate).

The average pass rate for the oral exam is traditionally in the 80% range.

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Can ABNS Directors, ABNS Examiners and Guest Examiners participate in an oral exam prep course?

The ABNS strives hard to create a level “playing field” for all candidates applying for ABNS certification.

1) The ABNS discourages review of a candidate’s actual oral exam cases/slide presentations at any oral board preparation course. The course content and recommendations may not be consistent with the actual ABNS examination

2) Candidates are encouraged to review their oral board cases/PowerPoint with colleagues, residency or practice mentors as a way to prepare for the oral exam

3) To promote a fair process for all candidates, whether they participate in preparation courses or not, guest examiners and Directors will not participate in any oral board preparation course for the 12 month period following their participation as an ABNS examiner

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How often is the Oral examination offered and what is the format?

The ABNS will continue to offer the Oral Examination twice yearly for the conceivable future. The format of the exam consists of 3 sections; each are 45 minutes in length.

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What changes is the ABNS making specific to Continuous Certification (formally MOC)?

We have responded to our Diplomates requests to make Part III of CC educationally beneficial, more relevant and an efficient use of their valuable time.  The ABNS has a goal of transforming the ABNS learner from a passive receptor of information to a collaborator in the learning process while being sensitive to the expectations of the public who expect that their neurosurgeons are up to date with continuous learning and maintenance of certification.  Furthermore, in a recent survey the majority of ABNS Diplomates agreed that MOC/CC was appropriate and important to help maintain the highest standards  for the practice of neurological surgery. Hence it is our hope that the Part III adaptive learning tool will be both educational and meet the needs of the public.

The emphasis is on learning evidence based “core neurological surgery concepts” to enable Diplomates to better serve their community.

Completing the ABNS Continuous Certification Adaptive Learning Tool annually satisfies the American College of Surgeons (ACS) CME  requirement for covering an ACS Level I certified Trauma Center.

Maintenance of Certification renamed Continuous Certification

The ABNS is continually trying to improve the CC process to minimize the burden and maximize its value.  The ABNS is approaching 3,500 as the total number of Diplomates participating in CC.  In addition, there are more than 100 Diplomates who hold a time unlimited certificate who are participating in CC. These providers signed up voluntarily due to the value CC brings to thier practice.  All ABNS Directors participate in CC.

The key features of the Annual Continuous Certification program are:

Part I and IV: Annual verification of state license, hospital credentials and
attestation of  active participation in mortality/morbidity conference(s)

Part II: 20 CME of any type per year

Part III:  Completion of  Annual Adaptive learning tool focused on general and emergency principles in neurological surgery

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How do I print the certificate for completing the annual adaptive learning tool and/or modules?

Your certificate will be available upon completing all the questions within the CC Adaptive Learning Tool. Once complete, click on “My Learning Tools and Exams” in the main navigation and click the “Access Certificates” button.

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How long do I have access to the CC Annual Adaptive Learning Tool and/or modules?

The CC Annual Adaptive Learning Tool is refreshed every year on January 1. You will have access to the current CC Annual Adaptive Learning tool through December 31. In January a new CC Annual Adaptive Learning Tool will need to be purchased, which will give you access through December 31 of that year.

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The site allows for purchase of more than one CC Adaptive Learning Tool and modules. Does that mean I can purchase for members of my staff, group, or organization?

Yes. If desired, you can purchase more than one CC Adaptive Learning Tool and/or modules for your staff, group, or organization. If you do purchase more than one CC Adaptive Learning Tool and/or modules, your receipt will contain an equivalent number of unique key codes that you can issue to  intended parties, who would then simply go to the site, register, and activate the key to access the CC Adaptive Learning Tool and/or module. Note that if you as the purchaser do NOT wish to use the CC Adaptive Learning Tool yourself, please be certain to disallow auto-enroll during the purchase process.

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How many neurosurgeons has ABNS certified since founding in 1940?

Since its founding in 1940, the ABNS has certified  over 7,892 Diplomates.

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What Focused Practice areas are recognized by ABNS?

The ABNS continues to work on the details of Recognition of Focused Practice (RFP) in three separate areas:

  1. Neurocritical Care Medicine: collaboration with CAST and the ACGME
  2. Pediatric Neurological Surgery: collaboration with the ABPNS
  3. CNS Endovascular Surgery: collaboration with the American Board of Radiology, and the American Board of Psychiatry and Neurology

Helpful links:

American Association of Neurological Surgeons

American Board of Medical Specialties

The Society of Neurological Surgeons (SNS) aka “The Senior Society”

American Board of Pediatric Neurological Surgery

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What is the difference between ABNS, RRC, SNS and CAST?

How many residents are being trained in Neurosurgery?

There are 1,489 residents training in 115 ACGME approved neurosurgical resident programs being tracked by the ABNS.

16% of neurosurgery residents are women.

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Who do I contact with POST or Oral Board questions?

POST or Oral Board questions should be directed to Susan Butterbaugh.

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Who do I contact with CAST questions?

CAST questions should be directed to Linda Kvall-Boynton.

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How do I contact technical support?

For questions and assistance, you may send an email to

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What is the refund policy when purchasing a CC/MOC learning tool?

All sales are final once the CC/MOC Learning Tool has been accessed. Refunded monies for Learning Tools not yet accessed will be returned minus the payment portal processing fee.

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What is the best web browser to use on this site?

The site and classes are compatible with all web browsers that have been updated within the past three years. The site and courses are also available on mobile devices.

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I’m having trouble viewing all site content. What should I do?

Some hospital security settings and firewalls may block website content; you may wish to log in from a home network or have your hospital IT department whitelist this website.

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I forgot my password. What should I do?

Click the “Login” link in the top navigation, then click “Lost your Password?”.  Enter your email address or username on the following page and you will be sent an email with a link that will allow you to reset your password. If you have technical difficulties, then contact the Service Center.

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