Subspecialization in neurology: the role of the united council for neurologic subspecialties

Abstract

AAN= : American Academy of Neurology; ABMS= : American Board of Medical Specialties; ABPN= : American Board of Psychiatry and Neurology; ACGME= : Accreditation Council for Graduate Medical Education; ANA= : American Neurological Association; AUPN= : Association of University Professors of Neurology; CNS= : Child Neurology Society; PCN= : Professors of Child Neurology; RCPSC= : Royal College of Physicians and Surgeons of Canada; UCNS= : United Council for Neurologic Subspecialties. In recent decades, there has been considerable growth in neurologic subspecialties. In response to this trend, the American Academy of Neurology (AAN), American Neurological Association (ANA), Association of University Professors of Neurology (AUPN), Child Neurology Society (CNS), and Professors of Child Neurology (PCN) helped establish the United Council for Neurologic Subspecialties (UCNS) in order to provide accreditation of training (fellowship) programs in neurologic subspecialties and certification of graduates of these programs (and, during a limited “practice track” period, practitioners qualified by their substantive experience). This article reviews the reasons why UCNS was established, how it operates, and what it has accomplished. In the first issue of Neurology ® in 1951, an article by Pearce Bailey, MD, entitled “The past, present, and future of neurology in the United States,” noted that by the end of World War II, neurology had not yet attained “unchallenged professional autonomy as a medical specialty.”1 Bailey pointed to the establishment of the AAN in 1948 as reason for hope that there would be “a new renaissance of neurology in the near future” and he concluded that “[t]he time has come for neurology as a specialty to assume responsibility for the total medical treatment of neurologic patients.” In the decades since Bailey's article, AAN has undertaken many initiatives to help neurologists achieve this goal. In 1998, AAN President Francis I. Kittredge, Jr, MD, FAAN, appointed a Commission on Subspecialty Certification that was chaired by Stephen M. Sergay, MB BCh, FAAN. This was a time of major change in neurology. Neuroscience was advancing at an explosive rate. New technologies and treatments were developed that promised dramatic advances in neurologic care. The boundaries between emerging areas of practice in neurology and other specialties were becoming blurred. The number of AAN sections was growing fast, and new subspecialties did …