FAQs

Frequently Asked Questions About the UCNS

Q: Will the UCNS process improve training and patient care?

A: Yes. The process used to create the UCNS is the same system that makes the United States a world leader in medicine. Specialty medicine in the United States is based on well-defined, accredited training followed by evaluation and certification meeting clear standards. This provides the foundation for the evolution of medical research and practice for each specialty and subspecialty, allowing it to grow and evolve. Most neurology post-residency programs are not accredited by any organization. The UCNS offers an opportunity to standardize program requirements within a neurological subspecialty. This should result in enhanced quality of training, benefiting both physicians and patients, and will allow prospective fellows to evaluate programs more completely.

Q: Will Neurologists use the UCNS?

A: There is no way to absolutely determine usage prior to implementation of the system. From June through November 2002, the UCNS sponsors commissioned an extensive research effort to acquire information on this question. The data obtained reflected the need of neurological subspecialties for accreditation and certification.

Q: Who is likely to participate in the UCNS program?

A: The UCNS program is designed to recognize added competence and to assist subspecialties that have matured to the point where accreditation of training programs and certification of program graduates is appropriate.

Q: Why is the current certification system provided by the American Board of Medical Specialties (ABMS) not feasible for some Neurological Subspecialty Areas (NSAs)?

A: Gaining acceptance of a new subspecialty certificate through the ABMS is complex. The ABMS system is not organized to accredit and certify newly developing subspecialty areas. The UCNS will provide such an environment. These neurological subspecialties will need developmental support. The UCNS Parent Organizations will assist in providing this support.

Q: Will this hurt the ABPN or the Accreditation Council for Graduate Medical Education (ACGME)?

A: It is not the intent nor the expectation that the establishment of the UCNS would be negative for either the ABPN or the ACGME. The subspecialties interested in UCNS recognition are not of current interest to the ABPN. If these subspecialties mature in size to the level required by the ABPN, such subspecialties may proceed with accreditation (through the ACGME) and certification (through the ABPN). Subspecialties choosing ACGME accreditation would be welcomed in the UCNS certification system.

Q: How much will this process cost Neurology organizations?

A: Startup costs (approximately $200,000 in 2003) will be borne by the parent organizations. Increasing revenues would offset operating costs. Although the American Academy of Neurology (AAN) will be supporting the majority of the expense initially, the UCNS is expected to be self-supporting in the long-term.

Q: Will the UCNS organization be recognized by outside agencies?

A: Several governmental and non-governmental organizations recognize valid certificates issued by credible groups. It is the intent of the UCNS to meet and exceed necessary standards. It will take a good deal of effort, however, to make the information on the UCNS process available to appropriate agencies. The UCNS is committed to making this information available to the Parent Organizations, who with the assistance of a fully fledged lobbying effort of all interest groups, will attempt to ensure recognition among government organizations and outside agencies. The focus of the UCNS will be on ensuring the quality of accreditation and certification and not on lobbying, per se. Hospitals and other independent credentialing organizations generally base their decisions on a series of independent criteria including the credibility of the accreditation and certification organization.

Q: Why does Neurology need to create another organization? Why not have an established Neurology organization provide these services?

A: The process of certification in medicine, as in other professional fields, depends on the credibility of the organization issuing certificates. When a certification system is owned by one membership organization, the potential for and perception of a conflict of interest is strong. By establishing an independent organization with all of the major specialty organizations as sponsors, the credibility of the certification and accreditation process is strengthened.

Q: What will be the impact on the general neurologist?

A: Many believe that all neurologists are generalists with special expertise acquired through years of experience and training. Therefore, there is little need for a subspecialty certification process. However, the trend across all medical specialties has been toward subspecialization. This is driven, in part, by new science and technology, which expand both the need and options for subspecialization. Neurologists have responded to this trend. In 2000, 75% of graduating neurology residents entered subspecialty fellowship programs.*

Formal establishment of subspecialties has been an avenue for expansion for many medical specialties. Consider the growth of Internal Medicine through the development of subspecialties in Cardiology, Oncology, Gastroenterology, Pulmonary/Critical Care, and Allergy. All are considered major areas of practice, and many have developed subspecialties of their own. Though clinically related neurosciences and neurotechnology have exploded in the past decade, formal recognition of NSAs has not. In fact, Neurology?s scope of practice has decreased as larger, better-organized efforts of others have resulted in non-neurologists providing the bulk of care in subspecialties in which there are overlapping areas of interest.

Neurologists care for only a fraction of patients who have neurologic diseases. It is believed that further definition of the subspecialties of neurology will expand the number of patients with neurologic disease cared for by a neurologist. This will expand the opportunities for care by all neurologists, both generalists and subspecialists.

Q: If Neurologists are not certified, will they still be able to practice in the area of the certificate?

A: Certification provides evidence that an individual physician has met specific training criteria and has been found proficient in that field by the experts in that field. Patients, hospitals, and other credentialing organizations use a variety of criteria for selection including certification. The purpose of certification is not to exclude individuals but to provide evidence of the standards met by those who do hold the certificate.

*Source: American Academy of Neurology and Association of University Professors of Neurology, Graduating Neurology Residency Survey, 2000.