Certification Application Submission Checklist

Before beginning the online application, use this checklist to review and prepare the information and attachments that will be required during the online application process. Complete eligibility criteria information is available on each subspecialty certification web page.

General Eligibility Information

Candidate Information
  • First, middle, and last name
  • Credential(s)
  • Birthdate
  • Home address and phone number
  • Work address and phone number
  • Preferred email address
Medical Education Information
  • Medical school name and location
  • Education start and end dates
  • Degree received
  • Date degree was received
Residency Training Information
  • Institution name and locations
  • Specialty
  • Training start and end dates
  • Number of months of training
  • Full/part time
Board Certification Information
  • Type of certification (primary/subspecialty)
  • Name of certifying board(s)
    • Faculty Diplomate applicants may include: 1) an ABMS member board or the RCPSC, 2) a specialty certification board of the American Osteopathic Association, 3) an appropriate board of the European Union of Medical Specialists, or 4) the medical board of the applicant's country of origin, such board to be approved by the Certification Council.
  • Certification number(s)
  • Issue and expiration dates
Medical Licensure Information​​
  • State/province of license
  • License number
  • Expiration date
  • License restrictions, if any

Application Pathways

UCNS-accredited Fellowship
  • Name of UCNS-accredited training program
  • Start and end dates of fellowship
  • Number of months of training
  • Full/part time
  • Upload Fellowship Training Verification letter or a copy of fellowship completion certificate
    • Use template letter text provided on the UCNS certification page
    • Template text must be on institution letterhead
    • Letter must be signed by the program director
Practice Track
The practice track option is closed for some subspecialties. Check the eligibility criteria on the subspecialty certification web page to find out if this option is available.

Must provide required information for one of three practice track pathways:
  1. Non-accredited Subspecialty Fellowship: Successful completion of non-accredited fellowship program that was 12 or more months in length
    • Name of training program
    • Start and end dates of fellowship
    • Number of months of training
    • Full/part time
    • Upload Fellowship Training Verification Letter or a copy of fellowship completion certificate
      • Use template letter text provided on the UCNS certification page
      • Template text must be copied onto institution letterhead
      • Letter must be signed by the program director
  2. Continuing Medical Education (CME): Completion of required AMA PRA Category 1 CreditsTM specifically related to the subspecialty within the 60 months prior to application. Please refer to your subspecialty eligibility requirements for the total number to be submitted. 
    • Title of each CME program/activity
    • CME sponsoring organization
    • Start and end dates of each program/activity
    • Number of CME credits per activity
  3. Academic Appointment: Applicant holds an active, full-time academic appointment teaching medical students, residents, and/or fellows in the subspecialty
    • Upload Academic Appointment Verification Letter
      • Use template letter text provided on the UCNS certification page
      • Template text must be copied onto institution letterhead
      • Letter must be signed by the department chair
In addition to one of the three practice track pathways, the following additional information is needed:
  1. Practice Time Verification
    • Description of practice experience
    • Location of experience (city and state/province)
    • Start and end dates
    • Upload Subspecialty Practice Time Verification letter from two physicians familiar with the applicant's practice
      • Use template letter text provided on the UCNS certification page
      • Template text must be copied onto verifying physician's practice letterhead
      • Confirmation of required practice time dedicated to the subspecialty
  2. Practical Expertise Verification for Neuroimaging applicants only: Upload one of the following:
    • Upload a copy of valid certificate in MRI/CT from the American Society of Neuroimaging
    • Upload Practical Expertise Letter confirming supervised or independent written interpretation of 650 Neuroimaging cases, at least 500 of which must be in MRI of the brain or spine
      • Use template letter text provided on the UCNS certification page
      • Template text must be on institution letterhead
      • Letter must be signed by appropriate CME programs, mentors, medical directors, or program directors
  3. Practical Expertise Verification for Clinical Neuromuscular Pathology applicants only
    • Upload Practical Expertise Letter from the applicant certifying that he/she has provided written interpretations of at least 100 nerve or muscle biopsies (with a minimum of 30 of either) during the 60 months preceding the application deadline
      • Use template letter text provided on the UCNS certification page
      • Template text must be on institution letterhead
Faculty Diplomate​​
  • Upload Academic Appointment Confirmation letter
    • Use template letter text provided on the UCNS certification page
    • Template text must be on institution letterhead

Other Information

Special Testing Accommodations
  • If needed, complete Special Testing Accommodations Form
  • Submit required supporting documentation of disability and previous testing accommodations by email to applications@ucns.org
Electronic Signature
  • Type name preceded and followed by a forward slash (e.g., /Jane Doe/)
Payment Options
  • Credit card (Visa, MasterCard, American Express)
Special Testing Accommodations Form
(Microsoft Word Document)

Staff Contacts

Todd Bulson, Senior Manager Certification
tbulson@ucns.org
(612) 928-6067

Becky Swanson, Executive Assistant
bswanson@ucns.org
(612) 928-6050