News & Commentary: UCNS Recertification Alternative

From the Practical Neurology Online News

November 12, 2020—The National Board of Physicians and Surgeons has announced that they will provide recertification credentialing to physicians for neurologic subspecialty certification granted by the United Council of Neurologic Subspecialties (UCNS). This includes autonomic disorders, behavioral neurology & neuropsychiatry, clinical neuromuscular pathology, geriatric neurology, headache medicine, neurocritical care, neuroimaging, and neuro-oncology.

“NBPAS believes in the value of an initial certification examination after completing residency/fellowship and is committed to providing certification that ensures physician compliance with national standards and promotes lifelong learning.”--Paul Teirstein, MD, DNBPAS, FACC, president NBPAS

Recertification by the NBPAS requires that a physician have an unrestricted license to practice (with active hospital privileges for certain specialties, such as surgery), an active medical staff appointment or membership, and 50 hours of CME credit completed every 2 years. NBPAS recertification needs to be renewed every 2 years, but has no requirements other than licensure, active practice, and CME credits.

In addition to the UCNS subspecialities that NBPAS recertifies, recertification in neurology and neurologic subspecialties granted by the American Board of Psychiatry and Neurology (ABPN) are also available, including addiction psychiatry, brain injury medicine, child and adolescent psychiatry, clinical neurophysiology, consultation-liaison psychiatry (formerly psychosomatic medicine), epilepsy, forensic psychiatry, geriatric psychiatry, hospice and palliative medicine, neurocritical care, neurodevelopmental disabilities, neuromuscular medicine, pain medicine, sleep medicine, and vascular neurology.

“At a time when we are trying to grow subspecialties, such as headache medicine, it is fantastic that NBPAS will be recertifying Diplomates who may have otherwise decided to allow their certification to lapse,” --Paul Mathew, MD, DNBPAS, FAAN, FAHS, neurologist, headache specialist, director of legislative affairs for NBPAS, and co-chief medical editor of Practical Neurology.

The NBPAS has been recertifying physicians of all specialties and subspecialties who hold an initial certification from the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA) since 2014. Legislation limiting the use of ABMS Maintenance of Certification (MOC) compliance for licensure and/or credentialing has passed in 13 states and is under review in many others. In addition, 136 health care institutions have independently decided to accept NBPAS for physician credentialing.

Commentary from Alan M. Rapoport, MD

Alan Rapoport, MD is Clinical Professor of Neurology at The David Geffen School of Medicine at UCLA in Los Angeles, CA; Past President of The International Headache Society (IHS), Founder and Director-Emeritus of The New England Center for Headache in Stamford, CT & Editor-in-Chief of Neurology Reviews.

As Dr. Mathew aptly stated in the press release announcing this news, “It is unfortunate that despite requests from diplomates and other stakeholders, UCNS has decided to impose new requirements and additional fees on diplomates who have unexpired certificates based on passing an examination that granted a 10-year certification. . .”

For context, I will explain what has happened to me and about 200 neurologists and a few other specialists who took the first UCNS certifying exam in headache medicine. I sat for the first exam in a testing center in 2006, after paying a large fee. I passed and was granted a certificate for a 10-year certification in headache medicine. Prior to the expiration of that certificate, I was told I had to pay about $1800 and take a similar examination to recertify for another 10 years. I was not sure I needed to do that, as I was over 70 years of age and had not found the certification important; but I did so anyway, in a testing center and passed and was granted a new, dated certificate for another 10 years of certification in headache medicine.

Shortly after that, I began to get notices from UCNS that they were changing their certification process and I would soon have to read their designated articles, take an examination on that literature, pay $175 for this privilege of C-Cert yearly, all in spite of the fact that I had a valid certificate for 10 years of certification, which I had paid for recently.

After some of us complained, UCNS said we would only have to pay for this when we had 5 years left on our certification. When they advertised this new C-Cert plan on the AAN Headache list serve, even though advertising was against the rules of the list serve, I objected to it, saying we had paid for and received a 10-year certification. Their response was to abruptly take me off the list serve. Then they took others who agreed with me off as well and ultimately temporarily shut it down. In essence, I was banned from the AAN list serve (I have been a member since the 1960s and a Fellow for many years).

I have the certificate that proves that I have 5 to 6 years left for my certification, but UCNS will not recognize this or return the money they took from me. I believe that to be unfair, unethical and probably illegal, as do many senior headache specialists in the country who have the same issue I do. The attorney for the UCNS, who is also the attorney for the AAN, has disregarded our letters and objections. One of our members has asked the Chairman of the UCNS Board to bring this to their Ethics Committee. As they do not have one, we are waiting to see their next move. If UCNS goes ahead with their plan to place a notice next to my name that my certification is incomplete, they will be asking for further steps to be taken.

Now the National Board of Physicians and Surgeons (NBPAS) will be recertifying headache medicine doctors and those of other specialties who are in a similar situation and do not want to pay for the privilege of taking C-Cert exams yearly when they have already been certified. I expect many specialists will switch to this new way of specialty certification.

I believe the UCNS has cheapened the value of their certifications by not honoring them or even returning the money they have taken. I am surprised that the AAN would condone this behavior. Some of us have been members of the AAN for over 50 years and have been involved in education and have attended meetings for many of those years.