American Board of Neurological Surgery oral examination

Commencing in 2017, the American Board of Neurological Surgery (ABNS) certifying oral examination will be modified as follows:

1. Session one will test the candidate's fund of knowledge and competency on general neurosurgery.

2. Session two will test the candidate's competency on elements of his/her focused surgical practice. Each candidate will indicate their choice prior to the examination from a list of focused practice selections.

3. Session three will be a case based examination consisting of 5-8 cases selected from the 150 cases submitted during the credentialing process. Each candidate will prepare a PowerPoint using an ABNS slide template for each case that contains the clinical history, physical examination, key imaging, diagnosis and management, surgical coding, early result and follow-up.

The candidate must pass all three sessions to become ABNS certified.

The oral examination is the last event in the initial certification process, which begins with neurosurgical residency in an ACGME accredited neurosurgical program and passage of the written examination. Where the written examination explores an applicant’s knowledge in various relevant disciplines; the oral examination explores knowledge and judgment in clinical neurosurgical practice after an applicant has been an independent practitioner.

The oral examination is accomplished in a series of face-to-face examinations involving the applicant, current and former directors of the board and guest examiners. Examination of a candidate’s knowledge and judgment typically includes questions regarding the preoperative evaluation, intraoperative technical and judgmental issues and post-operative management, including appropriate treatment of complications.

The oral examination of the American Board of Neurological Surgery (ABNS) has undergone periodic review and revision over the years. Different medical boards conduct the oral examination in different ways and some do not have an oral examination. The ABNS seeks to maintain an oral examination process that is relevant, rigorous and of value to both our specialty and to the public. Commencing with the spring 2017 examination, a new format is being followed.

Candidates who pass the oral examination become certified diplomates of the ABNS.

Format: Exam is comprised of three sessions, each 45 minutes in length One session will consists of five questions focused on general neurosurgery Topics included:

Trauma craniotomy Intracerebral hemorrhage (from any cause) Acute stroke care; hemicraniectomy, suboccipital decompression Vascular dissection Atherosclerotic vascular disease Brain or spinal abscess Intratumoral hemorrhage, pituitary apoplexy Cauda equina syndrome Spinal cord injury management Spinal fracture management Brain metastases, adult glioblastoma, supratentorial meningioma Hydrocephalus Neurology (MS, temporal arteritis, other that mimics a surgical presentation) Baclofen pump failure, drug withdrawal/overdose Peripheral nerve disorders One session will consist of five questions focused on the pre-identified area of focused practice chosen by the candidate

Spine

Degenerative spine Spinal tumors Spinal vascular malformations Spinal pain Deformity Instrumentation Tumor (Neuro-oncology)

Glioma management Brain metastases Meningioma Vestibular or other schwannoma Brain mapping Pineal region tumor Intraventricular tumors Spinal tumors CNS lymphoma Pituitary/sellar tumors Endoscopic surgery Skull base tumors Vascular

SAH/aneurysm care (clipping, endovascular) AVM AVF Cavernous malformation Ischemic disease/stroke Endarterectomy Bypass Moya-Moya disease Functional

Movement disorders Epilepsy Pain, trigeminal neuralgia Behavioral disorders Neurology (Parkinson’s disease, Essential tremor) Trauma/Critical Care

Brain, spine, peripheral nerve injury surgery Injury physiology Critical care management Intracranial pressure management Secondary injury Infection Systemic injuries Pediatric Neurosurgery

Full spectrum of cranial and spinal pediatric neurosurgery General

The candidate may choose a second general session of five cases.

Applicant Cases Session

The third session will consist of five cases using case material submitted by the candidate.

From the 125 cases submitted as part of the credentials review 10 cases chosen for use at oral exam; five will be selected by the examiners for presentation by the candidate with discussion Case data fields will generate a slide presentation for each case using ABNS software