Neuromonitoring Certification and Licensure

Learn about all neuromonitoring certification and licensure here:

Professional & Technical Neuromonitoring Certification

Presently, there are two levels of practice for neuromonitoring (IONM) in the United States: Technical and Professional. The responsibilities that fall within the scope of each level are rather extensive and beyond the scope of this page. Essentially, technical practice involves electrode application and data collection, while professional practice involves supervision of technical personnel and interpretation of IONM data. In order to practice at the professional level, one must possess a doctoral degree and board certification. In circumstances where professional practice requires a license, providers may work in tandem with a licensed physician or audiologist.

Certification & Licensure

At the technical level, a certification to perform IONM is available but not required by the state- or federal government. Thus, anyone can practice IONM at the technical level. In an effort to change this, several groups are presently working to promote state licensure for all IONM practitioners. Presently, the only technical certification available for IONM is the CNIM (see below).

At the professional level, there are several national boards that issue certifications for advanced practice of IONM, but these board certifications are not required by most states. Rather, many states and insurance carriers require the practitioner to have a license. A license to practice medicine is commonly required, and, in some cases, a license to practice audiology is accepted. Doctoral-level individuals with board certifications are working to promote and achieve state licensure.

Professional Board Certifications


Diplomate, American Audiology Board of Intraoperative Monitoring:

The American Audiology Board of Intraoperative Monitoring (AABIOM) is recognized by the American Speech-Language-Association (ASHA) as a legally independent, subspecialty entity in the profession of audiology. The AABIOM serves to ensure the provision of clinical intraoperative monitoring and interpretation services (IOM) to referring surgeons, health care facilities and their respective patients, by licensed and competent audiologists who demonstrate a broad fund of knowledge, advanced clinical training and particular clinical expertise in the subspecialty field of IOM.

Diplomate, American Board of Clinical Neurophysiology:

The ABCN offers professional board certification in Clinical Neurophysiology. Eligibility is limited to physicians with training in neurology.  Candidates must pass two computer-based examinations. Part I tests the candidate on core knowledge in clinical neurophysiology, and Part II tests the candidate on their chosen subspecialty, such as IONM. See the ABCN website for more detailed information.

Diplomate, American Board of Electrodiagnostic Medicine:

The ABEM offers professional board certification in Neuromuscular and Electrodiagnostic Medicine. Eligibility is limited to physicians with training in neurology. Candidates must pass two examinations given over a 2 day period. Part I is a written examination, and Part II is an oral examination. There are no subspecialties specific to IONM.  See the ABEM website for more detailed information.

Diplomate, American Board of Neurophysiologic Monitoring:

The ABNM offers professional board certification in IONM.  It is the only professional board certification dedicated entirely to the practice of IONM. Eligibility is presently limited to individuals with a biomedial doctoral degree, formal education in neurophysiology and neuroanatomy, and minimum of 3 years experience in IONM with supervision of >300 cases across 6 different categories of surgical procedure. Candidates must pass two examinations.  Part I is a written examination, and Part II is an oral examination.  There are no subspecialties. See the ABNM website for more detailed information.

Diplomate, American Board of Psychiatry and Neurology:

The ABPN offers professional board certification in Psychiatry and Neurology. Eligibility is limited to physicians with training in neurology or psychiatry.  Candidates must pass two examinations.  Part I is a written examination, and Part II is an oral examination. There are no subspecialties specific to IONM; however, candidates may seek added qualification in Clinical Neurophysiology (which includes IONM). Eligibility for this certification requires the candidate to have completed a 1 year fellowship in clinical neurophysiology. The candidate must then pass a computer-based test of basic science (physiology and instrumentation), EEG, EMG, nerve conduction, etc. See the ABPN website for more detailed information.

Technical Certifications

Certified Neurophysiological Intraoperative Monitoring Technologist:

The American Board of Registration of Electroencephalographic and Evoked Potential Technologists (ABRET) offers Certification in Neurophysiological Intraoperative Monitoring (CNIM).  The applicant must show evidence of having monitored at least 150 spine cases and must pass a written examination.  There are currently two different pathways toward certification:

Pathway 1: Candidate is a registered EEG or evoked potential technologist.

Pathway 2: Candidate has a bachelor’s degree.

CNIM personnel are capable of performing intraoperative monitoring but must practice under the indirect supervision of an MD or a DABNM. The role of the technologist is defined through two major documents:

  1. Guidelines on Intraoperative Electroencephalography for Technologists (American Society of Electroneurodiagnostic Technologists).
  2. Guidelines for Intraoperative Monitoring of Sensory Evoked Potentials (American Clinical Neurophysiology Society).

5 thoughts on “Neuromonitoring Certification and Licensure

  • Mark Shaver February 25, 2015 at 20:42

    You might consider adding AABIOM to your page.

    • Richard Vogel February 26, 2015 at 16:38

      Thanks for bringing this to my attention. I’m happy to include it.

  • Mark Shaver March 1, 2015 at 10:06

    Thank you for providing such a great resource!

  • Amber June 11, 2015 at 10:05

    Hi Richard,
    I am a recent graduate trying to get into the field of IONM. Thank you for outling these steps, they are very helpful. I was just wondering if you had any ideas what companies typically look for when hiring techs in trainee positions? As far as GPA range, volunteerism, university name recognition, degree level, etc. Any information, even if it’s just the experience of you and your colleagues, would be helpful.


    • Richard Vogel June 15, 2015 at 16:04

      Hi Amber,

      These are all great questions. I can’t speak for any companies/hospitals out there, only from my own experience. I’ve certainly seen my share of resumes, and interviewed my share of applicants over the years… so I’ll tell you what I look for.

      First up is the resume/CV. My first contact with an applicant is usually the resume/CV. I consider it to be a written representation of who you are, both in background and personality. If the resume/CV is sloppy, if it lacks attention to detail, then I must assume the same is true of you and I’m not going to consider interviewing you. So, the resume/CV has to polished… No typos, no missing or inconsistent punctuation, etc. Beyond that, I don’t focus on details. I like the big picture, and what I hope to see is an image of a natural leader, a life-long learner, someone who is driven to achieve. I don’t want the applicant to tell me these things; rather, I want to see it in their background. This isn’t the time to show me how inventive and artistic you are, though. Keep it simple. You may see resumes out there on the web that are “interesting”, but they are geared toward people who work for design studios and advertising agencies that rather expect interesting approaches to resume design. Like I said, keep it simple. As far as contents of the resume/CV, people always like to see a high GPA in a challenging bio-related major, and particularly in the context of extracurricular activities (such as volunteerism). Beyond that, what I like to see is that the applicant has done something in their past to demonstrate interest in the field to which she is applying. Did she do an internship, volunteer, work, study, anything? These things aren’t required, but they help. I pay absolutely no attention to university name recognition (but if I’ve never heard of the school, I will check that it exists, that it’s accredited, and that the applicant graduated).

      Second is the interview. Are you on time and dressed to impress? Did you bring a copy of your resume? What do you know about the field, about the company/hospital/department? Why did you choose us? If you are experienced in the field, then I’ll spend most of the time grilling you on a bunch of different topics. What I really want to see is a deep conceptual understanding of neurophysiology, surgery, anesthesiology, etc. For the inexperienced applicant, I’m looking for people who are driven to become one of the best in the field, driven to achieve that deep conceptual understanding, people who are willing to put in the time and effort, people who are in it for life…not because they can’t find a job related to their major…not because they heard the field was cool. I have no time for that. Beyond the basics, I’m going to ask questions to gain a better understanding of what kind of leader you are, how well you work with a team, how you communicate, how you think, how you learn, how you make decisions, how you adapt to changing circumstances. I’m looking for someone who is a natural, but I’ll work with anyone who has the drive.

      Hope that helps!

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