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