News Vascular neurology: a new neurologic subspecialty in the United States Harold P. Adams Ã1 , Dorthea Juul 2 , and Stephen Scheiber 2 The American Board of Psychiatry and Neurology (ABPN) has established a cer- tification process for the subspecialty of vascular neurology. In addition, the Ac- creditation Council for Graduate Medical Education has approved residencies (fellowships) in vascular neurology in the United States. These steps are in response to the growth of a special body of knowledge related to the diag- nosis and treatment of patients with cerebrovascular disease. The certificate in vascular neurology recognizes those ABPN-certified neurologists or child neu- rologists who have demonstrated profi- ciency in the management of patients with vascular diseases of the central ner- vous system. This may have implications for similar initiatives in other countries During the last three decades, a group of neurologists across the United States de- veloped special expertise and interest in the diagnosis, evaluation, and treatment of persons with vascular diseases of the central nervous system, and many neu- rology departments in academic medical centers organized divisions or groups of physicians who focused their clinical, educational, and research activities on the management of cerebrovascular dis- ease. The importance of stroke as an independent area of medical expertise is evidenced by the large number of pub- lications in the field, the creation of journals that focus on stroke, and the establishment of professional organiza- tions that focus on cerebrovascular dis- ease including the Stroke Council of the American Stroke Association and the Stroke Section of the American Academy of Neurology (AAN). As a result of this growth, the AAN requested that the American Board of Psychiatry and Neurology (ABPN) apply to the American Board of Medical Spe- cialties (ABMS) to issue subspecialty certificates in vascular neurology. The application was endorsed by a large number of professional and public inter- est organizations in the United States, including the American Stroke Associa- tion, the National Stroke Association, the American Neurological Association, the Association of University Professors of Neurology, and the Child Neurology So- ciety. Support was also obtained from colleagues in neurological surgery, emer- gency medicine, and neuroradiology. In addition, the World Federation of Neu- rology and the International Stroke So- ciety supported this application. The ABMS approved the application in March 2003. The goals of the new certi- ficate are to improve care, teaching, and research for patients affected by these serious neurological diseases. The new certificate also recognizes those collea- gues who have demonstrated special pro- ficiency in the management of patients with complex vascular diseases of the central nervous system. Fellowship in vascular neurology In parallel with the approval of the certi- ficate in vascular neurology, the Accred- itation Council for Graduate Medical Education (ACGME) endorsed fellow- ship training in vascular neurology. The Neurology Residency Review Committee (RRC) of the ACGME developed require- ments for ACGME-accredited programs in vascular neurology. The training is 1 year in duration and fellowships are avail- able to trainees who have completed an ACGME-accredited residency program in neurology or child neurology. The fellowship requirements are avail- able in the Graduate Medical Education Directory that is published by the Amer- ican Medical Association and at the Neu- rology RRC link on the ACGME website (www.acgme.org). As of June 13, 2005, the ACGME has approved 26 programs in vascular neurology across the United States; additional programs are submit- ting applications. Satisfactory completion of the fellowship will be a credential to take the certification examination given by the ABPN. In addition, satisfactory completion of the fellowship in vascular neurology is a prerequisite for training in endovascular neurology/surgery. Certification in vascular neurology After the 2009 examination, only neuro- logists who have completed an ACGME- accredited program in vascular neurology will be eligible to take the certification examination. Until then, the ABPN ac- cepts applications from ABPN-certified neurologists or child neurologists who have received additional training in a non-ACGME-accredited stroke fellow- ship or who devote at least 25% of their practice time to the management of per- sons with stroke. In addition, the appli- cant must have an unrestricted license to practice medicine in the United States or Canada. More information about the application process, including applica- tion forms, can be found at the ABPN website (www.abpn.com). Correspondence: Harold P. Adams à , Department of Neurology, Carver College of Medicine, Uni- versity of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA. Tel: 001 319 356 4110; Fax: 001 319 356 4505; email: harold-adams@uiowa.edu 1 Division of Cerebrovascular Diseases, Depart- ment of Neurology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA 2 American Board of Psychiatry and Neurology, Deerfield, IL, USA & 2005 International Stroke Society International Journal of Stroke Vol 1, February 2006, 41–42 41