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Special Editorial & Latest IONM topics

A new column and a Blog Special Editorial on Neuromonitoring was launched few days ago and it is Active now, did you visit, do you have your say or got questions, write to the emails of the author and blogger.

IONM Training

This page is created to discuss and compile whatever available information out there with regard to Neuromonitoring training?. Are there any Training Place or Are there any real training like a residency or PhD, the answer is None!. 
If there is none,  then let us pave some foundation for the future endeavors of training Neurophysiologists who would have expert knowledge in the field. 

Some of my colleagues and students have asked me how to get trained in Neuromonitoring??. Others who are already in the field asked me is there any training places for appearing CNIM or ABNM board exams ?.

Again, the answer for all the above question is a big no!. 

Openly available information on the internet or books or newsletter does not provide any official information from the most well known organizations like ASNM or ABNM about such training. At the moment, these organizations and American Neurophysiological association do not have such training in place, nor there can be any anticipation of such training centers in the near future that these organizations might begin to operate??.

So, Are there any private institutions or centers to provide neuromonitoring training, 
again...
the answer is no. The remotest information available on training is that in the past couple of years, there seems to be a couple of training opportunities initiated by some individuals, since I have no personal ideas about them, I will not write about them, except the fact that I can mention here, none of those individuals training places are either recognized or accredited or approved by ABRET or any equivalent organizations, as these organizations drafts standard policies for neuromonitoring field. This is the simple Fact today!.
Now let us delve into the practicality of the question, if there is none out there!!, then how do the IONM tech's or Neuromonitoring professionals are trained. As a matter of fact, most of the newly hired ones have a graduate or PhD degrees in related neuroscience or biological sceince fields and they are not Neurophysiologists to begin with, nor are they trained neurophysiologists. These people need special training, both theoritical and practical knowledge of Neurophysiology, in a given limited time, the so called training is a rudimentary for clinical job. But, they get away with it?. Most of the so called Neuromonitoring training today takes place inside the companies board rooms, it is an in house stuff?, many neuromonitoring companies train the graduates or PhD holders by providing study courses. lectures and some field trip to hospitals shadowing on the senior neurophysiologists who are already practicing neuromonitoring.  There is no format and no stipulations, some companies have a certain time line like three to 6 months and others may have different time line in training and credentialing qualified candidates. None of such training is accepted, accredited or approved by any established ABRET like organizations. It is an in house......Stuff!?.

While pretty much all the newly hired candidates go through such training as they are not exactly coming from  Neurophysiology discipline but from a related neuroscience fields, a training is imperative and most important, I wish there is a streamlined and well crafted training available for these people to go and work with patients, surgeons and hospital staff. So, without an accredited or approved training programs, all we have today is a rudimentary training that is ongoing now with different companies around US. In contrast, Neuromonitoring is unheard of in developing, poor nations, and even in developed countries only handful of them have this tools available to patients, countries like Canada, Hong Kong, Singapore, UK and few other advanced cities in other countries, to the most part neuromonitoring is not yet available to India, China and Brazil like the so called upcoming Super power dream nations, it is pretty painful to imagine such a great and life saving technique is not available in these countries. The rest of the world do not have access to intraoperative neuromonitoring.

Anyways, as far as training concerned, the only candidates who has the foundation and advanced knowledge to handle the most demanding and challenging Operation Room issues with spine, brain and nervous system are the neurophysiologists, trained and PhD holders in Neurophysiology subjects.

As far as PhD Neurophysiologists concerned, like the author of this Blog, there are hardly a few in the whole country,  and just a handful in the IONM field, as far as my knowledge goes, I haven't heard one Neurophysiologists with a PhD in Neurophysiology thus far inside the ASNM or ABRET or outside these authoritative organizations?..... I guess, this very post to hit some one harder, perhaps if there is any one out there is going to get very upset.......how dare you can say you are the only one.....oh yea I hear you!!!......I am Hoping to hear from someone after I post this message, I would be glad to hear from you fellow NPhys!!

Since the very basic training and foundation is laid on Neurophysiology, for those who have this background, intraoperative neuromonitoring is their field of expertise, except that they might need to be oriented towards the functionality of hospitals, patient care regulatory issues, IONM machine handling and protocol setting up etc., the peripheral knowledges of IONM is not a big deal. But, for those rest of the thousands of aspiring candidates and those who are already in the field, gaining a better insight and broader knowledge of the Core subject of Physiology is a must inorder to deliver better patient care and protect the patient from iatrogenic or other injuries. 
In my next write up, I will try to update this page with more specific information as to where to go? and whom to approach for a training?.
Jan 17, 2011.
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Here is the ABNM Exam score Outline and some study direction:
http://iomstudy.com/dabnm_examination.htm

EXAM CONTENT OUTLINE
I. BASIC NEUROSCIENCE......................................... 20%
II. SIGNAL ACQUISTION AND PROCESSING ............... 5%
III. ELECTROENCEPHALOGRAPHY (EEG) ......................5%
IV. SENSORY EVOKED POTENTIALS ...........................30%
V. MOTOR POTENTIALS ............................................30%
VI. EFFECTS OF ANESTHESIA .................................... 10% 
    notes
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Intraoperative Neurophysiological Monitoring guidelines & Societies!

Where to Look for Intraoperative Neuromonitoring Policies, standards and guidlines!!
ABNM American Board of Neurophysiologic Monitoring
ASNM The American Society of Neurophysiological Monitoring

ACNS
American Clinical Neurophysiology Society
IFCN International Federation of Clinical Neurophysiology
ASET American Society of Electroneurodiagnostic Technologist
OSET International Organization of Societies for
Electrophysiological Technology

Other NeuroPhysiology Societies to look for more information
ABCN-American Board of Clinical Neurophysiology, Inc

Apart from these Main Societies, there are other organizations that provides technological platform and guidelines
List to be updated........!



Michael R. Isley and Roland C. Pearlman Strongly recommend neuromonitoring guidelines from the above societies!.