Future of Subspecialty Training in Vascular Neurology

In 2003, the American Board of Psychiatry and Neurology (ABPN) received approval from the American Board of Medical Specialties (ABMS) to recognize the expertise of those board-certified neurologists who were providing specialized care of patients with a broad spectrum of cerebrovascular diseases (vascular neurology.) This designation reflected the growth in knowledge about stroke as reflected by dedicated meetings and focused journals. The expansion in knowledge in vascular diseases of the brain and spinal cord, which was the result of advances in experimental, epidemiological, and clinical research, also served as an impetus. In 2005, the ABPN started the process of awarding 10-year time-limited certificates in vascular neurology. Now, ≈10 years later, it is reasonable to review the progress in the field of vascular neurology and to look at the future of the subspecialty.Because of their demonstrated special expertise and experience in the diagnosis and treatment of patients with a broad spectrum of vascular diseases of the central nervous system, vascular neurologists are and will continue to be at the forefront of stroke management. Patients, third-party payers, and colleagues will continue to seek the advice and care of vascular neurologists. With the advent of specialized training and resultant certification, many general neurologists now refer their problematic cases to vascular neurologists. This trend likely will continue and probably will accelerate. In addition, vascular neurologists are well-suited for leadership positions within hospital quality improvement programs and clinical initiatives. As of January 2013, the Centers for Medicare and Medicaid Services began mandatory hospital reporting of 7 stroke quality metrics known as core measures. Performance on these measures may become incorporated in determining reimbursement incentives and penalties in the future. The Joint Commission also is certifying primary and comprehensive stroke centers based on the recommendations of the Brain Attack Coalition. Certification standards include a well-defined …