To present data on the 25-year development of CNP as an ABPN/ACGME recognized subspecialty.

ABPN and ACGME data on programs, trainees, and certificates awarded were reviewed.  A survey related to percentage of practice time devoted to performing CNP procedures was administered to all CNP diplomates (currently and previously certified) with current email addresses in the ABPN database.

In 1990, there were 51 non-ACGME-accredited programs with about 60 trainees.  In AY 2001-02 there were 85 programs with 156 trainees, and a decade later (AY 2011-12), the numbers had increased to 94 and 217, respectively.  Currently (AY 2018-19), there are 89 programs and 167 trainees.

As of 2017, 3,035 certificates had been issued to:  2,638 neurologists; 368 child neurologists; 3 double-boarded neurologists/child neurologists; 8 psychiatrists; and 18 double-boarded neurologists/psychiatrists.

The survey response rate was 28% (690/2,487).  Of the respondents, 32.1% spent 1-25% of time performing CNP procedures; 42.5% spent 26-50%; 15.4% spent 51-75%; and 9.9% spent 76-100%.  Most of the respondents (80.2%) performed EEGs; 54.1% performed EMGs, and 34.0% performed evoked potentials.  Smaller percentages performed intraoperative monitoring (23.5%), sleep studies (19.5%), and autonomic testing (7.6%).  These results were similar to those found on practice surveys conducted in 1992 and 2001.

In the 25 years since the first examination was administered, CNP has developed a robust number of training programs, but the advent of subspecialty certification in neuromuscular medicine, epilepsy, and sleep medicine may be affecting these programs as evidenced by a decrease in the numbers of programs and trainees in recent years.  The survey results indicate that a majority of diplomates spend more than 25% of their practice time performing CNP procedures.