Free Practice Questions for ABPN Neurocritical Care

The ABPN Neurocritical Care Subspecialty Certification Examination is jointly developed by ABA, ABEM, ABIM, ABNS, and ABPN, and administered by ABPN at Pearson VUE test centers to eligible diplomates of all five boards at the same sitting. It certifies expertise in the management of critically ill patients with primary or secondary neurologic injury — including acute ischemic and hemorrhagic stroke, aneurysmal subarachnoid hemorrhage, traumatic brain injury, status epilepticus, brain death determination, post-cardiac arrest care, neuromuscular respiratory failure, and multimodal neuromonitoring. UCNS has certified NCC physicians since 2007 as a separate, non-ABMS credential; ABMS approved the ABPN-administered subspecialty in 2018, and the first ABPN-administered exam was given in 2021.

Candidates must hold primary ABMS certification in Neurology, Neurosurgery, Anesthesiology, Internal Medicine, or Emergency Medicine, and hold a valid unrestricted medical license at the time of examination. For the 2021-2026 exams, a temporary practice pathway (UCNS/CAST certification, a qualifying fellowship, or attested NCC clinical practice) was open to neurology/child neurology candidates. After the 2026 administration, most candidates need either 1 year of ACGME-accredited general critical care fellowship plus 1 year of ACGME-accredited neurocritical care fellowship, or 2 years of ACGME-accredited neurocritical care fellowship; neurosurgery candidates need 1 year of ACGME-accredited NCC fellowship, and internal medicine candidates need ABIM Critical Care Medicine certification plus 1 year of ACGME-accredited NCC fellowship. Application is submitted through the ABPN website (or the candidate's own board, for ABA/ABEM/ABIM/ABNS diplomates) during the designated application window.

The exam is delivered at Pearson VUE test centers in five 54-question sections (270 one-best-answer multiple-choice items total), with 320 minutes of scheduled testing time (5 min NDA/tutorial, 310 min for the questions, 5 min survey) plus up to 40 minutes of optional pooled breaks between sections. Questions frequently include clinical vignettes with neuroimaging (non-contrast CT for ICH/SAH/herniation, CTA for aneurysm or LVO, CT perfusion, DWI/FLAIR MRI), invasive monitoring waveforms (ICP, EVD), continuous EEG patterns (status epilepticus, burst suppression, malignant post-arrest), and decision algorithms for ICP escalation, brain death determination, and post-arrest neuroprognostication.

The 2026 Initial Subspecialty Certification Examination Fee is $1,900, plus a $500 late application fee if applicable. Cancellation and refund policies follow the ABPN schedule with decreasing refunds as the exam date approaches. ABPN states there is currently no limit on the number of times an applicant may apply to take the initial certification exam; each attempt requires full re-registration and fee payment. Enrollment in the ABPN Continuing Certification (MOC) program includes annual activities and associated fees.

Highest-yield topics include: Brain Trauma Foundation thresholds (ICP >22 mm Hg, CPP 60-70 mm Hg) and tiered ICP management (hyperosmolar therapy with 3% saline or mannitol, EVD CSF drainage, decompressive craniectomy per RESCUEicp); aneurysmal SAH management (aneurysm securement as early as feasible, preferably within 24 h [2023 AHA/ASA], nimodipine 60 mg q4h × 21 days, TCD vasospasm monitoring, induced hypertension for symptomatic DCI); ESETT-staged status epilepticus algorithm (lorazepam → fosphenytoin/levetiracetam/valproate → continuous midazolam/propofol/pentobarbital); AAN/AAP/CNS/SCCM 2023 brain death determination prerequisites and the apnea test (requires ALL of no respirations, pH <7.30, AND PaCO2 ≥60 mm Hg and ≥20 mm Hg above baseline); the 2025 AHA post-cardiac arrest target temperature of 32-37.5 °C for ≥36 h and post-cardiac arrest neuroprognostication ≥72 h (N20 SSEP, NSE, EEG, DWI); 20/30/40 rule for neuromuscular respiratory failure; the 2022 AHA/ASA ICH guideline (SBP 150-220 → target 140, maintain 130-150 [COR 2b]; <130 potentially harmful); and propofol infusion syndrome thresholds.

Plan 300-500 hours over 9-15 months during and after fellowship. Core resources include the Neurocritical Care Society Practice Update materials, Continuum Lifelong Learning in Neurology — Neurocritical Care issues, Brain Trauma Foundation 4th edition guidelines, the 2022 AHA/ASA spontaneous ICH guideline and 2026 AHA/ASA acute ischemic stroke guideline, the AAN/AAP/CNS/SCCM 2023 brain death consensus update, NCS status epilepticus guidelines, and the ABPN Neurocritical Care Content Specifications. Drill high-volume MCQs with timed sets, master trial acronyms (DAWN, DEFUSE-3, SELECT2, ATTENTION, ESETT, RESCUEicp, DECRA, TTM2, BOOST-3, INTERACT3, ATACH-2, ISAT, RAMPART, STASCIS), and complete 2-3 full-length (270-question) timed mock exams.

The Neurocritical Care exam is offered by ABPN every other year, in even-numbered years. The 2026 exam is scheduled for October 5-9, 2026, with the next administration in 2028. Applications open months before the exam with a submission deadline prior to the testing window, after which candidates schedule specific Pearson VUE appointments.

ABPN uses a criterion-referenced scaled scoring system with a passing standard set by subject-matter experts. A candidate's pass/fail result depends on performance relative to the fixed cut-score rather than on other test-takers. Score reports include subdomain performance to guide future learning. Score reports are typically provided within 10-12 weeks after the testing window closes, per ABPN/Pearson VUE.