✓ In recent years, one-half of the 23 recognized specialty boards in medicine have begun formally to recognize subspecialization with some type of certification process. One such board, the American Board of Internal Medicine, examines and certifies in 11 subspecialty areas while the American Board of Pathology does so in nine, the American Board of Pediatrics in eight, the American Board of Obstetrics and Gynecology in four, and the American Board of General Surgery in three. Arguments for and against similar recognition of subspecialization within neurosurgery are reviewed. The present position of other specialties and their boards regarding this sensitive issue is summarized, as well as their certification structure. The various pathways available to certifying boards for recognition of subspecialization are also presented. The American Board of Neurological Surgery (ABNS) has approved a subspecialty certificate called a “certificate of Special Qualification in Critical Care Medicine.” This is a subspe...