International Academy of Neuromusculoskeletal Medicine (IANM)

Introduction

The International Academy of Neuromusculoskeletal Medicine (IANM) is an independent certification and accreditation body dedicated to advancing standards in neuromusculoskeletal medicine and chiropractic orthopedics. The Academy serves as the specialty credentialing organization responsible for developing, administering, and maintaining board certification programs, subspecialty certifications, fellowships, and CCC programs for healthcare professionals practicing in the field of nonsurgical neuromusculoskeletal medicine.

The mission of the IANM is to qualify, examine, certify, and recredential specialists who evaluate and manage patients with neuromusculoskeletal disorders, spinal and extremity conditions, pain syndromes, and related biomechanical dysfunctions using evidence-based, patient-centered approaches.

Organizational Status

The International Academy of Neuromusculoskeletal Medicine is a nonprofit corporation organized under the laws of the State of Iowa and operates as a tax-exempt organization under Section 501(c)(3) of the Internal Revenue Code. The Academy functions independently of chiropractic political and trade organizations and is dedicated exclusively to professional certification, accreditation, education, and scholarly activities.

All officers, board members, committee members, examination personnel, and subject matter experts serve the Academy in a volunteer capacity, contributing their expertise to uphold certification standards and promote excellence within the profession.

Composition and Makeup of Personnel

The Academy is governed by a Board of Directors consisting of elected officers, committee chairpersons, public representatives, advisors, and international representatives.  The inclusion of a public (lay) member helps ensure public accountability and stakeholder representation within governance processes. International representation further supports the Academy’s global perspective in neuromusculoskeletal medicine.

The Academy’s credentialing programs are based upon the IANM Pillars of Practice, a comprehensive job analysis that defines the knowledge, skills, abilities, and competencies required of the advanced nonsurgical neuromusculoskeletal medicine specialist. The Pillars of Practice are periodically reviewed and updated to reflect current evidence and professional practice standards.

Governance

Governance Structure and Organizational Oversight

Purpose

The governance structure of the International Academy of Neuromusculoskeletal Medicine (IANM) is designed to ensure organizational integrity, independence, transparency, accountability, and consistency in the administration of certification, accreditation, examination, and CCC activities.

The governance model establishes clear authority, defined responsibilities, and oversight mechanisms to support the Academy’s mission of advancing standards in neuromusculoskeletal medicine through competency-based education, assessment, certification, and professional development.

The governance structure is designed to protect the validity and reliability of credentialing decisions by maintaining separation between educational activities, examination processes, accreditation decisions, and individual certification determinations.

Organizational Status and Governance Authority

The International Academy of Neuromusculoskeletal Medicine (IANM) operates as a nonprofit corporation organized under the laws of the State of Iowa and functions as a tax-exempt organization under Section 501(c)(3) of the Internal Revenue Code.

The Academy operates as an independent credentialing organization responsible for:

• Establishing specialty competency standards
• Developing certification pathways
• Administering board certification examinations
• Accrediting educational programs and related entities
• Recognizing specialty certificates and fellowships
• Maintaining credentialing standards
• Protecting the integrity of specialty certification

All governance activities are conducted in accordance with applicable nonprofit governance principles, ethical standards, and credentialing best practices.

Board of Directors

Authority and Responsibility

The Board of Directors serves as the primary governing authority of the Academy.

The Board is responsible for:

• Establishing organizational mission and strategic direction
• Approving policies and procedures
• Ensuring financial and operational accountability
• Maintaining independence of certification decisions
• Appointing committees and oversight bodies
• Ensuring compliance with organizational requirements
• Protecting public trust in the credentialing process

The Board provides oversight while delegating operational responsibilities to appropriate committees and administrative personnel.

Composition of the Board

The Board of Directors may include representation from:

• Certified specialists
• Academic representatives
• Clinical experts
• International representatives
• Public representatives
• Administrative leadership
• Subject matter experts

The inclusion of a public representative supports transparency, accountability, and consideration of public interest within organizational decisions.

The diversity of representation supports broad professional perspectives while maintaining specialty expertise.

Officers and Leadership Roles

The Academy leadership structure may include:

President

Responsibilities include:

• Providing organizational leadership
• Presiding over Board activities
• Supporting implementation of strategic objectives
• Representing the Academy in professional matters

Vice President

Responsibilities include:

• Supporting presidential duties
• Assisting with organizational initiatives
• Assuming leadership responsibilities when necessary

Secretary/Treasurer

Responsibilities include:

• Maintaining organizational records
• Documenting official proceedings
• Managing governance documentation

• Supporting financial oversight
• Reviewing financial reports
• Promoting responsible stewardship of resources

Executive Leadership

Administrative leadership supports:

• Daily operations
• Program implementation
• Communication
• Administrative coordination

Committees and Advisory Structure

The Academy utilizes committees and advisory groups to support specialized functions.

Committees may include:

Certification Committee

Responsibilities:

• Oversees certification processes
• Reviews eligibility requirements
• Supports certification policy development
• Maintains credentialing standards

Examination Committee

Responsibilities:

• Oversees examination development
• Maintains examination blueprint integrity
• Coordinates SME involvement
• Reviews examination quality

The committee ensures that examinations remain valid, reliable, fair, and aligned with specialty practice.

Accreditation Committee

Responsibilities:

• Reviews accreditation applications
• Evaluates institutional and program compliance
• Reviews faculty and examination platform accreditation
• Provides accreditation recommendations

The committee applies established standards consistently and objectively.

Fellowship and Specialty Committee

Responsibilities:

• Reviews advanced specialty pathways
• Establishes fellowship expectations
• Supports subspecialty development

Continuing Competency Committee

Responsibilities:

• Oversees CCC
• Reviews continuing education standards
• Supports lifelong learning requirements

Subject Matter Expert Governance

Subject Matter Experts (SMEs) provide specialized expertise while operating within defined governance processes.

SMEs may participate in:

• Practice analysis
• Examination blueprint development
• Item writing and review
• Standard setting
• Accreditation evaluation
• Curriculum review

SMEs must meet established qualifications and disclose potential conflicts of interest.

Independence and Conflict of Interest

To protect the integrity of certification and accreditation decisions, the Academy maintains conflict-of-interest safeguards.

Individuals involved in governance activities must:

• Disclose potential conflicts
• Avoid participation where impartiality may be compromised
• Maintain confidentiality
• Act in the best interest of the Academy and public protection

Individuals involved in examination development or scoring decisions must not have inappropriate influence over individual candidate outcomes.

Separation of Functions

The Academy maintains separation between:

Education

Activities involving teaching and preparation.

Accreditation

Activities involving evaluation and approval of educational entities.

Examination Development

Activities involving creation and validation of assessment instruments.

Certification Decisions

Activities involving determination of individual credential status.

This separation supports fairness, objectivity, and defensibility of credentialing decisions.

Transparency and Accountability

The Academy promotes transparency through:

• Published standards
• Defined eligibility requirements
• Documented policies
• Consistent review processes
• Appeals procedures
• Public-facing information regarding certification pathways

Governance decisions are documented and maintained according to organizational record requirements.

Appeals and Due Process Oversight

The Academy maintains procedures that allow review of:

• Certification decisions
• Examination-related concerns
• Accreditation decisions
• Administrative issues

Appeals are reviewed through established processes designed to provide fairness, impartiality, and procedural consistency.

Continuous Governance Improvement

The Academy periodically reviews governance structures to ensure continued effectiveness.

Review areas may include:

• Organizational performance
• Stakeholder feedback
• Regulatory expectations
• Credentialing standards
• Emerging professional needs

The governance system evolves to maintain alignment with best practices in certification and accreditation.

Summary of Governance

The IANM governance structure provides an organized framework for responsible oversight of certification, accreditation, examination, and CCC activities. Through Board oversight, committee structures, subject matter expert participation, conflict-of-interest protections, and separation of credentialing functions, the Academy maintains the integrity and reliability of its specialty recognition processes.

The governance framework supports the Academy’s commitment to professional excellence, public protection, and advancement of neuromusculoskeletal medicine.

Test Methodology

The International Academy of Neuromusculoskeletal Medicine (IANM) employs a comprehensive, competency-based examination development process designed to ensure that certification examinations accurately assess the knowledge, skills, clinical reasoning, and professional judgment required for specialty practice in neuromusculoskeletal medicine. The examination program is founded upon accepted psychometric principles, criterion-referenced assessment methodologies, and practice analysis data to support validity, reliability, fairness, and defensibility.

Foundation of Examination Development

The certification program is based upon the IANM Pillars of Practice, which serves as the profession’s comprehensive practice analysis and competency framework. The Pillars of Practice identify the knowledge domains, clinical competencies, skills, abilities, and professional behaviors required for effective specialty-level practice.

The practice analysis is periodically reviewed and updated by panels of subject matter experts representing diverse clinical settings, educational backgrounds, geographic regions, and areas of specialization. The purpose of these reviews is to ensure that examination content reflects contemporary practice patterns, emerging scientific evidence, technological advances, and changes in healthcare delivery systems.

The results of the practice analysis are translated into examination blueprints that specify:

• Content domains to be tested 
• Relative weighting of examination content 
• Knowledge and skill expectations 
• Cognitive complexity levels 
• Clinical performance expectations 
• Professional and ethical responsibilities 

Role of Subject Matter Experts

The Academy utilizes trained Subject Matter Experts (SMEs) throughout the examination development process. SMEs are selected based upon demonstrated expertise, board certification status, academic credentials, clinical experience, scholarly contributions, and familiarity with specialty practice.

SMEs participate in:

• Practice analysis studies 
• Examination blueprint development 
• Test specification development 
• Item writing 
• Item review and editing 
• Item rating
• Standard setting studies 
• Examination validation 
• Performance evaluation 
• Continuing examination improvement 

To minimize bias and enhance examination quality, multiple reviewers independently evaluate examination items before inclusion in the examination pool.

Examination Blueprint Development

The examination blueprint serves as the foundation for all certification examinations. The blueprint identifies the percentage of examination questions allocated to each major competency domain and ensures that examination content accurately reflects real-world specialty practice.

Domains commonly represented within the blueprint include:

• Patient history and interview 
• Physical examination 
• Functional assessment 
• Diagnostic imaging 
• Laboratory evaluation 
• Differential diagnosis 
• Clinical decision making 
• Treatment planning 
• Outcome assessment 
• Evidence-based practice 
• Documentation and records management 
• Professional ethics and patient safety 

Blueprint review is conducted regularly to ensure continued relevance and alignment with specialty practice requirements.

Item Development Process

Examination questions are developed through a structured item-writing process designed to produce valid and reliable assessment instruments.

Each item undergoes multiple stages of review including:

1. Initial development by a qualified SME. 
2. Technical review for accuracy and clarity. 
3. Content review for relevance to the examination blueprint. 
4. Editorial review for grammar and consistency. 
5. Bias and sensitivity review. 
6. Psychometric review when performance data become available. 

Items that fail to meet established quality standards are revised or removed from the item bank.

Cognitive Levels Assessed

The examination assesses multiple levels of cognitive functioning, moving beyond simple recall of facts to measure higher-order analysis and clinical reasoning.

Assessment levels may include:

Knowledge and Recall

Candidates demonstrate recognition and recall of foundational scientific and clinical information.

Examples include:

• Anatomy 
• Physiology 
• Pathology 
• Diagnostic criteria 
• Imaging findings 

Application

Candidates apply knowledge to clinical scenarios and patient presentations.

Examples include:

• Selection of examination procedures 
• Interpretation of clinical findings 
• Diagnostic test selection 
• Initial treatment planning 

Clinical Reasoning and Analysis

Candidates evaluate complex clinical information and integrate multiple data sources.

Examples include:

• Differential diagnosis 
• Interpretation of imaging studies 
• Identification of red flags 
• Risk assessment 
• Management prioritization 

Evaluation and Judgment

Candidates demonstrate mastery-level decision making consistent with specialty practice.

Examples include:

• Case management decisions 
• Referral determinations 
• Evidence integration 
• Prognostic assessment 
• Interdisciplinary care planning 

Examination Formats

The Academy may employ multiple examination formats to evaluate candidate competence.

These may include:

Written Examinations

Written examinations assess cognitive knowledge, clinical application, and diagnostic reasoning through:

• Multiple-choice questions 
• Clinical case scenarios 
• Imaging interpretation items 
• Extended matching questions 
• Evidence-based decision-making exercises 

Clinical Examinations

Clinical examinations assess applied competencies and may include:

• Structured clinical cases 
• Oral examinations 
• Objective Structured Clinical Examination (OSCE) stations 
• Case analysis exercises 
• Patient management simulations 

Clinical examinations evaluate a candidate’s ability to integrate knowledge into practical patient care situations.

Psychometric Analysis

Following administration, examination data undergo psychometric evaluation to ensure quality and performance.

Statistical analyses may include:

• Item difficulty analysis 
• Item discrimination analysis 
• Reliability estimation 
• Validity evaluations
• Criticality assessment and rating
• Examination form equivalency analysis 
• Candidate performance trends 
• Blueprint compliance analysis 

Poorly performing items may be revised, recalibrated, or removed from scoring calculations when justified by psychometric evidence.

Standard Setting and Passing Scores

Certification examinations are criterion-referenced rather than norm-referenced. Candidates are not evaluated against one another but against predetermined standards of competency.

Passing standards are established through recognized standard-setting methodologies that may include:

• Modified Angoff Method 
• Ebel Method 
• Nedelsky Method 
• Criterion Mastery Method 
• Expert Panel Consensus 

These methodologies involve panels of subject matter experts who determine the minimum level of competence expected of a specialty practitioner.

The resulting passing score represents the threshold for competent specialty practice rather than a predetermined percentage of candidates who may pass.

Examination Security

The Academy maintains rigorous examination security procedures designed to protect the integrity of the credential.

Security measures may include:

• Candidate identity verification 
• Confidentiality agreements 
• Secure examination administration 
• Non-disclosure agreements
• Proctoring procedures 
• Statistical monitoring for irregularities 
• Investigation of suspected misconduct 
• Secure item bank management 

Violations of examination security policies may result in score invalidation, disciplinary action, or loss of eligibility.

Fairness and Due Process

The Academy is committed to fair and equitable assessment practices.

Candidates are provided with:

• Published eligibility requirements 
• Examination content specifications 
• Examination policies and procedures 
• Appeals procedures 
• Accommodation procedures when appropriate 
• Score reporting processes 

Formal mechanisms exist for review of administrative concerns, examination irregularities, and candidate appeals.

Continuous Quality Improvement

The examination program operates within a continuous quality improvement framework. Examination committees regularly review:

• Examination performance statistics 
• Candidate feedback 
• Changes in professional practice 
• Advances in scientific evidence 
• Emerging healthcare trends 
• Regulatory and accreditation requirements 

This ongoing review process helps ensure that certification examinations remain current, relevant, legally defensible, and reflective of contemporary specialty practice.

Summary of Test Methodology

The IANM examination program utilizes a systematic, evidence-informed, psychometrically sound methodology designed to assess mastery-level competency in neuromusculoskeletal medicine. Through practice analysis, blueprint development, expert item construction, criterion-referenced standard setting, psychometric evaluation, and continuous quality improvement, the Academy seeks to ensure that board-certified specialists possess the knowledge, clinical skills, and professional judgment necessary to provide safe, effective, and evidence-based patient care.

Job Analysis Foundation

The examination blueprint is derived from the IANM Pillars of Practice, which has undergone periodic review since the early 1990s. The blueprint reflects contemporary clinical practice and defines the domains tested on certification examinations.

Eligibility Requirements

Candidates must complete advanced postdoctoral educational requirements, including a minimum of 300 hours of approved postgraduate study in neuromusculoskeletal medicine or chiropractic orthopedics prior to examination eligibility.

Examination Structure

The certification process consists of:

• Part I Examination
• Part II Objective Structured Clinical Examinations OSCEs

These examinations are designed to assess cognitive knowledge, clinical reasoning, diagnostic interpretation, and management competencies required for mastery and expert level specialty practice.

Formal appeals and re-scoring procedures are available to candidates.

Board Certification at Mastery Level

The IANM certification process is designed as a mastery-level credentialing program rather than an entry-level educational assessment.

Board certification signifies that the candidate has demonstrated advanced competency in:

• Patient history and clinical interviewing
• Physical examination
• Differential diagnosis
• Diagnostic imaging interpretation
• Laboratory interpretation
• Evidence-based clinical decision making
• Treatment planning
• Outcome assessment
• Medicolegal Documentation
• Non-surgical neuromusculoskeletal management

Certification serves as evidence that the specialist possesses the knowledge and clinical judgment expected of an advanced practitioner in neuromusculoskeletal medicine. The Academy identifies itself as the credentialing body responsible for defining and certifying specialists within chiropractic orthopedics and neuromusculoskeletal medicine.

Continuing Clinical Competence (CCC) 

Continuing Clinical Competence (CCC) Program Standard

Official Policy Governing Active Board Certification

View the Policy and Procedure for Content Accreditation Review

Purpose

Continuing clinical competence is essential for all health care practitioners, particularly those who have achieved specialty certification and professional recognition.

Specialty-level practice must be continually advanced and improved to remain current with developments in clinical science, diagnostic procedures, patient management, professional standards, and all aspects of health care delivery.

The Continuing Clinical Competence (CCC) Program Standard establishes the requirements by which Diplomates and Fellows of the International Academy of Neuromusculoskeletal Medicine demonstrate ongoing professional development and maintain active board certification.

Specialty certification represents a continuing commitment to clinical excellence rather than the completion of professional education. Diplomates and Fellows are expected to participate in lifelong learning, scholarly activity, ethical practice, and professional development to ensure that their knowledge, clinical judgment, and professional skills remain current.

Participation in the CCC Program supports public confidence in specialty certification and provides the basis for the Academy’s Primary Source Verification of active board certification.

Historical Background

When the chiropractic orthopedic specialty was recognized in the late 1950s, certification was initially awarded as a lifetime recognition of academic and clinical achievement.

As the educational and clinical requirements of the specialty evolved, the American Board of Chiropractic Orthopedists was established. Educational standards, certification requirements, examination development, and testing procedures were continually upgraded and improved to comply with the accreditation and certification standards of the time.

The specialty became recognized as a leader in certification procedures, examination development and administration, psychometric evaluation, accreditation of educational providers and instructors, and the advancement of continuing clinical competence.

In 2003, responsibility for the examination process and continued development of the specialty was assigned to the Academy of Chiropractic Orthopedists.

In 2015, the Academy introduced a structured program requiring Diplomates and Fellows to demonstrate ongoing professional development through specified educational, scholarly, and clinical activities. Content requirements and completion periods were established to demonstrate to the public and other interested parties that Diplomates and Fellows continued to acquire advanced knowledge and skills as health care information and clinical practices evolved.

In 2018, the name of the Academy of Chiropractic Orthopedists was changed to the International Academy of Neuromusculoskeletal Medicine (IANM) to more accurately represent the scope of the specialty and the professionals participating in its certification programs.

The name change also recognized the inclusion of chiropractic, medical, and related health care specialties participating in the Academy’s continuing clinical competence process.

Before January 1, 2022, current Diplomates and Fellows of the American Board of Chiropractic Orthopedists, the Academy of Chiropractic Orthopedists, the International Academy of Neuromusculoskeletal Medicine, and other approved entities were granted initial membership in the IANM and invited to meet the CCC requirements.

After January 1, 2022, Diplomates and Fellows are required to comply with the CCC Program Standard to maintain active certification by the Academy.

Certification status and CCC compliance must be renewed annually for the Academy to provide Primary Source Verification when requested.

Primary Source Verification

The International Academy of Neuromusculoskeletal Medicine serves as a Primary Source Verification organization for the orthopedic and neuromusculoskeletal medicine Diplomate credential.

The IANM regularly receives requests for verification of credentials from:

• Licensing boards and regulatory agencies
• Federal, state, provincial, and local government agencies
• Third-party payers
• Hospitals and health care systems
• Legal and administrative jurisdictions
• Colleges, universities, and other institutions of higher education
• Military departments
• Professional health care organizations
• Other health care practitioners
• Patients and members of the public

Primary Source Verification of active board certification may be provided only for Diplomates and Fellows who remain in compliance with the CCC Program Standard and whose information is current with the Academy.

How the CCC Process Works

The IANM website tracks each Diplomate’s annual renewal and CCC status.

To view certification status, determine the next renewal date, or pay annual renewal fees, Diplomates and Fellows should select Diplomate Login in the website header.

A password may be reset by selecting the Lost Your Password link on the login page.

After the annual renewal fee has been paid, CCC Credit documentation may be uploaded through the Diplomate account.

Diplomates and Fellows should select the Renewal Documentation tab after logging in and upload documentation supporting the CCC Credits claimed.

The IANM may audit up to ten percent (10%) of submitted documentation each year to verify compliance with its responsibilities as a certifying board.

CCC educational activities may also qualify for professional license renewal. Each Diplomate is responsible for determining whether an activity is accepted by the licensing board or regulatory authority governing the Diplomate’s practice jurisdiction.

Annual CCC Requirement

Each active Diplomate shall earn a minimum of twelve (12) CCC Credits annually, unless an exemption applies under this Program Standard.

CCC Credits may be earned through approved continuing education, teaching, scholarly publication, examination development, or other activities approved by the IANM.

Where CCC-Approved Credits May Be Obtained

Courses submitted for CCC Credits must be taught by board-certified chiropractic specialists in recognized chiropractic specialties who have maintained active Diplomate status.

Classes should be sponsored or approved by:

• A Council on Chiropractic Education-accredited chiropractic college or university offering a postgraduate program;
• An appropriately accredited international chiropractic college or university;
• An educational organization approved by the IANM; or
• Another provider meeting the Academy’s educational and instructor requirements.

Diplomates and Fellows with questions concerning a course they are considering should contact the IANM before enrolling to verify whether the activity qualifies for CCC Credits.

Online learning is acceptable when the course, provider, instructor, and documentation satisfy IANM requirements.

Approved Educational Organizations

Oraganizations, programs institutions and other educaitonal activities recognized by the IANM are listed on the Educational tab.

Current neuromusculoskeletal medicine and chiropractic orthopedic Diplomate classes offered online or on-site are acceptable when they meet IANM requirements.

Educational activities taught by individuals who do not meet the Academy’s board-certification and instructor requirements are not eligible for CCC Credits unless specifically approved by the IANM.

CCC Credit Opportunities

The following activities may satisfy the annual twelve-credit requirement.

Approved Continuing Education

Completion of twelve (12) hours of approved postgraduate education shall earn twelve (12) CCC Credits.

Postgraduate Instruction

A postgraduate neuromusculoskeletal medicine or chiropractic orthopedic instructor who teaches a minimum of four (4) instructional hours during an approved course in a calendar year shall earn twelve (12) CCC Credits.

Doctor of Chiropractic Program Instruction

A professor or instructor who teaches a minimum of six (6) instructional hours during an academic year in an approved Doctor of Chiropractic program at a CCE-accredited college or university shall earn twelve (12) CCC Credits.

Scholarly Publication

A Diplomate who authors or coauthors a case report, research article, or comparable scholarly work published in a peer-reviewed journal shall earn twelve (12) CCC Credits.

Part I Examination Development

A Diplomate who develops twenty (20) Part I multiple-choice examination questions that are accepted by the examination board and successfully completes the required psychometric review shall earn twelve (12) CCC Credits.

Part II Examination Development

A Diplomate who develops one (1) Part II Objective Structured Clinical Examination that is accepted by the examination board and successfully completes the required psychometric review shall earn twelve (12) CCC Credits.

Documentation

Diplomates and Fellows are responsible for retaining and submitting adequate documentation supporting all claimed CCC Credits.

Acceptable documentation may include:

• Certificates of completion
• Official transcripts
• Letters from educational providers
• Teaching schedules or institutional verification
• Copies or citations of published scholarly work
• Examination-development approval records
• Other documentation accepted by the IANM

The Academy may request additional information when necessary to determine whether an activity satisfies the CCC Program Standard.

Retired Diplomates and Fellows

Retired Diplomates and Fellows are not required to earn annual CCC Credits.

A retired Diplomate who returns to active clinical practice may be required to satisfy current CCC requirements before active certification status, and Primary Source Verification privileges are restored.

Questions Regarding Eligible Credits

Questions concerning eligible courses, activities, documentation, or CCC Credits should be directed to the IANM.

Telephone: 844-532-2378

Email: admin@ianmmedicine.org

Failure to Meet the CCC Program Standard

Failure to complete the annual CCC requirements may result in:

• Removal of the Diplomate’s name and practice information from the IANM Doctors Directory;
• Loss of active Diplomate status;
• Ineligibility for Primary Source Verification;
• Suspension of board certification; or
• Forfeiture of the Diplomate credential when authorized by applicable Academy policies.

Diplomates and Fellows receiving their certification after January 1, 2022, may have their Diplomate or Fellow certification suspended or forfeited for failure to comply with the CCC Program Standard.

The Academy shall provide notice and follow any applicable review or reinstatement procedures before final disciplinary action is taken.

Primary Source Verification and Current Information

Because the IANM serves as the Primary Source Verification organization for the orthopedic and neuromusculoskeletal medicine Diplomate or Fellow credential, the Academy must maintain accurate and current information for each Diplomate or Fellow.

The IANM cannot verify active certification for an inquiring organization when a Diplomate has not satisfied the CCC Program Standard, has not paid applicable renewal fees, or has not provided current professional information.

Annual Review

The International Continuing Clinical Competence (CCC) Program Standard shall be reviewed annually by the IANM Board of Directors or its designated committee.

Approved revisions shall be published no later than November 1 of each calendar year and shall become effective on the date established by the Board.

The current published version of the CCC Program Standard shall govern all annual renewal and continuing clinical competence requirements. 

Credentials

As of July 1, 2026, the IANM shall consider certifying Diplomates and Fellows to use DACO, DIANM or FIANM as appropriate credentials.

Annual Credential Renewal

Certified individuals must complete annual renewal requirements to maintain active credential status.

Renewal activities may include:

• Updating personal and professional information
• Confirming licensure status
• Verifying professional standing
• Completing required documentation
• Paying applicable renewal fees
• Attesting to continued compliance with IANM standards

Failure to complete renewal requirements may result in inactive credential status.

Continuing Education Requirements

Certified specialists are expected to participate in ongoing professional development activities relevant to neuromusculoskeletal medicine.

Acceptable educational activities may include:

• Accredited postgraduate education
• Specialty conferences
• Professional workshops
• Online educational activities
• Case-based learning activities
• Research and scholarly activities
• Teaching activities
• Clinical skills development

Continuing education should support maintenance and advancement of competencies identified within the IANM Pillars of Practice.

Specialty-Relevant Learning Activities

Continuing education activities should contribute to competency development in areas including:

• Patient evaluation
• Physical examination
• Diagnostic reasoning
• Imaging interpretation
• Laboratory interpretation
• Differential diagnosis
• Evidence-based practice
• Treatment planning
• Outcome measurement
• Patient safety
• Professional documentation

The purpose of continuing education is not simply accumulation of hours but demonstration of continued specialty competence.

Voluntary Examination and Reassessment

The Academy may utilize reassessment activities to support continued demonstration of specialty competency.

These activities may include:

• Knowledge assessments
• Specialty examinations
• Case-based evaluations
• Clinical competency assessments
• Continuing competency evaluations

Reassessment activities ensure that credential holders remain current with advances in evidence, diagnostic approaches, and clinical management strategies.

Professional Standing Requirements

Credential holders must maintain appropriate professional standing.

Requirements may include:

• Active professional licensure where applicable
• Compliance with professional regulations
• Ethical professional conduct
• Absence of unresolved disciplinary actions affecting professional competence

IANM reserves the right to review credential status when professional conduct concerns arise.

Documentation and Verification

Certified individuals are responsible for maintaining documentation supporting compliance with maintenance requirements.

Documentation may include:

• Continuing education certificates
• Course completion records
• Professional development activities
• Licensure verification
• Specialty activity documentation

IANM may request documentation for verification purposes.

Audit Process

The Academy may conduct periodic audits to verify compliance with CCC requirements.

Audit procedures may include:

• Review of submitted documentation
• Verification of educational activities
• Confirmation of professional status
• Review of CCC records

Individuals selected for audit must provide requested documentation within established timelines.

Noncompliance and Deficiency Procedures

Failure to meet CCC requirements may result in:

• Notification of deficiency
• Requirement for corrective action
• Temporary inactive status
• Suspension of credential
• Loss of certification status

Individuals may be provided an opportunity to correct deficiencies according to established policies.

Reinstatement of Credentials

Individuals whose credentials become inactive may apply for reinstatement.

Reinstatement requirements may include:

• Submission of reinstatement application
• Completion of outstanding requirements
• Documentation of continuing competency
• Payment of applicable fees
• Additional assessment activities when required

The purpose of reinstatement is to ensure that returning credential holders meet current specialty standards.

Primary Source Verification

IANM serves as a primary source verification organization for CCC status.

Verification may include confirmation of:

• Credential type
• Certification status
• Effective dates
• Fellowship or specialty recognition

Primary source verification supports credentialing activities by employers, healthcare organizations, and professional institutions.

Credential Status Categories

Credential status may include:

Active

The individual has fulfilled all current CCC requirements.

Inactive

The individual has not completed required CCC activities within established timelines.

Suspended

Credential privileges have been temporarily removed pending resolution of identified concerns.

Expired

The credential is no longer valid due to failure to maintain requirements.

Continuous Improvement of the CCC Program

IANM periodically reviews the CCC program to ensure alignment with:

• Advances in clinical science
• Specialty practice evolution
• Assessment best practices
• Healthcare quality standards
• Stakeholder expectations

The Academy may modify CCC requirements to ensure continued relevance and effectiveness.

Summary of CCC

The IANM Internatinoal Continuing Clinical Competence  program provides a structured process to ensure continued competency, professional growth, and accountability among certified neuromusculoskeletal medicine specialists.

Through annual renewal, continuing education, professional activity verification, reassessment opportunities, and quality improvement processes, the program supports lifelong learning and maintains the integrity of specialty certification.

CCC represents the ongoing commitment of certified specialists to excellence in patient care, evidence-based practice, and advancement of neuromusculoskeletal medicine.

The CCC process demonstrates to patients, employers, insurers, governmental agencies, licensing boards, and credentialing organizations that certified specialists remain current with evolving evidence-based healthcare practices.

Current requirements include:

• Annual renewal
• Documentation of approved continuing education
• Voluntary Examination
• Verification of specialty-related educational activities
• Declaration of professional standing
• Payment of applicable renewal fees

The Academy serves as a primary source verification (PSV) organization for certification and CCC status verification.

Certificates, Board Certifications, and Fellowships

The IANM offers multiple credentialing pathways that recognize varying levels of professional achievement.

Certificate Programs

Certificate programs recognize focused education and competency in specific subspecialty areas, including:

• Injection Therapy
• Forensic Science
• Concussion Management
• Diagnostic Ultrasound
• Geriatrics
• Sports Neuromusculoskeletal Medicine
• Whiplash Associated Disorders (WAD)
• Other emerging specialty disciplines

These programs document successful completion of specialty-specific education and assessment requirements.

Board Certification

The Academy awards board certification to candidates who successfully complete eligibility requirements and pass the certification examination process.

Examples include:

• Diplomate of the International Academy of Neuromusculoskeletal Medicine (DIANM)

Board certification represents specialty recognition in neuromusculoskeletal medicine and chiropractic orthopedics.

Fellowship Programs

Fellowship programs represent advanced achievement beyond initial board certification and are available in selected sub-specialty disciplines.

Examples include:

• Injection Therapy Fellowship
• Forensics Science Fellowship
• Concussion Management Fellowship
• Diagnostic Ultrasound Fellowship
• Geriatric Fellowship
• Sports Neuromusculoskeletal Medicine Fellowship
• Whiplash Associated Disorders Fellowship

Fellowships recognize advanced expertise, additional education, specialized clinical competence, and leadership within a focused area of practice.

Accreditation

Purpose

The purpose of the IANM accreditation and program approval process is to ensure that educational institutions provide a curriculum that adequately prepares candidates for specialty practice in neuromusculoskeletal medicine and chiropractic orthopedics. The process establishes a direct relationship between educational outcomes and the competencies required for board certification.

Alignment with the Pillars of Practice

The primary standard utilized during program review is the IANM Pillars of Practice. This document serves as the specialty profession’s job analysis and competency framework and identifies the knowledge, skills, and abilities expected of a certified specialist. Educational programs seeking recognition must demonstrate that their curriculum addresses the domains contained within the Pillars of Practice. 

The curriculum is evaluated to determine whether it adequately prepares candidates in:

• Patient history and clinical interviewing 
• Physical examination procedures 
• Diagnostic imaging interpretation 
• Laboratory diagnosis 
• Differential diagnosis 
• Evidence-based practice 
• Treatment planning 
• Outcome assessment 
• Documentation and records management 
• Professional and ethical practice 

Faculty Qualifications Review

The Academy evaluates faculty qualifications to ensure instruction is delivered by individuals possessing appropriate expertise and specialty credentials.

Faculty members are generally expected to:

• Hold advanced specialty credentials. 
• Demonstrate expertise in the subject matter taught. 
• Maintain current professional licensure where applicable. 
• Possess teaching experience and clinical competency. 

The IANM specifically notes that instructors must be affiliated with postgraduate departments of recognized chiropractic colleges or universities and that specialty qualifications are reviewed to ensure compliance with Academy standards. 

Curriculum Review

Program accreditation review includes evaluation of:

• Course objectives 
• Learning outcomes 
• Instructional hours 
• Syllabi and course materials 
• Clinical training experiences 
• Assessment methodologies 
• Faculty resources 
• Educational support services 

The review process determines whether the curriculum provides comprehensive preparation consistent with specialty-level neuromusculoskeletal medicine practice. 

Contact Hour Verification

A significant component of the review process involves verification of educational hours.

The University of Bridgeport program currently provides:

• Approximately 300 hours of online specialty instruction. 
• Additional live contact hours available through approved educational sites. 

These hours satisfy the educational eligibility requirements established by the Academy for board certification examination candidacy. 

Competency-Based Educational Outcomes

The Academy evaluates educational programs based upon their ability to develop competency rather than simply deliver instructional hours.

Programs must demonstrate educational experiences that allow candidates to acquire competency in:

• Clinical reasoning 
• Diagnostic decision making 
• Evidence appraisal 
• Imaging interpretation 
• Management planning 
• Patient safety 
• Professional communication 

The emphasis is placed on preparing practitioners for specialty-level independent practice. 

Continuous Quality Improvement

Accredited or approved educational programs are expected to participate in continuous quality improvement processes.

These activities may include:

• Curriculum updates 
• Faculty development 
• Review of specialty practice changes 
• Incorporation of emerging evidence 
• Assessment of educational outcomes 
• Alignment with updated Pillars of Practice revisions 

The Academy periodically updates the Pillars of Practice, requiring educational programs to maintain curricular alignment with evolving specialty standards. The current revision cycle includes updates extending through 2030 and incorporates specialty-focused job analyses across multiple subspecialty disciplines. 

Relationship to Board Certification

Completion of an approved residency or post-doctoral educational program does not automatically confer board certification.

Rather, successful completion of the UB program provides educational eligibility to apply for the IANM certification examination process. Candidates must still:

1. Meet all eligibility requirements. 
2. Submit an application for certification. 
3. Successfully complete the Part I written examination. 
4. Successfully complete the Part II examination. 
5. Satisfy all Academy credentialing requirements. 

Board certification is awarded only after successful completion of the independent certification process administered by the IANM. 

Accreditation Outcomes

When a program successfully meets Academy standards, the Academy may recognize the program as an approved educational pathway for certification eligibility. Such recognition signifies that:

• The curriculum aligns with the IANM Pillars of Practice. 
• Faculty qualifications meet Academy standards. 
• Educational outcomes support specialty competency development. 
• Program graduates possess the educational preparation necessary to pursue specialty certification. 

The relationship between the IANM and a program or institution helps ensure that specialty education, certification eligibility, and professional competency remain aligned with the standards established for neuromusculoskeletal medicine specialists.

Transparency and Accountability

The Academy promotes transparency through:

• Published standards
• Defined eligibility requirements
• Documented policies
• Consistent review processes
• Appeals procedures
• Public-facing information regarding certification pathways

Governance decisions are documented and maintained according to organizational record requirements.

Appeals and Due Process Oversight

The Academy maintains procedures that allow review of:

• Certification decisions
• Examination-related concerns
• Accreditation decisions
• Administrative issues

Appeals are reviewed through established processes designed to provide fairness, impartiality, and procedural consistency.

International Academy of Neuromusculoskeletal Medicine (IANM)

Accreditation and Certification Standards Framework

Institutional, Program, Faculty, and Examination Platform Accreditation

1. Introduction and Purpose of Accreditation

Purpose

The International Academy of Neuromusculoskeletal Medicine (IANM) accreditation system establishes a structured framework to evaluate and recognize educational institutions, training programs, instructors, and examination delivery systems that demonstrate compliance with established standards for quality, competency development, assessment integrity, and continuous improvement.

The purpose of accreditation is to ensure that educational and assessment systems supporting neuromusculoskeletal medicine specialty training are designed and operated in a manner that promotes:

• Competent healthcare practitioners
• Evidence-based clinical practice
• Patient safety
• Educational quality
• Assessment validity
• Public confidence

Accreditation provides formal recognition that an organization or educational component has met established standards established by the Academy.

2. Definitions and Terminology

Accreditation

A formal review and recognition process by which IANM determines that an institution, program, instructor, or examination platform meets established quality standards.

Certification

A formal credential awarded to an individual who has demonstrated competency through completion of eligibility requirements and successful performance on an approved certification examination.

Certificate Program

A structured educational program designed to provide focused knowledge and skills within a defined area of practice.

Board Certification

A specialty credential demonstrating that an individual has achieved mastery-level competency within neuromusculoskeletal medicine through examination and credential review.

Fellowship

An advanced educational and competency-based recognition program completed beyond initial specialty certification.

Candidate

An individual applying for or participating in a certification process.

Subject Matter Expert (SME)

A qualified professional possessing advanced knowledge, clinical expertise, and experience relevant to a specific competency area.

Educational Provider

An institution responsible for delivering approved educational content.

Examination Provider

An organization responsible for secure administration and delivery of certification examinations.

3. Accreditation Philosophy and Principles

IANM accreditation is founded on the principles of:

Competency-Based Education

Educational programs must demonstrate that learners acquire the knowledge, skills, and abilities required for specialty practice.

Evidence-Based Practice

Educational content must reflect current scientific evidence and accepted clinical standards.

Fairness and Transparency

Accreditation decisions must be based on defined criteria applied consistently.

Public Protection

Accreditation supports the preparation and assessment of qualified practitioners who provide safe patient care.

Continuous Improvement

Accredited organizations must demonstrate ongoing evaluation and improvement.

4. Accreditation Categories

IANM recognizes multiple accreditation categories.

Institutional Accreditation

Applies to:

• Universities
• Colleges
• Educational organizations
• Specialty training institutions

Evaluation includes governance, resources, educational infrastructure, and administrative capacity.

Program Accreditation

Applies to:

• Residency programs
• Postgraduate specialty programs
• Fellowship programs
• Certificate programs

Evaluation includes curriculum, faculty, assessment, and educational outcomes.

Instructor Accreditation

Applies to:

• Faculty members
• Course instructors
• Clinical educators
• Assessment specialists

Evaluation includes expertise, teaching ability, and professional qualifications.

Examination Platform Accreditation

Applies to:

• Online testing systems
• Remote proctoring systems
• Assessment delivery providers

Evaluation includes security, reliability, accessibility, and examination integrity.

5. Accreditation Application Process

Application Submission

Applicants must provide documentation demonstrating compliance with accreditation standards.

Required materials may include:

• Institutional profile
• Organizational structure
• Mission and objectives
• Curriculum documentation
• Faculty qualifications
• Assessment methods
• Policies and procedures
• Quality improvement plan

Review Process

The accreditation review consists of:

Administrative Review

Determines completeness of submitted materials.

Expert Review

Conducted by qualified reviewers with appropriate professional expertise.

Verification Review

May include:

• Virtual interviews
• Documentation verification
• Faculty review
• Technology assessment
• Program evaluation

Accreditation Committee Decision

Final determination is made by the designated IANM accreditation authority.

6. Accreditation Standards and Criteria

Standard 1: Governance and Administration

The organization must demonstrate:

• Clear leadership structure
• Defined responsibilities
• Accountability mechanisms
• Ethical governance

Standard 2: Curriculum and Educational Content

Programs must demonstrate:

• Clearly defined objectives
• Competency alignment
• Appropriate instructional methods
• Current evidence-based content

Standard 3: Faculty Qualifications

Faculty must demonstrate:

• Subject expertise
• Professional qualifications
• Teaching competency
• Continued professional development

Standard 4: Assessment System

Programs must demonstrate:

• Valid assessment methods
• Reliable evaluation procedures
• Competency measurement
• Learner feedback processes

Standard 5: Continuous Quality Improvement

Organizations must demonstrate:

• Outcome evaluation
• Improvement strategies
• Periodic review processes

7. Accreditation Review Committee Structure

The accreditation review process shall utilize qualified reviewers and subject matter experts.

Committee responsibilities include:

• Reviewing applications
• Evaluating compliance
• Making accreditation recommendations
• Reviewing improvement plans

Members must disclose conflicts of interest and recuse themselves when appropriate.

8. Site and Program Evaluation Process

Evaluation activities may include:

Document Review

Review of:

• Policies
• Curriculum
• Faculty credentials
• Assessment systems

Interviews

May include:

• Leadership
• Faculty
• Students
• Administrative personnel

Outcome Review

Evaluation of:

• Graduate performance
• Examination outcomes
• Program effectiveness

9. Accreditation Decisions

Possible outcomes include:

Full Accreditation

The organization meets established standards.

Conditional Accreditation

Approval granted with required improvements.

Probation

Significant deficiencies require correction.

Denial

Standards are not adequately demonstrated.

Withdrawal

Accreditation may be removed for failure to maintain requirements.

10. Appeals and Due Process

IANM provides a formal process allowing organizations to appeal accreditation decisions.

Appeals may address:

• Procedural concerns
• Interpretation of standards
• Review findings

Appeals are reviewed independently to ensure fairness.

11. Complaints and Public Accountability

Accredited organizations must maintain procedures for handling complaints.

Complaint processes include:

• Submission procedures
• Investigation
• Documentation
• Corrective action

IANM maintains commitment to transparency and public accountability.

12. Records Retention and Data Security

Accredited organizations must maintain secure records including:

• Student records
• Faculty documentation
• Examination records
• Accreditation materials

Organizations must implement safeguards protecting:

• Confidential information
• Candidate data
• Educational records

13. Relationship Between Accreditation and Certification

Accreditation and certification are separate processes.

Accreditation verifies that an educational or assessment system meets established standards.

Certification verifies that an individual has demonstrated professional competency.

Completion of an accredited program provides educational preparation and eligibility but does not independently confer board certification.

Candidates must successfully complete all certification requirements established by IANM.

14. Continuous Improvement and Review Cycle

Accredited organizations must demonstrate ongoing improvement through:

• Annual review activities
• Curriculum updates
• Faculty development
• Technology improvements
• Outcome analysis

IANM may revise standards to reflect:

• Advances in science
• Changes in healthcare practice
• Educational developments
• Assessment best practices

15. Appendices and Supporting Documentation

Accreditation documentation may include:

Appendix A

Institutional Accreditation Application

Appendix B

Program Self-Study Report

Appendix C

Faculty Credential Verification Form

Appendix D

Examination Platform Security Checklist

Appendix E

Site Evaluation Report

Appendix F

Conflict of Interest Disclosure Form

Appendix G

Accreditation Decision Notification Templates

Summary of Accreditation

The IANM accreditation framework provides a comprehensive system for evaluating institutions, programs, instructors, and examination platforms involved in the preparation and assessment of neuromusculoskeletal medicine specialists.  Through defined standards, expert review, competency-based evaluation, secure assessment practices, and continuous improvement requirements, accreditation supports the development of qualified specialists and promotes confidence in specialty education and certification processes.

Conclusion

The International Academy of Neuromusculoskeletal Medicine functions as an independent nonprofit certification and accreditation body dedicated to establishing standards for advanced nonsurgical neuromusculoskeletal medicine specialists. Through the use of subject matter experts, competency-based examination methodologies, mastery-level board certification, ongoing CCC, and advanced fellowship programs, the Academy promotes professional excellence, public protection, and lifelong learning among healthcare practitioners specializing in neuromusculoskeletal medicine.