Blasphemy!

I wasn’t intending to do a follow-up post, but I’ve been catching some heat lately.

Comments. Text. Even phone calls.

You know something just hit the fan if people actually use their phone to call you.

I touched a nerve when I called the CNIM a luxury item. I knew it might ruffle some feathers if I wasn’t able to take you in the direction I was heading. I tried to not make it antagonizing clickbait. I even tried to tip my hand at the end of the title:

The CNIM Is JUST A Luxury Item (But Not How You Think)

OK, that’s not 100% true either, seeing as I put the word JUST in all caps.

And that’s probably what did it: teasing a definition I didn’t intend to use.

I risked confusing people. And that’s on me.

The reason?

I tried to use the element of surprise. Surprise is one of my favorite emotions. I know that’s weird to hear because surprise naturally doesn’t feel good. The sensation you feel is the palpable consequence of “reward prediction errors” in our subcortical brain when novelty-triggered neurons respond, ultimately transferring those stored memories to higher cortical areas. There’s a risk associated with not being able to accurately predict future occurrences.

But it’s not all bad. It means you were incorrect in how you saw the world previously and need to update your priors. So it’s a signal that there’s something to learn  (I’m halfway through this topic in a future post about my surprise at CEA anesthesia recommendations).

But I crossed some people up.

My target was not the surprise of “Joe thinks we should get rid of the CNIM?,” but the surprise of “Oh, I never thought of the CNIM in that light. Those on the fence about taking it should really consider this point, seeing as it is a hidden force likely to affect their future career.”

But (unsurprisingly), I fell short of clarity.

So I decided to post some of the communication where I needed to do better with my definitions and post it here.

Cool. But What Would You Do If You Were Me?

Unfortunately, I don’t get to make the rules. All I can do is look at what’s happened, where we are, and guess the likelihood of where we might be headed.

All I have are situational opinions, which is what I’ll give now. On 9/2022, taking into account the info I laid out in my previous post:

• if I was in the IONM field and didn’t have my CNIM, I’d start watching videos, take my notes, and pass the CNIM.
• if I was in the field but didn’t have the credentials to be eligible to sit for the CNIM, I’d get to work on earning my degree, EEG license, or keep my resume spruced up. The direction the market is headed and the risk of being credentialed out of a position is too high to not be prepared. 
• if I had no path to the CNIM and wasn’t in the field, I wouldn’t try to get into it until I could be eligible for the CNIM.
• if I had a degree but am having trouble finding a surgical neurophysiologist job, I’d be very hesitant to go for another degree in IONM. That is… unless Mr. Biden is picking up the tab. The numbers make it hard to justify.

But remember 2 things:

1) I’m part of the wolfpack. I’m incentivized to say it. I want others to want it and not some alternative to it that can do just as good of a job. I don’t want those making the credentials to make it a layup of an examination or to allow just anyone to take it. The “right” people have to want it. It has to mean something, so we’ll need sacrificial lambs. At the same time, it can’t be so exclusive that not enough people get it for it to matter. So my advice is tainted, no matter how objective I try to be.

2) Things can, do, and will change. That’s why we prepare to adapt; we take note of shifts in scarcity. I strongly think the CNIM has legs, but not absolutely. 0 and 1 are not probabilities.

So, Nothing Has Changed Your Mind?

Not yet. This is the same advice I’ve given in the past on the website and to those I’ve spoken to personally. The last post wasn’t about reporting some new revelation to start a revolution.

It was much more benign than that.

It was more of a nudge to those experienced in the field to get their CNIM, as well as try to set higher expectations for those coming into the field to meet the current trend of more places requiring the CNIM.

I hope to flash a light into the foggy future to those that might have their livelihoods challenged so that they might have time to prepare.

Still, that doesn’t mean a free-for-all. The push I’m looking to make does not remove the exclusion. It just shifts the selection criteria from those willing to get it to those capable of getting it.

Because that’s the next step on the continuum (nothing, nice-to-have, luxury item, requirement), assuming we get there and the CNIM credential to do it.