Subspecialty and Combined Training Careers

Although this section of IMpact explores the subspecialty and combined training careers of internal medicine, it's worth emphasizing what makes internal medicine unique. Internal medicine physicians see things differently. Holistically. And in a unique way that allows them to analyze, lead, and humanize health care in a variety of different settings and roles. See all the career opportunities internal medicine can provide.

Neurocritical Care Medicine

The Discipline

Neurocritical care medicine focuses on the diagnosis and treatment of life-threatening diseases of the nervous system, including brain and spinal cord trauma, cerebral edema, ruptured aneurysms, severe strokes, encephalitis and meningitis, refractory seizures, and complicated brain tumors. Neurocritical care subspecialists also manage the medical complications that may occur in their patients, and deal with ethical and social issues including estimating prognosis, planning advance directives, and counseling patients and their families.

Physicians trained in neurocritical care medicine typically work in hospital-based settings, often in specialized neurocritical intensive care units, usually with a comprehensive team that often includes neurologists, neurosurgeons, neurological radiologists, critical care nurses, respiratory therapists, rehabilitation specialists, pharmacists, and social workers who collectively coordinate care for the critically ill neurologic patient.


Internal medicine physicians pursuing neurocritical care medicine must be previously certified by the American Board of Internal Medicine in Critical Care Medicine and complete 12 months of accredited clinical neurocritical care fellowship training.

Certification in neurocritical care is jointly administered by the American Board of Internal Medicine, the American Board of Anesthesiology, the American Board of Emergency Medicine, the American Board of Neurological Surgery, and the American Board of Psychiatry and Neurology.

Training Positions

In the 2022-2023 academic year, there were 32 Accreditation Council for Graduate Medical Education (ACGME)-accredited training programs in neurocritical care (multidisciplinary) with 26 trainees.

Major Professional Society

  • Neurocritical Care Society

See all the career pathways open to internal medicine physicians.

Back to the April 2023 issue of ACP IMpact