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How to Become an Intraoperative Neuromonitoring Technologist

Intraoperative neuromonitoring or IONM technologists work alongside ansthesiologists and surgeons in operating rooms, monitoring brain signals and testing the nervous system to reduce or avoid complications. They use technologies like electromyography, somatosensory-evoked potentials, and lectroencephalography, among others. As of 2011, very few standardized training programs or legislative requirements for IONM technologists exist, but you can become a technologist by following a few different paths and receiving certification from the American Board of Registration of Electroencephalographic and Evoked Potential Technologists (ABRET). In some cases, you may be able to obtain employment as an IONM technologist if you have a background or years of experience in a field like neuroscience, audiology medicine, neurophysiology or another health profession.

Associate's Route

Obtain an associate's degree in electroneurodiagnostic technology (END), accredited by the Commission on Accreditation of Allied Health Education Programs. An END program, offered by vocational schools, community colleges and training hospitals, typically takes two years. You'll receive your hands-on technical training in surgical technologies like evoked potential (EP), EEG and intraoperative monitoring.

Enroll in a course leading to CPR certification and Basic Cardiac Life Support certification. You need at least the CPR certification to become credentialed as a registered technician in a neurodiagnostic technology. You can find hospitals and local Red Cross chapters that offer CPR and BCLS programs.

Apply for certification offered by ABRET in one or more neurodiagnostic technologies, such as EEG, EP or Long-Term Monitoring. Pass the exam required to receive your credential as a registered technologist.

Seek employment as a noncertified intraoperative neuromonitoring (IONM) technologist. Complete at least 150 surgical monitoring cases to prepare for the certification examination in neurophysiologic intraoperative monitoring from ABRET.

Submit your application materials to ABRET for the CNIM exam. Provide your academic transcripts, employer- or supervisor-documented surgical monitoring cases, and CPR/BCLS certifications along with your application. Take the required "Path 1" exam and receive your credentials as a certified neurophysiologic intraoperative monitoring (CNIM) technologist.

Bachelor's Route

Complete a bachelor's degree program in a biological science, such as human biology, neurobiology or molecular, cellular and developmental biology. Many universities offer general curriculum programs in the biological sciences without a specific concentration.

Look for a job as an intraoperative neuromonitoring technologist trainee. Stay in the "trainee" position, observing other technologists and learning how to monitor surgeries. Develop competencies in neuromonitoring technologies (i.e., EEG, EP) and "work" your way up to fulfilling supervisory roles of other trainees and monitoring surgeries on your own. Participate in any continuing education requirements offered or encouraged by your employer.

Obtain certifications in CPR and Basic Cardiac Life Support. You can find hospitals, community colleges and local chapters of the American Red Cross that offer programs and classes leading to these certificates.

Apply for the CNIM exam with ABRET after you've monitored a minimum of 150 surgical cases as a non-certified intraoperative neuromonitoring technologist. Surgeries you participate in as a "trainee" do not count. Submit your university transcript, CPR card or BCLS certificate and documented surgical cases, along with the CNIM exam application, to ABRET. Pass the required "Path 2" written exam and receive your CNIM credential.


Matthew Schieltz has been a freelance web writer since August 2006, and has experience writing a variety of informational articles, how-to guides, website and e-book content for organizations such as Demand Studios. Schieltz holds a Bachelor of Arts in psychology from Wright State University in Dayton, Ohio. He plans to pursue graduate school in clinical psychology.