ABR DX RADIOLOGY CERTIFICATE NRC RECOGNITIONS

• §35.290 Imaging and Localization Studies

• Diagnostic Nuclear Medicine Imaging

• §35.392 “Low-Dose” I-131 Therapy

• ≤ 33 mCi (1.22 GBq)

• §35.394 “High Dose” I-131 Therapy

• > 33 mCi (1.22 GBq)

NRC TRAINING REQUIREMENTSABR DR CERTIFICATES

• STILL 700 Hours of Supervised Work Experience

• STILL 80 hours of Classroom and Laboratory Training

• Part of the 700 Hours

WHAT DOES 80 HOURS OF “CLASSROOM AND LABORATORY

TRAINING” MEAN?”

• The 80 hours must contain content applicable

• To the subject areas described in the regulations

• To the use of Sodium I-131

• Low Dose Therapy

• High Dose Therapy

• The "classroom and laboratory training" can be fulfilled in settings other than the traditional classroom setting -

• Hands-on experience using by-product material

• Performance of Radiation Safety Tasks

• Quality Control Procedures

• Patient Experience – 6 Cases (minimum)

• “High Dose” Therapy

• Experience with 3 cases (> 33 mCi)

• “Low Dose” Therapy

• Experience with 3 cases (≤ 33 mCi)

• These cases must be for Therapy

• NOT for whole body imaging

• Must be supervised by an AU preceptor under 35.392 &/or 35.394

ABR I-131 THERAPY REQUIREMENTS

WHAT DOES WORK EXPERIENCE MEAN?

NM EDUCATION REQUIREMENTSI-131 THERAPY

• NRC: Radiation Safety & Safe Handling• Does not address the Practice of Medicine

• ABR: Medical Aspects of I-131 Therapy• Provide Meaningful Experience for Trainees

I-131 THERAPY: WHAT CONSTITUTES “MEANINGFUL EXPERIENCE” ?

• 1. Familiarity with Patient History and Laboratory Findings

• 2. Determination of any contraindications

• 3. Review of appropriate Imaging Studies

• 4. Full Explanation of the Therapeutic Procedure to Patient• Radiation Safety Precautions to be followed

• 5. Determination of the administered dose

• 6. Supervision of administration of the dose to the patient

• 7. Arrangement for appropriate follow-up

ABR I-131 THERAPY REQUIREMENTS

PROGRAM DIRECTOR INFORMATION

• ABR Form A (PD Attestation)• Attestation to NRC T&E (§35. 290, 35.392 & 35.394)

• ABR Form B (Preceptor Attestations)• 3 cases of Low-dose Therapy (AU Supervised)• 3 cases of High-dose Therapy (AU Supervised)

• 2011 Written and Oral ABR DR Exams will include • Low-dose Therapy I-131 (≤ 33 mCi) (§35.392 )• High-dose Therapy I-131 (> 33 mCi) (§ 35.394)

• NRC AU-Eligibility on Certificates (Issued in 2011 and beyond)• ALL or NONE Designation

DIAGNOSTIC RADIOLOGY/ NUCLEAR RADIOLOGY OPPORTUNITY IN TRAINING CHANGES

• Nuclear Medicine Training in DR Residency

• Decreased from 6 months to 4 months

• ABR Core (comprehensive) exam at 36 months

• Possibility for More focused 4th year

• DR-RRC

• Allows16 months of in single subspecialty

DIAGNOSTIC RADIOLOGY/ NUCLEAR RADIOLOGY 16-MONTH PATHWAY - REQUIREMENTS

• Diagnostic Radiology Residency Program• Institution with either:• ACGME-Nuclear Radiology Fellowship, or• ACGME-Nuclear Medicine Residency

• 16-months in Nuclear Medicine• 10-months consecutive

DIAGNOSTIC RADIOLOGY/ NUCLEAR RADIOLOGY 16-MONTH PATHWAY - CERTIFICATIONS

• ABR Certified in Diagnostic Radiology

• 15 months Post-Residency

• ABR Certified in Nuclear Radiology

• After obtaining DR Certification

• Year of Clinical NM Practice Not Required

• ABR Subspecialty Certification Requirements

• ACGME-Approved Fellowship (12-months or more)

• Pass SS Examination within 10-years of Training Completion

• Cohort of SS -Trained Diagnostic Radiologists

• Chose NOT to seek SS-Certification

• 10-year post-training period has lapsed

• Unlikely to Complete a Second SubSpecialty Training Year

• Growing Awareness of Value of SS Certification

• Credentialing and Privileging

• Career Enhancement

• Leadership Opportunities

• Growing Importance of Quality

• Perception of Accountability

• Payor Pressures and Incentives

• Requests from these DR Diplomates to obtain SS-Certification

• LifeTime DR Certificate Holders

• Most Not DR MOC Participants

• Addressing Genuine Needs for these Radiologists

• Obtain SS Certification

• Participate in Maintenance of Certification

• Curing this need is in the Public’s Best Interest

• ABR Should Develop a Time-Limited Opportunity for

Subspecialty Certification for Affected Radiologists

• Completed an ACGME Fellowship more than 10 years

• Or, Completed a Fellowship before Accreditation

• 60% SS Practice in prior 2 years

• Active unrestricted license

• Must Apply

• Applications accepted for a 3-year period

• Begins July 1, 2011 – Ends June 30, 2014

• 2-year Program of required CME/SAMs, PQI

• VIR Participants: Maintain 2-year case log during program

• SS Examination in November of Year 2

• Must Complete Program Requirements by

December 31 of year 2 to achieve Certification