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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 REQUIREMENTS ABR 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 ABR I-131 THERAPY REQUIREMENTS WHAT DOES WORK EXPERIENCE MEAN? • 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 NM EDUCATION REQUIREMENTS I-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 4 th 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