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  • 1. American Board of Science in Nuclear Medicine Requirements for ABSNM Certification Each candidate must take the ABSNM certifying examination in two parts: General Nuclear Medicine Science examination and one of the three Specialty examinations: Nuclear Medicine Physics and Instrumentation, Radiopharmaceutical Science, and Radiation Protection. Credentialing requirements for these Specialties are given below. A. Requirements for candidates taking Nuclear Medicine Physics and Instrumentation Specialty (i) General Education: A master’s or a doctorate degree in physics, medical physics, engineering, applied mathematics, or other physical sciences from an accredited college or university, and (ii) Training/Work Experience: Two years (doctorate candidates) or three years (master’s candidates) of full-time practical training and/or supervised experience in medical physics: (1) Under the supervision of a medical physicist who is certified in medical physics by a specialty board recognized by NRC or an Agreement State, and who will provide a letter of reference attesting to the candidate’s experience and competency; or (2) In clinical nuclear medicine facilities providing diagnostic and/or therapeutic services under the direction of physicians who meet the requirements for authorized users in 10CFR35.290 and 10CFR35.390, and who will provide a letter of reference attesting to the candidate’s experience and competency. B. Requirements for candidates taking Radiopharmaceutical Science Specialty (i) General Education: A master’s or a doctorate degree in physics, nuclear pharmacy, biological science, radiopharmaceutical science, chemistry, other pharmaceutical science or medicine from an accredited college or university, and (ii) Training/Work Experience: Three years of full-time practical training and/or supervised experience in radiopharmaceutical science: (1) Under the supervision of an authorized nuclear pharmacist who is on a licensee’s radioactive material license and has experience in radiation safety, and who will provide a letter of reference attesting to the candidate’s experience and competency; or (2) In clinical nuclear medicine facilities providing diagnostic and/or therapeutic services under the direction of physicians who meet the requirements for authorized users in 10CFR35.290 and 10CFR35.390, and who will provide a letter of reference attesting to the candidate’s experience and competency.
  • 2. C. Requirements for candidates taking Radiation Protection Specialty (i) General Education: A master’s or a doctorate degree from an accredited college or university in physical science, engineering, health physics, or biological science with a minimum of 20 college credits in physical science, and (ii) Training/Work Experience: five or more years of professional experience in health physics (graduate training may be substituted for no more than 2 years of the experience) including at least 3 years in applied health physics. D. Examination: All candidates must pass an examination for certification by ABSNM. The examination evaluates knowledge and competence of the candidates in radiation physics and instrumentation, radiation protection, radiation biology, radioisotope production, radiopharmaceutical chemistry, radiation dosimetry, and diagnostic nuclear medicine physics and instrumentation. The certifying examination is written and consists of two parts: General Nuclear Medicine Science and Specialty Examinations. The details of the examinations are available on the website, www.snm.org/absnm. Please read carefully the above credentialing requirements for taking the ABSNM certifying examination prior to filling up the application. Details are available on website, www.snm.org/absnm. You only need to submit the following application part, and do not include this “Requirements for ABSNM Certification” part.
  • 3. APPLICATION for ABSNM Certification A. Choose (one) Specialty examination you plan to take: __ A. Nuclear Medicine Physics and Instrumentation __ B. Radiopharmaceutical Science __ C. Radiation Protection B. Your Personal Information ________________________________________________________________________________________________________________________ Last Name First Name Middle Initial _______________________________________________________________________________________________ Date of Birth Mo/ Day/ Year Citizen of SS No. _______________________________________________________________________________________________ Home Address Telephone # _______________________________________________________________________________________________ City State Zip _______________________________________________________________________________________________ Business Address Telephone # _______________________________________________________________________________________________ City State Zip _______________________________________________________________________________________________ FAX number E-Mail Address Send Mail to: __ Home Address __ Business Address C. Academic Preparation: ________________________________________________________________________________________________ Institution Major Minor Years Attended Degree Year _______________________________________________________________________________________________ Institution Major Minor Years Attended Degree Year ________________________________________________________________________________________________ Institution Major Minor Years Attended Degree Year ________________________________________________________________________________________________ Institution Major Minor Years Attended Degree Year D. Supervised professional training/experience in the Specialty of your choice: In the space provided below, describe in your own words your major responsibilities and time spent in Specialty activities. The minimum total time must meet the requirements stated in “Requirements for ABSNM Certification.” Begin with present position and work back.
  • 4. 1. ___________________________________ Employer: ___________________________________________ Address: ___________________________________________ Exact Title of Position: ____________________________________________ Dates of Experience from: to: ____________________________________________ Name and Title of Supervisor: ____________________________________________ Description of Work: ____________________________________________ ____________________________________________ ____________________________________________ ____________________________________________ ____________________________________________ 3. ___________________________________ Employer: ____________________________________________ Address: ___________________________________________ Exact Title of Position: ____________________________________________ Dates of Experience from: to: ____________________________________________ Name and Title of Supervisor: ____________________________________________ Description of Work: ____________________________________________ ____________________________________________ ____________________________________________ ____________________________________________ ____________________________________________ 2. ___________________________________ Employer: ___________________________________________ Address: ___________________________________________ Exact Title of Position: ____________________________________________ Dates of Experience from: to: ____________________________________________ Name and Title of Supervisor: ____________________________________________ Description of Work: ____________________________________________ ____________________________________________ ____________________________________________ ____________________________________________ ____________________________________________ 4. ___________________________________ Employer: ____________________________________________ Address: ___________________________________________ Exact Title of Position: ____________________________________________ Dates of Experience from: to: ____________________________________________ Name and Title of Supervisor: ____________________________________________ Description of Work: ____________________________________________ ____________________________________________ ____________________________________________ ____________________________________________ ____________________________________________
  • 5. E. Professional and Honorary Societies: (Attach additional pages, if necessary) Name of Organization Class of Membership Year Accepted Offices or Committees ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ F Journal Publication, Chapters and Books: (Attach additional pages, if necessary.) _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________ G. Professional References: List the names, addresses, e-mails and telephone/fax numbers of supervisors from Section D, who qualify as references per “Requirements for ABSNM Certification” and who will be submitting letters attesting to your competence and experience directly to ABSNM. Name Address E-mail Telephone/Fax No. _____________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________ ____________________________________________________________________________ _____________________________________________________________________________ ______________________________________________________________________________ H. Checklist ___ An official transcript(s) of your Masters or Doctorate degree in a major field, appropriate for the Specialty of your choice (See Requirements for ABSNM Certification) (Foreign graduates contact ABSNM office — ABSNM Administrator) ___ Documentation of your training in Specialty of your choice. A list of graduate or professional education courses, including dates and location. ___ Letter of reference from professional persons under whose supervision you worked and who attest in detail to your competency and work experience in the Specialty you have chosen including the length of time (2 to 3 years depending on the choice of specialty – see details in Requirements for ABSNM Certification and on ABSNM website). Ask these references to write directly to ABSNM. ___ Recent photograph for purposes of identification at the time of examination. ___ Check in the amount of $750 for first-time applicants, $550 for re-takes on General or Specialty exams, payable to the American Board of Science in Nuclear Medicine. Applicants deemed not to have met the admission requirements will be refunded the application fee less an administrative cost of $100. ___ Completed application postmarked by March 15, 2006 to: ABSNM Administrator, Society of Nuclear Medicine, 1850 Samuel Morse Drive, Reston, VA 20190.
  • 6. I. Ackowledgement I certify that the statements above (including any attachments submitted hereto) are to the best of my knowledge accurate. I understand that any falsification of information in this application will be cause for rejection of the application or withdrawal of a certification already made. ___________________________________________________________________________ Your Signature Date _______________________________________________________ State and County of Before me, a Notary Public in and for said County and State, on this__________day of________, 20____, personally SEAL appeared______________________to me known to be the identical person who signed this application. Witness my hand and official seal this date. ____________________________________________________ Notary Public ____________________________________________________ My commission expires ____________________________________________________ Signature (in ink)