Candidate Bulletin-2
Upcoming SlideShare
Loading in...5
×
 

Candidate Bulletin-2

on

  • 815 views

 

Statistics

Views

Total Views
815
Views on SlideShare
815
Embed Views
0

Actions

Likes
0
Downloads
5
Comments
0

0 Embeds 0

No embeds

Accessibility

Categories

Upload Details

Uploaded via as Adobe PDF

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

Candidate Bulletin-2 Candidate Bulletin-2 Document Transcript

  • The Certification Board of Nuclear Cardiology announces 2005 October 23, 2005 Donald Stephens Convention Center (near Chicago O'Hare airport) 5555 North River Road Rosemont, Illinois, USA AND InterContinental Wien Hotel Johannesgasse 28 Vienna, Austria
  • CBNC BOARD OF DIRECTORS Representing the American Representing the American Society of Nuclear Cardiology College of Cardiology James A.Arrighi, MD Kenneth A. Brown, MD Providence, RI Burlington,VT Manuel D. Cerqueira, MD Cleveland, OH Robert J. Gropler, MD St. Louis, MO Officers Milena J. Henzlova, MD Manuel D. Cerqueira, MD New York, NY President Steven C. Port, MD Robert J. Gropler, MD Milwaukee,WI Vice President Jeffrey A. Rosenblatt, MD James A.Arrighi, MD Portland, ME Secretary William A.Van Decker, MD William A.Van Decker, MD Philadelphia, PA Treasurer Frans J.Th.Wackers, MD, PhD New Haven, CT Please retain this Bulletin through exam date as it contains information you may need prior to the exam. Copyright © 2005 Certification Board of Nuclear Cardiology
  • TABLE OF CONTENTS Introduction Eligibility and Letters (Non-US Candidates) . . . . . . . . . Page 6 CBNC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 1 Applying to Take the Examination Purpose of Certification . . . . . . . . . . . . . . . . . . . . . . . . Page 1 Application Information and Checklist. . . . . . . . . . . . . Page 8 Additional Exam in 2005 . . . . . . . . . . . . . . . . . . . . . . . Page 1 Application Form. . . . . . . . . . . . . . . . . . . . . . . Pages 9 and 10 Scope of Certification . . . . . . . . . . . . . . . . . . . . . . . . . . Page 1 Application Documents and Revocation of Certification. . . . . . . . . . . . . . . . . . . . . . Page 1 Instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 11 Changes in Policies and Procedures . . . . . . . . . . . . . . . Page 1 Taking the Examination About the Examination Registration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 11 Exam Development . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 2 Test Site Regulations . . . . . . . . . . . . . . . . . . . . . . . . . . Page 12 Determination of Passing Score and Reporting . . . . . . Page 2 Request for Hand Scoring . . . . . . . . . . . . . . . . . . . . . . . Page 2 Preparing to Take the Examination Cancellation and Appeals Policies . . . . . . . . . . . Pages 2 and 3 How to Prepare. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 12 Special Testing Arrangements . . . . . . . . . . . . . . . . . . . . Page 3 Examination Outline . . . . . . . . . . . . . . . . . . . Pages 12 and 13 Fee. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 3 Sample Questions . . . . . . . . . . . . . . . . . . . . . Pages 13 and 14 Filing Your Application . . . . . . . . . . . . . . . . . . . . . . . . . Page 3 References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 15 Eligibility COCATS Guidelines Eligibility and Letters (US Candidates) . . . . . . . Pages 4 and 5 Guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 16 INTRODUCTION Rosemont, IL, USA and in Vienna, Austria.The exams will be conducted simultaneously. Both are in English only. CERTIFICATION BOARD OF NUCLEAR SCOPE OF CERTIFICATION CARDIOLOGY The eligibility requirements and examination materials for The Certification Board of Nuclear Cardiology (CBNC) was the CBNC Certification Examination in Nuclear Cardiology founded in 1996. CBNC is a not-for-profit corporation estab- have been developed based on substantial review and analy- lished to develop and administer practice-related examina- sis of the current state of medical and scientific knowledge tions in the field of Nuclear Cardiology and to award certi- of Nuclear Cardiology as reflected in the medical literature. fication to those physicians who successfully complete the The CBNC Examination Committee, with the assistance and CBNC examination process. CBNC is a fully autonomous advice of professionals in relevant fields, has attempted to entity, independent of any other association, society, or develop a certification that recognizes accepted levels of academy. This independence allows the CBNC to maintain expertise in the profession with the goal of improving integrity concerning policy matters related to certification. patient care. However, no certification program can guaran- The CBNC will issue a certificate to successful candidates tee competence or successful treatment to the public. In who then may present themselves to the public as special- addition, given the rapid changes in medical knowledge and ists in the field of Nuclear Cardiology. Successful candidates the speed of scientific developments, the CBNC cannot may designate on letterhead, cards, etc. that they are warrant that the examination materials will at all times “Diplomates of the Certification Board of Nuclear reflect the most current state of the art. The CBNC wel- Cardiology.” A listing of certified physicians is available to comes constructive comments and suggestions from the medical groups and to the public on the CBNC website profession. The CBNC Certification Program has been (www.cbnc.org). To date there are 3,696 physicians certi- designed to comply with testing industry standards. fied by the CBNC. REVOCATION OF CERTIFICATION THE PURPOSE OF CERTIFICATION The CBNC Board of Directors may, at its discretion, revoke The Certification Board of Nuclear Cardiology (CBNC) is certification if the Diplomate fails to maintain moral, ethical committed to the certification of Nuclear Cardiology prac- or professional behavior satisfactory to the Board or titioners. Certification provides practice-based require- engages in misconduct that adversely affects professional ments against which members of the profession can be competence or integrity.This includes, but is not limited to, assessed. The purposes of the CBNC Certification Program the Diplomate losing his/her license to practice medicine are as follows: either through suspension or termination or conviction of • to establish the domain of the practice of Nuclear a felony or other serious crime. Cardiology for certification; • to assess the level of knowledge demonstrated by CHANGES IN POLICIES Nuclear Cardiology specialists in a valid manner; AND PROCEDURES • to encourage professional growth in, and enhance the The information contained in the 2005 Candidate Bulletin quality of, the practice of Nuclear Cardiology; is valid for 2005 only. The Board of Directors reserves the • to recognize formally individuals who meet the require- right to make changes in its Policies and Procedures, includ- ments set by CBNC; and ing eligibility requirements and fees, from year to year. The • to serve the public by encouraging quality patient care Board cannot assume responsibility for giving advance in the practice of Nuclear Cardiology. notice thereof. The provisions of this publication are not to be construed as a contract between any candidate and the ADDITIONAL EXAM ADMINISTRATION CBNC. IN 2005 The 2005 exam will be conducted in two locations… in 1 View slide
  • ABOUT THE EXAMINATION rectly and (b) a diagnostic report showing their perfor- mance in each content area. Candidates who pass the exam- Exam Development ination will receive a certificate suitable for framing.These will be mailed by February 1, 2006. A national analysis of the practice of Nuclear Cardiology was conducted in 1995 in order to define the responsibilities, If a candidate does not succeed in passing the examination tasks and knowledge necessary for physicians to practice in after three (3) attempts, he or she will be required to show the field of Nuclear Cardiology. A second Practice Analysis proof of courses, seminars and/or formal preceptor study was conducted in 2001 to ensure that the content of the taken to remedy deficiencies. A new application form and CBNC examination continues to reflect accurately current all applicable fees must be submitted each time reexamina- practice in Nuclear Cardiology. The data for the studies were tion is requested. collected from a cross section of specialists in the field. The analysis of the 2001 data was used to update the examination Request for Hand Scoring specifications and determine the content of the current examination. The examination content outline can be found Candidates who fail the examination may request that their on pages 12 and 13. examination be rescored by hand to verify reported scores. Requests must be in writing and accompanied by a check The certification examination is composed of 175-200 multi- or money order in the amount of $45 (U.S. Funds), made ple-choice questions. Each question contains four options or payable to the CBNC.The written request must include the choices, only one of which is the correct or best answer. candidate’s name, date of birth, and signature. Requests for Examinees will have four and one-half (4 1/2) hours to com- hand scoring can be honored only up to six (6) months plete the examination. Some questions include interpretation after the testing date and should be directed to: of black and white images presented on hard copy. Certification Board of Nuclear Cardiology, 19562 Club The examination questions were developed by the CBNC House Road, Montgomery Village, MD 20886. Examination Committee, an expert panel of the CBNC, under the guidance of Knapp & Associates International, Inc. The Cancellation of Scores examination question pool is updated on a regular basis to If, for any reason, candidates decide that they do not want reflect current knowledge. Individual questions are modified their score reported, they may follow either of two proce- or deleted based on statistical analysis of the examination. dures: The CBNC retains Knapp & Associates International, Inc. of 1. Before leaving the test site, inform the examiner that Princeton,NJ,to provide assistance in the development of the their score should be cancelled and fill out a Score certification examination. Knapp & Associates International is Cancellation form. a research and development firm that serves certification 2. Send a letter or FAX to CBNC requesting cancellation of bodies by planning, developing, and administering assess- their score.These written requests must be signed and ment procedures and programs designed to measure profes- be received within five (5) working days after the date sional competence. of the examination. The CBNC is currently investigating the possibility of com- A cancelled score will not be reported to candidates. No puter-based delivery of the exam post 2005. refunds will be given to candidates requesting score can- cellations.To retake the examination after a score cancella- Determination of Passing Score and tion, a new application and fee must be submitted. Reporting Appeals The passing score is based on an expected level of knowl- edge; it is not related to the distribution of scores obtained Appeals relative to decisions of the Eligibility Committee during a particular examination administration. Thus, in any should be directed to the address shown on page 2. given year, a candidate has the same chance of passing the Any failing candidate may appeal a decision of the CBNC by examination whether the group taking the examination at submitting written notice of appeal within thirty (30) days that time tends to have high scores or low scores. In other of the date carried on the notice of his/her score for the words, each candidate is measured against a standard of examination. knowledge, not against the performance of the other indi- viduals taking the examination. Exam answer sheets will be retained by CBNC for six Approximately eight (8) weeks following the months following an exam. If there are appeals by candi- administration of the examination, the CBNC will dates, those records will be retained until the appeal mail each candidate his or her examination process is concluded. results. RESULTS WILL NOT BE GIVEN OVER THE All appeals shall be conducted in accordance with the TELEPHONE OR BY FAX. appeal procedures adopted by the CBNC Board of All candidates will receive: (a) a letter indicating the Directors. Appeal requests should be directed to: percentage of correct questions needed to pass the exami- Certification Board of Nuclear Cardiology, 19562 Club nation and the percentage of questions they answered cor- House Road, Montgomery Village, MD 20886. 2 View slide
  • Cancellations and Failure to Take the between May 28 and July 22, 2005. Applications that are Examination postmarked or overnight shipment dated after July 23, 2005 will not be accepted and will be returned to the applicant. In the event the candidate decides for any reason to cancel participation in the examination, all fees paid less the pro- Payment may be made by check or money order and must cessing fee of $100 (U.S. Funds) will be returned to the can- be made payable to the Certification Board of Nuclear didate provided that the cancellation notice is received Cardiology. American Express, MasterCard and VISA pay- from the candidate by CBNC NO LATER THAN September ments are also accepted and may be made by using the 30, 2005. The notification must be in writing and must form on the Checklist page (page 8). carry the legal signature of the candidate. Email can- A processing fee of $100 (U.S. Funds) is included in both cellations cannot be accepted. Faxed cancellations with the $675 and $775 application fees. This $100 charge is signature are accepted. If the candidate fails to cancel by effective upon receipt of your application by CBNC and this date or for any reason fails to appear on October 23, covers the administrative costs to be incurred by CBNC in 2005 to sit for the examination, the candidate may request processing the application. However, if your application a refund of $325 (U.S. Funds) provided that this request is cannot be accepted due to seating limitations for the exam- received by the CBNC NO LATER THAN November 30, ination, the full application fee paid will be refunded to you. 2005. Candidates who cancel participation or fail to sit for the examination will be required to file new applications, If for some reason you fail to meet the eligibility require- pay applicable fees and meet the applicable eligibility crite- ments, your application and documentation will be ria if they wish to sit for future examinations. returned to you. Your fee will be refunded, less the $100 processing fee. Nondiscrimination Policy Filing Your Application The CBNC does not discriminate against any person on the basis of age, gender, sexual orientation, race, religion, It is important that you file your application form as early as national origin, medical condition, physical disability, or possible as seating is limited. CBNC reserves the right to marital status. limit the number of candidates taking the examination. For regular applications, your completed application and all Maintenance of Certification necessary papers plus the fee of $675 must be postmarked or overnight shipment dated NO LATER THAN May 27, Certification is for a limited period of ten (10) years, after 2005. For late applications, your completed application and which those holding certificates dated October 26, 1997 or all necessary papers plus the fee of $775 must be post- later will need to complete a recertification process in marked or overnight shipment dated NO LATER THAN July order to maintain their certification. 22, 2005. Special Testing Arrangements Payment of the examination fee must accompany your application. Only the application form found in this Bulletin The CBNC will make reasonable efforts to accommodate can be accepted. Before mailing your application, please eligible candidates, who provide documented evidence of review carefully the information and specific instructions their disability, with auxiliary aids and services that do not included with this Bulletin.When your application has been present an undue burden to the CBNC and do not funda- reviewed and accepted, you will be sent an acknowledg- mentally alter the measurement of the knowledge the ment and your name will be entered on the examination assessment program is intended to test. Candidates requir- registration roster. ing special testing arrangements must contact CBNC rela- tive to their needs in writing NO LATER THAN July 22, Housing Arrangements 2005. (Rosemont, IL, USA site only) The CBNC reserves the right to limit the number of See the Hyatt Regency O’Hare Hotel Housing Form candidates taking the examination. It is recommend- enclosed. Note the cut-off date for reservations. When call- ed that you submit your application as early as possi- ing for a reservation, be sure to indicate that you are part of ble to assure your participation, if eligible. the “CBNC Reservation Block.”All housing inquiries must be directed to the hotel at 847-696-1234. Fee for Taking the Examination Candidates sitting for the exam at the Vienna, Austria The application fee for taking the certification examination site will need to make individual arrangements for is $675 (U.S. Funds) if the application is postmarked or housing. Contact information for the InterContinental overnight shipment dated by May 27, 2005. Late applica- Wien is: Tel. +43.1.711.22.0; FAX: +43.1.713.44.89; tions will be accepted with a fee of $775 (U.S. Funds) if the www.vienna.intercontinental.com. application is postmarked or overnight shipment dated 3
  • 2005 ELIGIBILITY C. If you have completed an accredited residency in nuclear medicine or radiology, you must submit: REQUIREMENTS FOR A verification letter written on organizational letterhead CANDIDATES RESIDING IN addressed to CBNC and signed by your principal pre- ceptor. That individual must be an authorized user* THE UNITED STATES who meets the NRC requirements in Part 35.200 uses or equivalent Agreement State requirements. The letter Requirement 1: Licensure must state precisely that “Dr. ’s training was Applicants must hold a current, unconditional, unrestricted equivalent to Level 2 training in nuclear cardiolo- license to practice medicine in the US at the time of appli- gy as outlined in the ACC/ASNC COCATS cation and must provide a copy of the current license. Guidelines (revised 2000).” The Guidelines are shown on page 16 of the 2005 Bulletin.The verification Requirement 2: Board Certification letter must also state precisely that “Dr. is Applicants must be physicians who, at the time of applica- competent to independently function as an autho- tion, are Board Certified by a board which holds member- rized user under 10 CFR 35.290 uses.” ship in either the American Board of Medical Specialties, or D. If you have completed an accredited residency/fellow- the Bureau of Osteopathic Specialists of the American ship in a specialty other than cardiology, nuclear medi- Osteopathic Association. cine or radiology, you must submit the following: Requirement 3:Training/Experience in the A verification letter written on organizational letterhead provision of Nuclear Cardiology Services addressed to CBNC and signed by your principal pre- ceptor. That individual must be an authorized user* A. If you have completed/will complete an accredited fel- who meets the NRC requirements in Part 35.200 uses or lowship in cardiovascular disease after July 1, 1998, you equivalent Agreement State requirements. The letter must submit the following: A verification letter written must state precisely that “Dr. has satisfac- on organizational letterhead addressed to CBNC and torily completed at least 700 hours of didactic signed by your principal preceptor. That individual training or work experience which includes radi- must be an authorized user* who meets the NRC ation safety, interpretation of clinical cases and requirements in Part 35.200 uses or equivalent hands-on experience as outlined in the ACC/ASNC Agreement State requirements. The letter must state COCATS Guidelines (revised 2000).” The Guidelines precisely that “Dr. has completed a train- are shown on page 16 of the 2005 Bulletin. The verifi- ing program in nuclear cardiology that meets the cation letter must also state precisely that requirements as outlined in the ACC/ASNC “Dr. is competent to independently function COCATS Guidelines (revised 2000).” The Guidelines as an authorized user under 10 CFR 35.290 uses.” are shown on page 16 of the 2005 Bulletin.The verifica- tion letter must also state precisely that “Dr. is *NOTE: The preceptor verifying training/experi- competent to independently function as an autho- ence must include in the preceptor letter his or rized user under 10 CFR 35.290 uses.” her NRC or Agreement State Authorized User B. If you completed an accredited fellowship in cardiovas- Number. cular disease prior to July 1, 1998, you must submit the following: NOTE: Your application will be placed “on hold” and your A verification letter addressed to CBNC and signed by Preceptor letter returned to you if you do not include this your principal preceptor. That individual must be an verification letter which includes the precise wording authorized user* who meets the NRC requirements in shown above. (See sample Preceptor letters on page 5.) Part 35.200 uses or equivalent Agreement State require- NOTE: All applicants who completed training after July 1, ments. The letter must be written on organizational let- 1998 must have had formal training in nuclear cardiology, terhead within the last 6 months and must state pre- nuclear medicine or radiology.The nuclear cardiology train- cisely that “Dr. ’s training and/or experi- ing must be taken as a part of an accredited fellowship or ence in nuclear cardiology meets the require- residency in cardiology, nuclear medicine or radiology. ments as outlined in the ACC/ASNC COCATS Guidelines (revised 2000).” The Guidelines are Training and experience requirements for licensure shown on page 16 of the 2005 Bulletin. The verification by the Nuclear Regulatory Commission [NRC] or letter must also state precisely that “Dr. is Agreement States vary from state to state; therefore, competent to independently function as an autho- candidates seeking licensure should check with their rized user under 10 CFR 35.290 uses.” regional NRC office or the office responsible for licen- sure in the Agreement State in which they practice. Information is also available on the NRC Internet web- site at: http://www.hsrd.ornl.gov/nrc/asdirectr.htm. 4
  • 2005 Sample Preceptor Letters for Candidates Residing in the United States A. For Candidates who have completed/will complete an accredited fellowship in cardiovascular disease AFTER July 1, 1998 Letter addressed to: Certification Board of Nuclear Cardiology [Written on organizational letterhead] Dr. ____________ has completed a training program in nuclear cardiology that meets the requirements as outlined in the ACC/ASNC COCATS Guidelines [revised 2000]. Dr. ____________ is competent to independently function as an authorized user under NRC 10 CFR 35.290 uses. Sincerely, [signature of Preceptor] [name of Preceptor] NRC or Agreement State Authorized User Number B. For Candidates who completed an accredited fellowship in cardiovascular disease PRIOR to July 1, 1998 Letter addressed to: Certification Board of Nuclear Cardiology [Written on organizational letterhead within the last 6 months] Dr.____________ ’s training and/or experience in nuclear cardiology meets the requirements as outlined in the ACC/ASNC COCATS Guidelines [revised 2000]. Dr.____________ is competent to independently function as an authorized user under NRC 10 CFR 35.290 uses. Sincerely, [signature of Preceptor] [name of Preceptor] NRC or Agreement State Authorized User Number C. For Candidates who have completed an accredited residency in nuclear medicine or radiology Letter addressed to: Certification Board of Nuclear Cardiology [Written on organizational letterhead] Dr. ____________ ’s training was equivalent to Level 2 training in nuclear cardiology as outlined in the ACC/ASNC COCATS Guidelines [revised 2000]. Dr. ____________ is competent to independently function as an authorized user under NRC 10 CFR 35.290 uses. Sincerely, [signature of Preceptor] [name of Preceptor] NRC or Agreement State Authorized User Number 5
  • 2005 ELIGIBILITY stating that “Dr. ’s training was equivalent to Level 2 training in nuclear cardiology as rec- REQUIREMENTS FOR ommended in the ACC/ASNC COCATS Guidelines CANDIDATES RESIDING (revised 2000).” The Guidelines are shown on page 16 of the 2005 Bulletin. OUTSIDE THE UNITED STATES B. If you have completed formal training in cardiology, AT THE TIME OF APPLICATION nuclear medicine or radiology prior to July 1, 1998 and wish to qualify through training and/or experience, you Requirement 1: Licensure must submit a statement from your Division or Applicants must hold a current, unconditional, unrestricted Laboratory Head (for hospital/institution-based physi- license to practice medicine at the time of application and cians) OR a physician colleague (for non-hospital-based must provide a copy of the current license. physicians) - written on organizational letterhead with- in the last six months - stating that “Dr. ’s train- Requirement 2: Board Certification ing and/or experience was equivalent to Level 2 You must submit evidence that you are Board certified. If training in nuclear cardiology as recommended in the country in which you practice does not certify your the ACC/ASNC COCATS Guidelines (revised medical specialty, you must submit a letter stating this fact 2000).” The Guidelines are shown on page 16 of the and indicating what qualifications you have that distinguish 2005 Bulletin. you as a specialist. NOTE: Your application will be placed “on hold” and your Requirement 3:Training/Experience in the Preceptor letter returned to you if you do not include this provision of Nuclear Cardiology Services verification letter which includes the precise wording A. If you have completed/will complete formal training in shown above. (See sample Preceptor letters below.) nuclear cardiology, nuclear medicine or radiology after NOTE: All applicants who completed training after July 1, July 1, 1998, you must submit a statement written on 1998 must have had formal training in nuclear cardiology, organizational letterhead from your training director nuclear medicine or radiology. 2005 Sample Preceptor Letters for Candidates Residing Outside the United States at the Time of Application A. For Candidates who have completed/will complete training in nuclear cardiology, nuclear medicine or radiology AFTER July 1, 1998 Letter addressed to: Certification Board of Nuclear Cardiology [Written on Organizational Letterhead.] Dr. ____________ ’s training was equivalent to Level 2 training in nuclear cardiology as recommended in the ACC/ASNC COCATS Guidelines [revised 2000]. Sincerely, [signature of Preceptor] [name of Preceptor] B. For Candidates who have completed formal training in cardiology, nuclear medicine or radiology PRIOR to July 1, 1998 Letter addressed to: Certification Board of Nuclear Cardiology [Written on Organizational Letterhead.] Dr. _______________’s training and/or experience was equivalent to Level 2 training in nuclear cardiology as recom- mended in the ACC/ASNC COCATS Guidelines [revised 2000]. Sincerely, [signature of Preceptor] [name of Preceptor] 6
  • INSTRUCTIONS FOR COMPLETING APPLICATION FORM 1. IMPORTANT NOTICE: The 2005 exam will be given simultaneously at two venues (Rosemont, IL, USA and Vienna, Austria). Applicants must make cer- tain to check the appropriate box on the Application Form to indicate where they wish to sit for the exam. 2. It is very important that your application form be completed carefully and accurately1. The information you provide on this form and any accompanying documents required will be used by CBNC to determine your eligibility to sit for the examination. If accepted, your acknowledgment, your admission notice, and your examination results will be sent to the mailing address (#2) indicated on the form. Nota Bene: If you change your address after you have been accepted to sit for the exam, it is most important that you notify the CBNC office of this address change so that admission letters and other correspondence will reach you promptly. 3. Type or print clearly in ink all information requested, except signatures. 4. Candidates with Social Security numbers are not required to disclose them on the Application Form (#7) other than on a voluntary basis. The numbers are useful as a secondary check in matching registration information to scores to ensure that they are reported correctly. 5. Information relative to the test sites has been printed on the checklist form. Please mail the completed checklist, application form, fee, and documentation to the appropriate address below. FAXED APPLICATIONS WILL NOT BE ACCEPTED. APPLICATIONS MUST BE MAILED TO: Certification Board of Nuclear Cardiology 19562 Club House Road Montgomery Village, MD 20886 USA Questions: Tel: +240-631-8151 (Hours: 9:00am - 4:00pm ET, M-F) FAX: +240-631-8152 Email: administration@cbnc.org 1 CBNC reserves the right to return incomplete applications as of September 15, 2005. 7
  • This page MUST accompany your application. All supporting documents, including the preceptor letter of verification, should be forwarded by the applicant to CBNC IN ONE MAILING. APPLICATION INFORMATION AND CHECKLIST ALL APPLICATIONS MUST BE MAILED TO: Questions: Tel: +240-631-8151 Certification Board of Nuclear Cardiology (Hours: 9:00am - 4:00pm ET, M-F) 19562 Club House Road FAX: +240-631-8152 Montgomery Village, MD 20886 USA Email: administration@cbnc.org Examination Date: Sunday, October 23, 2005 Application Postmark Deadlines: Regular applications – May 27, 2005. Late applications – July 22, 2005. US Location: Donald Stephens Convention Center, 5555 North River Road, Rosemont, Illinois, USA US Time: 7:45 a.m. – 12:45 p.m. (Central Time). Includes time for instructions to candidates and time to answer the exam questions. European Location: InterContinental Wien Hotel, Johannesgasse 28,Vienna,Austria European Time: 12.45 – 17.45 (local Vienna time). Includes time for instructions to candidates and time to answer the exam questions. Application and Test Fee: Regular applications (postmarked or overnight shipment dated by May 27, 2005) – $675 (U.S. Funds). Late applications (postmarked or overnight shipment dated May 28 through July 22, 2005) – $775 (U.S. Funds). Before completing this form, please read the sections entitled “Applying to Take the Examination” and “Instructions for Completing Application Form” in the Candidate Bulletin. Mail this page with check (✔) marks in all boxes and include the completed application form, a check or money order or credit card information filled out below and verification documentation to CBNC at the address listed above. FAX APPLICA- TIONS WILL NOT BE ACCEPTED. The application, including all documentation, must be postmarked or overnight shipment dated by one of the two deadlines listed above. Be sure to include: This page with check (✔) marks in all boxes. Completed and signed application form, pages 9 and 10 (incomplete forms will be returned). Selection of Site. Also check selection on page 9. Payment (check type) in U.S. Funds for $675, or $775 if application will be received after May 27, 2005, payable to the Certification Board of Nuclear Cardiology: Check Money Order Credit Card. For Credit Card Payment: MasterCard VISA American Express $675 $775 Card Number: _______________________________________________ Expiration Date: _______________________ Signature: __________________________________________________________________________________________ Two recent, identical, PASSPORT-SIZE photos of yourself. These photos must be identical originals and SIGNED IN INK ON THE FRONT with your name printed clearly on the back of each photo. If the photos are included exactly as described above, they will be returned to the applicant and the application will not be able to be processed until they are received back in the correct format. Do not staple photos. Copy of your current medical license (or certificate in NY) which must include an expiration date. Required Preceptor verification relative to your training/experience; see Eligibility Requirement #3. (See sample letters on pages 5 and 6.) The preceptor’s NRC or Agreement State Authorized User Number MUST be included on ALL Preceptor verification letters. (For Letters from Candidates Residing in the U.S. only). PLEASE NOTE: Your application will be placed “on hold” and your Preceptor letter returned to you if you do not include this verification letter with precisely the wording shown on page 5 or 6. A copy of your ABMS or osteopathic certificate if you are board certified in the United States. If you do not practice in the United States, you must provide a statement of the certification requirements in your country, and a copy of your board certificate, if applicable. Determination of eligibility will be made on a case-by-case basis. NOTE for USA site applicants only: DO NOT SEND YOUR HOUSING FORM TO CBNC. Housing Forms must be mailed to the hotel address shown on the Housing Form. 8
  • CBNC Application Form – For office use only 2005 Exam Date Received: __________________________________ Rosemont, IL, USA Vienna, Austria Amount: ________________________________________ (Candidates MUST select one site.) Payment: _______________________________________ Please note that this form is just one part of the required documentation. Be sure that you have sent all documents listed on the “Application Information and Checklist” page. Please PRINT clearly or type all information (this information MUST be provided to determine eligibility). ❐ MD ❐ DO APPLICATION TYPE: First-time Applicant Re-Applicant [year of last application __________________] ❐ ___________ other 1. NAME: ________________________________________________________________________________________________________________________ First Middle Name or Initial Last [List name as you wish it to appear on certificate if you pass the exam.] 2. PREFERRED ADDRESS FOR ALL CBNC MAIL: ________________________________________________________________________________________________________________________ Street Address Apt./Suite # Please specify: Home Office ________________________________________________________________________________________________________________________ City State Zip/Postal Code Country (if non-US) 3. OFFICE TELEPHONE: ( ) Ext. ________________________________________________________________________________________________________________________ 4. FAX: ( ) Email: ________________________________________________________________________________________________________________________ 5. HOME TELEPHONE: ( ) ________________________________________________________________________________________________________________________ 6. DATE OF BIRTH: ____________/ ____________/ _____________ Month Day Year 7. SOCIAL SECURITY #: ________________________________________ (optional) 8. My medical education included the following (list Medical School/Residency/Fellowship — not continuing medical education courses): Facility (Name/Location) Specialty Dates Attended Year Completed 9. I hold a current, unconditional, unrestricted license to practice medicine in the following state(s) or country: ___________________ _________________________________________________________________________________________________________________ 10. I have carefully reviewed Eligibility Requirement #3, pages 4 and 6, and have enclosed the necessary written verification, with precise wording shown in quotes, from my Preceptor that my training and experience meets all of the Eligibility Requirements. (OVER) Initials 9
  • CBNC Application Form Page 2 11. Board Certification: I am board-certified by a board which holds membership in either the American Board of Medical Specialties, or the Bureau of Osteopathic Specialists of the AOA or hold a non US specialty certificate. (Please - provide no more than 3 certifications): 1. _____________________________________________ Date Certified: _________________________________________ 2. _____________________________________________ Date Certified: _________________________________________ 3. _____________________________________________ Date Certified: _________________________________________ I do not reside or practice in the United States. (Please include certification from the institution or agency authorized to grant specialty certification). 12. My primary professional setting is (check all that apply) a) Private Practice, Group b) Private Practice, Solo c) Hospital Practice Based Physician d) Medical School Based Physician e) Other (Please Specify): 13. Indicate your PRIMARY type of practice (check ONLY one): Cardiology Nuclear Medicine Radiology other ___________ (specify) 14. Candidates with Disabilities: Candidates requiring modifications in the examination administration because of a disability must sub- mit documentation outlining the reason why special accommodations must be provided relative to their participation in the exam. PLEASE READ AND SIGN THE FOLLOWING STATEMENT I hereby apply for certification offered by the Certification Board of Nuclear Cardiology (CBNC) in accordance with and subject to its rules. I understand that the information accrued in the certification process may be used for statistical purposes and for evaluation of the certification program. I further understand that the information for my certification records will be treated confidentially.To the best of my knowledge, the information contained in the application is true, complete, correct, and is made in good faith. I understand that CBNC reserves the right to verify any or all information on this application and that any incorrect or misleading information may constitute grounds for rejection of my application, revocation of my certification, or other disciplinary action. I, the undersigned applicant, recognize the Board of Directors of the Certification Board of Nuclear Cardiology as the sole and only judge of my qualifications to receive and to retain a certificate issued by the CBNC and to have my name included in any list or directory in which the names of certificants of specialty examinations are published. I further agree to hold harmless, individually and collectively the officers, directors, and appointed examiners of the Certification Board of Nuclear Cardiology for any decision or action in pursuance of their duties in connection with this application, the examination, the score or scores given with respect to any examination or for the failure of said CBNC to issue me a certificate. I understand and agree that in the consideration of my application my moral, ethical and professional standing may be reviewed and assessed by the CBNC; that the CBNC may make inquiry of such persons as the CBNC deems appropriate with respect to my moral, ethi- cal and professional standing; that if information is received that would adversely affect my application, I will be so advised and given an opportunity to rebut such allegations, but I will not be advised as to the identify of the individuals who have furnished adverse informa- tion concerning me; and that all statements and other information furnished to the CBNC in connection with such inquiry shall be confi- dential, and not subject to examination by me or by anyone acting on my behalf. I also pledge myself to the highest ethical standards in the practice of Nuclear Cardiology. I fully understand that if I engage in any prac- tice or activity which, in the determination of the CBNC is deemed to be in violation of this pledge, that the CBNC has full authority to withdraw my certification. Furthermore, I understand that if I engage in any form of exam impropriety before or during the exam, my exam papers will not be scored. I understand also that, should any impropriety on my part occur, I will not be allowed to re-apply until three (3) years have passed and a new application and candidate fees will be required. I have read the 2005 Candidate Bulletin and understand and agree to abide by all policies of the Certification Board of Nuclear Cardiology as outlined in the 2005 Candidate Bulletin. I meet all of the Eligibility Requirements as outlined in the 2005 Candidate Bulletin. ________________________________________________________________________________________________________________ Signature (Required) Date 10
  • APPLYING TO TAKE THE APPLICATIONS MUST BE MAILED TO: EXAMINATION Certification Board of Nuclear Cardiology The CBNC Certification Examination in Nuclear Cardiology 19562 Club House Road will be administered on Sunday, October 23, 2005. The Montgomery Village, MD 20886 USA Rosemont, IL, USA exam will be administered from 7:45 am - 12:45 pm (Central Time). The Vienna,Austria exam will be Questions: administered from 12.45 - 17.45 (local Vienna time). The Tel: +240.631.8151 locations are as follows: (Hours: 8:30am - 4:00pm ET, M-F) FAX: +240.631.8152 Donald Stephens Convention Center Email: administration@cbnc.org (near Chicago O’Hare airport) 5555 North River Road Rosemont, Illinois, USA InterContinental Wien Hotel Johannesgasse 28 TAKING THE EXAMINATION Vienna,Austria Registration for the Examination Candidates must complete the Application Checklist and Once your application has been approved, you will receive Application Form found on pages 8, 9 and 10 of this Bulletin notification confirming successful registration for the exam- of Information to register for the examination. Please read ination. At least ten (10) days before the examination (14 all the information included in the Bulletin and follow all days if residing outside North America), you will receive an instructions carefully. admission document. It will contain your identification (ID) number and specific information about the date, time, and Application Documents and Instructions location of the test site. Please keep a record of your ID number as you will need it when you report to the test site, In order to have your application considered, you must when you complete your answer sheet, and later if you have submit the following: any inquiries about your test scores. 1. the application checklist (see page 8 of this Bulletin); Please contact CBNC if you: 2. a completed application (see pages 9 and 10 of this Bulletin); • lose your admission document • have not received your admission document seven (7) 3. a check or money order made payable to CBNC in the days before the examination date (10 days if outside amount of $675 (U.S. Funds) if application is postmarked North America). or overnight shipment dated by May 27, 2005 or $775 • change your address (U.S. Funds) if application is postmarked or overnight shipment dated between May 28 and July 22, 2005. (No You must bring your ADMISSION DOCUMENT to the applications will be accepted if the postmark or test site on the test date. You cannot be admitted overnight shipment date is after July 22, 2005.); without your admission document. 4. two (2) recent passport-size photographs (your name must be printed legibly in ink on the back of Taking the Examination each photograph, and you must sign your name in Strict security measures are maintained throughout all phas- ink on the front of each photograph); es of examination development and administration. All can- 5. a copy of your current medical license showing expira- didates will be required to present their ADMISSION DOC- tion date; UMENT and a PHOTO IDENTIFICATION in order to enter the testing site. Proctors will supervise the administration 6. correspondence verifying your training and experience of the examination, maintaining the strictest security (see Eligibility Requirement #3, pages 4 and 6 of this throughout the testing period. Irregularities observed dur- Bulletin); ing the testing period, such as creating a disturbance, giving 7. a copy of your ABMS or osteopathic board certificate or or receiving unauthorized information or aid to or from non U.S. specialty certificate. other examinees, or attempting to remove test materials or notes from the testing room, may be sufficient cause to ter- Mail the completed checklist, application, fee, and docu- minate examinee participation in the examination adminis- mentation to one of the following addresses. FAXED APPLI- tration, or to invalidate or cancel scores. Irregularities may CATIONS WILL NOT BE ACCEPTED. be identified by observation or suspicion by the examina- tion proctors or may be evidenced by subsequent statistical analysis of testing materials.The CBNC reserves the right to investigate each incident of misconduct or irregularity. 11
  • Test Site Regulations I. PHYSICS AND INSTRUMENTATION (10%) A. Basic physics as applied to clinical imaging (e.g., 1. All examinees must present their ADMISSION DOCU- isotope decay, decay modes, generators, high ener- MENT and PHOTO IDENTIFICATION (e.g., driver’s gy imaging) license, passport) at the test site in order to be allowed B. Gamma cameras, collimation, and equipment -qual- to take the examination. NO EXCEPTIONS TO THIS ity control procedures REQUIREMENT WILL BE MADE. C. Photon attenuation and scatter 2. Examinees should plan to arrive at the test site approx- II. RADIOPHARMACEUTICALS (8%) imately one hour prior to the starting time of the exam- A. Radiotracer kinetics and characteristics [Thallium- ination. Late arrivals will not be admitted to the 201 and Technetium-99m] test site. B. PET agents C. Red blood cell tagging 3. Devices with memory capabilities, books, calcula- D. Newer agents tors, paper, and notes are not permitted in the testing room. III. RADIATION SAFETY (10%) A. Radiopharmaceutical receiving, handling, monitor- 4. Unauthorized visitors will not be allowed at the test ing, and containment site. Observers approved by the CBNC may, however, be B. Handling radiopharmaceutical spills and waste present during the testing session. C. Storage and calibration of radiopharmaceuticals D. Dosimetry and MIRD 5. Food and beverages will not be allowed in the testing E. Radiation exposure and ALARA room. F. Radiation regulations 6. Any candidates not seated in the examination room by IV. NUCLEAR CARDIOLOGY DIAGNOSTIC TESTS AND 7:45 am in Rosemont, IL, USA and 12.45 (local Vienna PROCEDURES/PROTOCOLS (15%) time) in Vienna, Austria, Sunday, October 23, 2005 will A. Image acquisition (e.g., first pass and equilibrium be denied the right to take the examination. RNA, gating, SPECT) Announcements and procedures will begin promptly at B. Image processing (e.g., filtering, reorientation, these times. reconstruction) C. Standards of image display D. Exercise and pharmacologic stress protocols PREPARING TO TAKE THE E. Artifacts and causes of false-positive and false-nega- tive results EXAMINATION F. Quality control of image processing G. Quality assurance of interpretation How to Prepare for the Examination H. Quantitative aids to interpretation To help ensure adequate preparation for taking the certifi- I. Pharmacologic stress agents cation examination, the following suggestions are offered: V. GENERAL CARDIOLOGY AS IT RELATES TO IMAGE 1. Review the examination outline that follows. Indicated INTERPRETATION (10%) in parentheses is the approximate percentage of the A. Principles of molecular biology as applied to total examination that is allotted to each major content nuclear cardiology B. Coronary anatomy, pathophysiology, and area. chronic/acute ischemia 2. Answer the sample questions in this Bulletin to help C. Endothelial dysfunction/myocarditis familiarize yourself with the nature and format of the D. Unique characteristics of patient subgroups (e.g., questions that will appear on the examination. patients with diabetes, elderly patients, male vs. 3. The references listed on page 15 of this Bulletin may female patients) prove helpful in the review of the subject areas includ- E. Coronary angiography, interventions, and therapy ed in the examination. (Note:The listing of these refer- F. Exercise physiology and testing; ECG and clinical ences is intended for use as a study aid only.The CBNC parameters with rest and exercise does not intend the list to imply endorsement of spe- G. Measurements of left ventricle systolic and dias- cific texts, nor are the questions on the examination tolic function taken directly from these texts.) H. Valvular disease, cardiomyopathy, hypertension, CHF Examination Outline I. Coronary artery disease (stable and unstable, acute infarction) The following is a detailed outline of the nine major con- J. Medical therapy, percutaneous coronary interven- tent areas of the examination, with an indication (in paren- tion, and coronary bypass surgery theses) of the approximate percentage of the examination K. Indications for the use of alternative diagnostic devoted to each area: techniques (Echo, MRI, imaging of coronary calcifi- cation) 12
  • L. Bayes’ theorem, pre- and post-test likelihood, sensi- Sample Questions tivity, specificity, and referral bias M. Statistical analyses (e.g., kappa value, Bland-Altman, 1. Which of the following radiopharmaceuticals has the ROC curves, Kaplan-Meier) highest myocardial extraction fraction? N. Cost-effectiveness of diagnostic tests and princi- (A) Thallium-201 ples of outcome studies (B) Technetium-99m-sestamibi (C) Technetium-99m-pyrophosphate VI. RISK STRATIFICATION (10%) (D) Technetium-99m-tetrofosmin A. Coronary artery disease B. Unstable angina 2. For which of the following is myocardial perfusion C. Acute myocardial infarction imaging most appropriate? D. Acute chest pain (A) Risk assessment after acute myocardial infarction E. Candidates for noncardiac surgery (B) Screening of asymptomatic middle-aged men F. Post revascularization: percutaneous coronary (C) Evaluation of patients with premature ventricular intervention and CABG beats G. Evaluation of medical therapy (D) Diagnostic assessment of patients with right bun- dle branch block VII. MYOCARDIAL PERFUSION IMAGING INTERPRETATION (22%) 3. A patient with severe obstructive pulmonary disease is A. Interpretation of perfusion images with referred for a stress study to evaluate an atypical chest Technetium-99m-labeled tracers and Thallium-201 pain syndrome.The patient is on a therapeutic regimen B. Interpretation of images with PET agents including both oral theophylline and nebulizers. The C. Relationship of perfusion abnormalities to coro- most appropriate stress agent would be: nary anatomy (A) dipyridamole D. Combined function-perfusion imaging (B) adenosine VIII.VENTRICULAR FUNCTION IMAGING (10%) (C) dobutamine A. Rest and stress first pass radionuclide ventriculog- (D) exercise raphy 4. Which of the following patients would be best man- B. Rest and stress equilibrium radionuclide ventricu- aged by a conservative approach following an acute lography (planar and SPECT), including volume myocardial infarction? measurements and systolic and diastolic function C. ECG-gated SPECT myocardial perfusion imaging (A) A 57-year-old male with a fixed perfusion defect D. Effect of arrhythmia on ECG gating and LVEF of 52 % E. Evaluation of shunts (B) A 71-year-old female who completed six minutes of F. Effects of drugs, cardiotoxicity a modified Bruce exercise protocol with a reversible lateral perfusion defect IX. MYOCARDIAL VIABILITY (5%) (C) A 64-year-old male treated with thrombolytic ther- A. Thallium-201 imaging apy with exercise-induced ST depression, a small B. Technetium-99m imaging fixed inferolateral defect and a moderate reversible C. Positron tracers anteroseptal defect D. Outcome data related to myocardial viability (D) A 56-year-old female who had a recurrence of her E. Myocyte imaging angina at rest post inferior myocardial infarction 13
  • 7. If the count rate is measured as 1000 cps two feet away from a point source, what would the count rate be at one foot away from an uncollimated gamma camera? (A) 1,000 cps (B) 2,000 cps (C) 4,000 cps (D) 6,000 cps 8. Radionuclide imaging to assess myocardial viability is appropriate for which of the following patients? (A) A patient three days after a non-Q wave myocardial infarction having recurrent chest pains accompa- nied by transient ST depressions (B) A patient with left ventricular ejection fraction of 25% with triple vessel disease hospitalized with congestive heart failure The quality and size of the above illustration is not (C) A patient with a fixed inferior perfusion defect but representative of the figures which will be included in the normal left ventricular function on gated SPECT actual examination booklet. (D) A patient with primary dilated cardiomyopathy 9. Acquisition of an adequate first-pass study at peak exer- 5. The stress-rest Tc-99m Sestamibi SPECT images shown cise using an upright bicycle requires: above were obtained on a 57-year-old male who com- (A) recording of an electrocardiogram signal during plained of recurrent exertional chest pain 4 months the acquisition after triple bypass surgery. The patient exercised for a (B) an external marker applied to the chest for motion total of 7 minutes using the Bruce protocol. He devel- correction oped mild chest discomfort but stopped exercising (C) an external jugular vein injection because of fatigue. Which of the following interpreta- (D) count rates of 150,000 cts/sec or greater tions is most appropriate? 10. A 70-year-old male with left bundle branch block is test- (A) There is a fixed defect representing perioperative ed with exercise SPECT perfusion scintigraphy. The myocardial infarction scintigraphic finding most likely to represent an artifact (B) There is ischemia in the distribution of the left cir- is: cumflex artery (C) There is an infero-basal attenuation artifact on the (A) transient cavity dilation stress images (B) fixed cavity dilation (D) The study shows a motion artifact (C) reversible perfusion defect of the lateral wall (D) reversible perfusion defect of the septum 6. A reversible perfusion defect is most likely to occur in the absence of coronary stenosis in which of the fol- Answer Key: 1 (A), 2 (A), 3 (C), 4 (A), 5 (B), 6 (C), 7 (C), lowing clinical situations? 8 (B), 9 (D), 10 (D) (A) Right axis deviation (B) Right bundle branch block (C) Hypertrophic cardiomyopathy (D) Hypertension 14
  • REFERENCES The following is a list of references that may be helpful in reviewing for the examination.This listing is intended for use as a study aid only.The CBNC does not intend the list to imply endorsement of these specific references, nor are the test ques- tions taken from these sources. Links to publishers and associations are provided from this page on CBNC’s website (www.cbnc.org). ACC/AHA/ASNC Guidelines for the Clinical Use of Cardiac Radionuclide Imaging – Executive Summary:A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines J Am Coll Cardiol 2003; 42: 1318-33. American Society of Nuclear Cardiology. Updated imaging guidelines for nuclear cardiology procedures, Part 1. J Nucl Cardiol 2001;8:G5-52. American Society of Nuclear Cardiology. Imaging guidelines for nuclear cardiology procedures: Part 2. J Nucl Cardiology 1999; 6:G49-G84. Braunwald E (ed): Heart Disease:Textbook of Cardiovascular Medicine, 6th edition, Saunders, Philadelphia, PA, 2001. Cerqueira,MD,Weissman,NG,Dilsizian V,et al. Standardized Myocardial Segmentation and Nomenclature for Tomographic Imaging of the Heart. A statement for healthcare professionals from the cardiac imaging committee of the council on clinical cardiology of the American Heart Association. J Nucl Cardiol 2002;9: 240-5. Chandra R: Nuclear Medicine Physics:The Basics, 5th edition Lippincott Williams & Wilkin. Cohen MC: Nuclear Cardiology Knowledge Self-Assessment Program.American Society of Nuclear Cardiology, Bethesda, MD, rev. 2003. DePuey EG, Berman DS, Garcia, EV (ed): Cardiac SPECT Imaging. 2nd edition, Lippincott Williams & Wilkins 2001. Early PJ and Sodee DB (eds): Principles and Practice of Nuclear Medicine. 2nd edition, Mosby, St. Louis, MO 1994 [NOTE: This reference is recommended, especially for cardiologists, for reviewing “physics” and “technical aspects” of nuclear medicine.] English, RJ: SPECT:A Primer, 3rd Edition, Society of Nuclear Medicine, 1996. Germano G, Berman DS: Clinical Gated Cardiac SPECT Futura Publishing,Armonk, NY, 1999. Heller, GV, Hendel, RC. Nuclear Cardiology: Practical Applications. McGraw-Hill, New York, NY, 2003. Iskandrian AS and Verani MS (ed): Nuclear Cardiac Imaging: Principles and Applications. 3rd edition edition, Oxford University Press, New York, NY 2003. Zaret BL and Beller GA (ed): Nuclear Cardiology: State of the Art and Future Directions. 2nd edition, Mosby, St. Louis, MO, 1999. Self-Study Program III:Nuclear Medicine CARDIOLOGY;Editor and major contributor Soc Nuc Med Publications, in progress - Component sections to be published include Topics 1-8, Topics 1-6 were published at press time of this Bulletin: Topic 1:Physical and Technical Aspects of Nuclear Cardiology - Garcia E, B Hasagawa, Ratzlaff N,Botvinick EH. Nuclear Cardiology Teaching Syllabus.Edit. Soc Nuc Med Publications, 1997. Topic 2:Pharmacologic Stress Scintigraphy and Associated Topics. Botvinick EH, Dae MM, Verani M, Leppo JA, Nuclear Cardiology Teaching Syllabus.Edit. Soc Nuc Med Publications, 1998. Topic 3:Cardiac Positron Imaging. Goldstein RA, Hawkins RA, Geltman EM, Hoh C, Brunken R, Choi Y, Botvinick EH. Nuclear Cardiology Teaching Syllabus.Edit. Soc Nuc Med Publications, 1998. Topic 4:Nuclear Cardiology in Congenital Heart Disease. Dae MW,Botvinick EH. Nuclear Cardiology Teaching Syllabus.Edit. Soc Nuc Med Publications, 1998. Topic 5:Myocardial Perfusion Scintigraphy-Technical Aspects.J Maddahi,Ratzlaff N,O’Connell JW, Dae MW,Botvinick EH. Nuclear Cardiology Teaching Syllabus.Edit. Soc Nuc Med Publications, 2001. Topic 6:Myocardial Perfusion Scintigraphy-Clinical Aspects.J Maddahi,Ratzlaff N,Dae MW,Botvinick EH. Nuclear Cardiology Teaching Syllabus.Edit. Soc Nuc Med Publications, 2002. Topic 7:The Evaluation of ventricular size and function with blood pool scintigraphy. S Port,E Botvinick,M Dae,JW O’Connell. Nuclear Cardiology Teaching Syllabus.Edit. Soc Nuc Med Publications, in press. Topic 8:Scintigraphic imaging of acute myocardial infarction. Botvinick EH, Dae MW, Nuclear Cardiology.Teaching Syllabus.Edit. Soc Nuc Med Publications, in press. 15
  • COCATS GUIDELINES (Revised 2000) Hands-on Experience Clinical Cases. Fellows acquiring Level 2 training should have hands-on AMERICAN COLLEGE OF CARDIOLOGY / supervised experience in a minimum of 35 patients: 25 patients with AMERICAN SOCIETY OF NUCLEAR myocardial perfusion imaging and 10 patients with radionuclide angiogra- phy. Such experience should include pretest patient evaluation, radio- CARDIOLOGY COCATS GUIDELINES FOR pharmaceutical preparation (including experience with relevant radionu- TRAINING IN NUCLEAR CARDIOLOGY clide generators), performance of the study, administration of the dosage, calibration and setup of the gamma camera, setup of the imaging comput- Overview of Nuclear Cardiology Training er, processing the data for display, interpretation of the studies and gener- Training in nuclear cardiology at all levels should provide an understand- ating clinical reports. ing of the indications for specific nuclear cardiology tests, the safe use of radionuclides, basics of instrumentation and image processing, methods of Work Experience. This experience must be under the supervision of an quality control, image interpretation, integration of risk factors, clinical authorized user who meets the NRC requirements of Part 35.200 or equiv- symptoms and stress testing and the appropriate application of the resul- alent Agreement State requirements, and must include: tant diagnostic information for clinical management. Training in nuclear a) Ordering, receiving and unpacking radioactive materials safely and per- cardiology is best acquired in Accreditation Council for Graduate Medical forming the related radiation surveys; Education (ACGME) approved training programs in cardiology, nuclear medicine or radiology. An exception to this ACGME requirement is the b) Calibrating instruments used to determine the activity of dosages and didactic and laboratory training in radiation safety and radioisotope han- performing checks for proper operation of survey meters; dling that may be provided by qualified physicians/scientists in a non- ACGME program when such a program is not available as part of the clin- c) Calculating, measuring and safely preparing patient or human research ical ACGME training program. subject dosages; Didactic, clinical case experience and hands-on training hours require doc- d) Using administrative controls to prevent a medical event involving the umentation in a logbook* and having the trainee’s name appear on the clin- use of unsealed byproduct material; ical report or other specific record. The hours need to be monitored and e) Using procedures to safely contain spilled radioactive material and verified by the nuclear cardiology training preceptor. using proper decontamination procedures; f) Administering dosages of radioactive drugs to patients or human Specialized Training - Level 2 research subjects; and (Minimum of 4 Months) g) Eluting generator systems appropriate for preparation of radioactive Fellows who wish to clinically practice the specialty of nuclear cardiology drugs for imaging and localization studies, measuring and testing the are required to have at least 4 months of training. This includes a minimum eluate for radionuclide purity, and processing the eluate with reagent of 700 hours of didactic, clinical study interpretation, and hands-on clinical kits to prepare labeled radioactive drugs. case and radiation safety training in nuclear cardiology. In training pro- grams with a high volume of procedures, clinical experience may be acquired in as short a period as 4 months. In programs with a lower vol- Additional experience ume of procedures, a total of 6 months of clinical experience will be nec- essary to achieve Level 2 competency.The additional training required of In addition, the training program for Level 2 training must provide experi- Level 2 trainees is to enhance clinical skills and to qualify to become an ence in computer methods for analysis. This should include perfusion and authorized user of radioactive materials in accordance with the regulations functional data derived from thallium or technetium agents and ejection of the Nuclear Regulatory Commission (NRC) and/or the Agreement fraction and regional wall motion measurements from radionuclide angio- States. Requirements do vary among the Agreement States; therefore those graphic studies. seeking licensure are advised to check the Agreement State/NRC internet web site at: http://www.hsrd.ornl.gov/nrc/asframe.htm. Table 1. Classification of Nuclear Cardiology Procedures Didactic 1) Standard nuclear cardiology procedures Lectures and self-study. The didactic training should include in-depth a) Myocardial perfusion imaging details of all aspects of the procedures listed in Table 1 (see below). This i) Single photon emission computed tomography (SPECT) with program may be scheduled over a 12- to 24-month period concurrent and technetium agents and thallium integrated with other fellowship assignments. ii) Planar with technetium agents and thallium Radiation Safety. Classroom and laboratory training needs to include iii) EGC gating of perfusion images for assessment of global and extensive review of radiation physics and instrumentation, radiation pro- regional ventricular function tection, mathematics pertaining to the use and measurement of radioac- iv) Imaging protocols tivity, chemistry of byproduct material for medical use, and radiation biol- v) Stress protocols ogy. There should be a thorough review of regulations dealing with radia- (1) Exercise stress tion safety for the use of radiopharmaceuticals. (2) Pharmacologic stress vi) Viability assessment including reinjection and delayed imaging of thallium and metabolic imaging where available Interpretation of Clinical Cases b) Equilibrium gated blood pool or “first pass” radionuclide angiogra- Fellows should participate in the interpretation of all nuclear cardiology phy at rest and during exercise or pharmacologic stress imaging data for the 4-6 month training period. It is imperative that the fel- c) Qualitative and quantitative methods of image display and analysis lows have experience in correlating catheterization/angiographic data 2) Less commonly used nuclear cardiology procedures with radionuclide-derived data in a minimum of 30 patients. A teaching a) Metabolic imaging using single photon and/or positron emitting conference in which the fellow presents the clinical material and nuclear radionuclides cardiology results is an appropriate forum for such an experience.A total b) Myocardial infarct imaging of 300 cases should be interpreted under preceptor supervision, either c) Cardiac shunt studies from direct patient studies or from a teaching file consisting of diverse types of procedures (see Table 1 below). * (Note: These logbooks are not to be submitted with the CBNC application.) 16