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ABR 2011 Update

ABR 2011 Update. Mickey Guiberteau , MD Trustee, American Board of Radiology. ABR 2011. NRC Training Requirements. ABR Dx Radiology Certificate NRC Recognitions. §35.290 Imaging and Localization Studies Diagnostic Nuclear Medicine Imaging §35.392 “ Low-Dose” I-131 Therapy

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ABR 2011 Update

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  1. ABR 2011Update Mickey Guiberteau, MD Trustee, American Board of Radiology

  2. ABR 2011 NRC Training Requirements

  3. ABRDx 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)

  4. NRC Training RequirementsABR DR Certificates • STILL 700 Hours of Supervised Work Experience • STILL80 hours of Classroom and Laboratory Training • Part of the 700 Hours

  5. 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

  6. ABR I-131 Therapy RequirementsWhat 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

  7. NRC: Radiation Safety & Safe Handling Does not address the Practice of Medicine ABR: Medical Aspects of I-131 Therapy Provide Meaningful Experience for Trainees NM Education RequirementsI-131 Therapy

  8. 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

  9. ABR I-131 Therapy RequirementsProgram 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

  10. ABR 2011 Diagnostic Radiology/ Nuclear Radiology 16-Month Pathway

  11. Diagnostic Radiology/ Nuclear RadiologyOpportunity 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

  12. Diagnostic Radiology/ Nuclear Radiology16-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

  13. Diagnostic Radiology/ Nuclear Radiology16-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

  14. ABR 2011 Eligibility ReinstatEmentPathwAy to Subspecialty Certification (NM, VIR, Neuro, Ped)

  15. ABRSubspecialty Certification • 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

  16. ABRSubspecialty Certification • 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

  17. ABR Considerations • 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

  18. ABREligibility ReinstatEment Pathwayto SS-Certification(More than 10-years since Fellowship)Qualifications • Completed an ACGME Fellowship more than 10 years • Or, Completed a Fellowship before Accreditation • 60% SS Practice in prior 2 years • Active unrestricted license

  19. ABREligibility ReinstatEmentto SS-Certification(More than 10-years since Fellowship)Program • 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

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