Inside the new authorized user attestation from the ABR

DR and IR radiology program directors will sign detailed checklist of requirements

Form A of the new Program Director Attestation from the ABR includes a detailed checklist related to compliance with NRC training and experience requirements

In March 2021, the American Board of Radiology (ABR) announced a detailed new attestation that radiology program directors will need to sign when residents graduate, related to nuclear medicine training. Compared with the relatively brief previous attestation, the new form contains 30+ checkboxes, including a higher level of detail on required curriculum elements. We cover the highlights below.

Specific curriculum elements

While the substance of this new checklist is unchanged from the original laws from the Nuclear Regulatory Commission (NRC), the move to a more explicit checklist highlights the importance of specific curriculum topics within the original NRC guidelines.

Here are some examples of very specific curriculum topics that residents should complete:

• Eluting generator systems appropriate for preparation of radioactive drugs
• Chemistry of byproduct material for medical use
• Processing the eluate with reagent kits to prepare radioactive drugs

Overall, the checklist items are divided into the following categories:

1. 700 hours of training and experience in nuclear imaging
2. 80 hours of training in radiopharmacy and radiation safety
3. 80 hours of training in I-131 oral administration
4. I-131 case log, including 3 cases ≤ 33 mCi, and 3 cases > 33 mCi

Lack of radiopharmacy presents didactic challenge

While some programs still have in-house radiopharmacists, most programs have found it more economical to outsource the preparation of radiopharmaceuticals to commercial facilities with their own radiopharmacists, generators, and quality control.

Outsourced radiopharmacies has made it more challenging for programs to teach the NRC-required radiopharmacy topics, because these areas are not commonly used in daily clinical practice which focuses on the interpretation of nuclear medicine studies.

The continued growth in clinical, teaching, and administrative demands has left nuclear medicine and radiology faculty depleted of time for the development of extensive curricula beyond mission-critical lectures in nuclear imaging that emphasize pathophysiology and diagnosis.

The ABR has recognized that various logistical challenges will need to be overcome, and program directors are still able to use the old attestation for residents graduating in June 2021.

Authorized user status now available to IR programs

IR programs are also now allowed to attest to authorized user (AU) eligibility for their residents. The ABR requires the same attestation form used by DR program directors for IR, and all of the NRC curriculum elements are the same for DR and IR.

References

1. “Program Director Attestation: Compliance with NRC training and experience requirements”, American Board of Radiology, March 2021, here
2. “Program Director Attestation: Compliance with NRC training and experience requirements”, American Board of Radiology, March 2017, here

The NRC-80 Labs by Core Physics Review are the fastest growing and most interactive way for program directors to cover the ACGME/NRC requirements for radiopharmacy & radiation safety. Learn more.