Structured Mentorship in Nuclear Medical Physics

General Orientation: During the orientation period, the resident will learn basic clinical aspects of nuclear medicine and will meet regularly with core members of the resident committee. Clinical Physics Rotations: During the clinical physics service rotations, the resident will be fully trained in all clinical activities of nuclear medicine physics, including imaging, therapeutic applications, radionuclide technique, radiopharmaceutical technique, radioprotection, and patient dosimetry. Training requires independent interaction with the attending physicians to the maximum extent possible. Clinical facilities must include access to the following equipment and capabilities at a minimum:

1.  PET/CT

2.  A nuclear pharmacy

3.  Radionuclide therapy services for the treatment of benign and malignant conditions

4.  Conventional SPECT imaging

5.  Physics dosimetry equipment, other appropriate test equipment, and appropriate phantoms

If any of the required facilities are not available on-site, the program must provide supervised clinical training on such equipment at another institution. The SM should be divided into a number of structured rotations. The following is a sample rotation schedule: Rotation Details

Activity	Number Required	Minimum Length
PET/CT	2	3 months
Scintillation Camera Imaging	2	3 months
Radiopharmacy	1	1 month
Therapeutic Use of Radionuclides	2	1 month
MRI	1	1 months
Radiation Protection	2	2 months
Other		16 months

PET/CT

•  1 SAM
•  1 SDEP as per the ABR website
•  1 Annual testing of a PET/CT as per the ACR Standards Guidelines
•  1 Testing of the CT as per the ACR Accreditation Guidelines
•  1 Testing of the PET scanner as per the ACR Accreditation Guidelines
•  1 Shielding design for a PET/CT facility
•  1 Shielding evaluation for a PET/CT facility
•  20 hours of reading room time with an appropriate physician supervisor
•  3 hours of CAMPEP-approved continuing education

Scintillation Camera Imaging

•  1 SAM
•  1 SDEP as per the ABR website
•  1 Annual testing of a scintillation camera per the ACR Standards Guidelines
•  1 Testing of the scintillation camera as per the ACR Accreditation Guidelines
•  20 hours of reading room time with an appropriate physician supervisor
•  3 hours of CAMPEP-approved continuing education

Radiopharmacy

•  1 SDEP as per the ABR website
•  1 Testing of a dose calibrator
•  Experience with a licensed radiopharmacist eluting a radionuclide generator, preparation of radiopharmaceuticals and safe handling of radiopharmaceuticals
•  Therapeutic Use of Radiopharmaceuticals

Because of the limitations on the availability of patients this rotation can be taken in small segments rather than as a continuous time block.

•  1 SDEP as per the ABR website
•  1 Testing of uptake probe/well counter
•  Experience with NRC requirements for safe release of patients
•  Experience instructing patients on post release precautions
•  Evaluation of the radiation protection practices associated with radionuclide administration
•  Participation in 5 treatments for hyperthyroidism
•  Participation in 3 treatments for thyroid cancer
•  Participation in three treatments for other conditions – bone pain, lymphoma, etc.

MRI

•  1 SAM
•  1 SDEP as per the ABR website
•  1 Testing of an MRI scanner as per the ACR Accreditation Guidelines
•  1 Safety evaluation of an MRI facility
•  20 hours of reading room time with an appropriate physician supervisor
•  3 hours of CAMPEP-approved continuing education

Other: The candidate and the physicist supervisor should structure additional rotations to meet the needs of the candidate. Up to 6 months may be spent in research. Additional requirements: The candidate must complete three PQI projects, and reports must be included in the portfolio. References

1. AAPM Report 90: Education and Training of Medical Physics Committee Subcommittee on Residency Training and Promotion, 2006.
2. IAEA Training Course Series 47: Clinical Training of Medical Physicists Specializing in Nuclear Medicine, 2011.
3. AAPM Report 197S: Education and Training of Medical Physicists Committee, 2011.

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