PURPOSES OF THE BOARD

The primary purpose of the Board, and therefore its most essential function, is the advancement of the health of the public through the establishment and maintenance of standards of training and education, and the qualification of physicians rendering nuclear medicine services to the people of the United States. The Board contributes to the improvement of health care in the United States and carries out this purpose by:

1. establishing requirements of graduate training related to examinations given by the board;
2. establishing requirements for maintenance of certification (MOC);
3. assessing the credentials of candidates for examination;
4. administering an examination for initial certification and maintenance of certification;
5. granting and issuing certificates in nuclear medicine;
6. maintaining a registry of holders of such certificates, and serving the medical and lay public by publishing the names of practitioners who have been certified by the Board on the ABMS website (www.abms.org).

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SIGNIFICANCE OF CERTIFICATION

A physician certified by the American Board of Nuclear Medicine has:

1. successfully completed the required preparatory training;
2. been judged to be competent in the practice of clinical nuclear medicine by the director of his or her nuclear medicine residency training program;
3. passed a secure computer based examination encompassing the medical uses of tracers, most often radiopharmaceuticals, and related physical sciences, thereby demonstrating mastery of the knowledge required for excellence in the practice of nuclear medicine.

A diplomate of this Board is capable of:

1. serving as consultant to other physicians, advising them of the clinical indications and limitations as well as benefits versus risks of diagnostic and therapeutic applications of molecular imaging and molecular medicine;
2. conducting or supervising the performance of clinical or therapeutic procedures involving the use of molecular imaging and molecular medicine;
3. rendering a valid verbal and written interpretation of the results of such procedures;
4. assisting in the medical management of persons exposed to ionizing radiation;
5. safely managing and disposing of radioactive and hazardous substances;
6. supervising a radiation safety program;
7. assuming clinical responsibility for patients under his or her care.

The certificate does not confer on any person legal qualifications, privileges, or license to practice medicine or the specialty of nuclear medicine. The Board does not purport to interfere with or limit the professional activities of any licensed physician.

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An applicant is allowed to take to the ABNM certification examination only when all of the preliminary and graduate educational requirements of the Board in force at the time of receipt of the formal application have been satisfactorily fulfilled.

A. General Professional Education
Graduation from a medical school approved by the Liaison Committee on Medical Education or the American Association of Colleges of Osteopathic Medicine. If the applicant is a graduate of a medical school outside the United States or Canada, he or she must have a currently valid certificate from the Educational Commission for Foreign Medical Graduates (ECFMG), 3624 Market Street, Philadelphia, PA 19104-2685 (Phone: 215-386-5900).

B. Preparatory Post-Doctoral Training
Before entering a nuclear medicine residency, trainees must satisfactorily complete one or more years of training in a residency program that provides broad clinical education, with primary emphasis on the patient and the patient's clinical problems. Residents should have a sufficiently broad knowledge of medicine to obtain a pertinent history, perform an appropriate physical examination, arrive at a differential diagnosis and communicate effectively. The training program must be accredited by one of the following organizations or provide equivalent clinical training.

1. Accreditation Council for Graduate Medical Education (ACGME)
2. American Osteopathic Association (AOA)
3. Royal College of Physicians and Surgeons of Canada (RCPSC)
4. Professional Corporation of Physicians of Quebec (PCPQ)

If the preparatory post-doctoral training is not accredited by one of the programs listed above, potential trainees must ask the ABNM to accept their prior training as being equivalent to the required training.  Before the ABNM will consider such a request, the potential trainee must have a personal interview with a program director of an ACGME-approved nuclear medicine residency and the program director must confirm equivalent training. The procedure and forms required for the review can be found in the credentialing FAQ. After receiving the required information, the ABNM will make the final judgment regarding the equivalency of training.

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C. Post-Doctoral Training in Nuclear Medicine

1. After completion of the preparatory post-doctoral training program, the resident must satisfactorily complete a two-year nuclear medicine residency training program (this requirement increases to three years for residents starting their training in July 2007) accredited by the ACGME, RCPSC or PCPQ. ACGME accredited nuclear radiology only programs do not qualify.
   A list of ACGME-approved residency training programs in nuclear medicine may be found in the Graduate Medical Education Directory published annually by the American Medical Association (website address: (http://www.acgme.org/adspublic/) or may be obtained by contacting: Secretary, Residency Review Committee for Nuclear Medicine, ACGME, 515 North State Street, Chicago, IL 60610 (website address: www.acgme.org). A list of Canadian Program is also available on the web (http://rcpsc.medical.org/residency/accreditation/arps/nuclear_e.php).
2. The residency training program in nuclear medicine must include:
   1. Training in clinical nuclear medicine including PET/CT
   2. Training in basic and allied sciences. In the United States, the training and experience requirements of the Nuclear Regulatory Commission as described in parts 10 CFR 35.190, 10 CFR 35.290 and 10 CFR 35.390 must be included. (see the following links for specific) http://www.nrc.gov/reading-rm/doc-collections/cfr/part035/part035-0190.html, http://www.nrc.gov/reading-rm/doc-collections/cfr/part035/part035-0290.html and http://www.nrc.gov/reading-rm/doc-collections/cfr/part035/part035-0390.html
   3. Training based on the six ACGME competencies (patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism and systems-based practice).
      
      More details about the training requirements can be found in the current ACGME nuclear medicine program requirements and in the ACGME program requirements effective July 2007. These documents can be found at http://www.acgme.org/acWebsite/RRC_200/200_prIndex.asp.
3. Applicants who fail the ABNM certification examination 3 times or who completed their training more than 7 years prior to the date of the certification examination are required to satisfactorily complete another year of training in an accredited nuclear medicine training program before they can retake the examination. Once they have completed this additional training, they will have 3 more chances to pass the exam in the 7 year period following completion of their additional training.

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D. Training Requirements of Candidates with Other Clinical Training

Candidates who have satisfactorily completed training in another clinical specialty are not be required to complete 3 years of nuclear medicine training.

1. Nuclear Medicine Training Before Diagnostic Radiology Training
   If a candidate satisfactorily completes 12 months of training in a nuclear medicine program accredited by the ACGME, RCPSC or PCPQ before enrolling in a diagnostic radiology residency program accredited by the ACGME or RCPSC, that candidate will meet the training requirements of the ABNM and will be able to apply to take the ABNM certification examination in the final year of the candidate's radiology residency training provided that the candidate meets the following conditions.
   1. In the United States, the nuclear medicine program director verifies that the candidate successfully complete the training and experience requirements of the Nuclear Regulatory Commission as described in parts 10 CFR 35.190, 10 CFR 35.290 and 10 CFR 35.390.
   2. The radiology program director verifies that the candidate has completed 4 months of additional nuclear medicine training during the radiology residency and before the candidate takes the ABNM certification examination.
   3. The candidate meets the other conditions for taking the ABNM certification examination.

Training in nuclear medicine must be completed within 7 years of applying for the ABNM certification examination.

2. Nuclear Medicine Training After Diagnostic Radiology Training
   If a candidate satisfactorily completes 12 months of training in a nuclear medicine program accredited by the ACGME, RCPSC or PCPQ after satisfactorily completing diagnostic radiology residency program accredited by the ACGME or RCPSC, that candidate will meet the training requirements of the ABNM provided that the candidate meets the following conditions.
   1. In the United States, the nuclear medicine program director verifies that the candidate successfully complete the training and experience requirements of the Nuclear Regulatory Commission as described in parts 10 CFR 35.190, 10 CFR 35.290 and 10 CFR 35.390.
   2. The candidate meets the other conditions for taking the ABNM certification examination.

Training in radiology must be completed within 7 years of applying for the ABNM certification examination if an applicant is not participating in ABR’s maintenance of certification program.

3. Nuclear Medicine Training After Other Clinical Specialties
   If a candidate satisfactorily completes 24 months of training in a nuclear medicine program accredited by the ACGME, RCPSC or PCPQ after satisfactorily completing a clinically related residency program (e.g., internal medicine, family practice, pathology, pediatrics, surgery) accredited by the ACGME or RCPSC, that candidate will meet the training requirements of the ABNM provided that the candidate meets the following conditions.
   1. In the United States, the nuclear medicine program director verifies that the candidate successfully completed the training and experience requirements of the Nuclear Regulatory Commission as described in parts 10 CFR 35.190, 10 CFR 35.290 and 10 CFR 35.390.
   2. The candidate meets the other conditions for taking the ABNM certification examination.

Training in another specialty must be completed within 7 years of applying for the ABNM certification examination if an applicant is not participating in in that specialty’s maintenance of certification program.

4. Combined Internal Medicine/Nuclear Medicine Training
   To be eligible for dual certification, a resident must seek American Board of Internal Medicine (ABIM) and ABNM approval of the proposed training program before beginning the combined program. The combined program consists of a total of 4 years of training in an accredited internal medicine and an accredited nuclear medicine training program and leads to admissibility to certification in both specialties. To meet eligibility for dual certification, the resident must satisfactorily complete 48 months of combined training that is verified by the directors of both training programs. It is strongly recommended that combined training occur in the same institution. Residents will be eligible for admission to the written certifying examination in internal medicine after successfully completing the R-3 year of training and for the nuclear medicine examination after the R-4 year. All training must be in ACGME, RCPSP or PCPQ accredited programs and approved by the director of each program. More details about this combined training program can be found at http://www.abim.org/certification/policies/combinedim/comnuc.aspx.

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1. The Board designates the directors of nuclear medicine residency programs and their supporting evaluation committees as the authorities who can most appropriately provide to the Board the necessary documentation of competence in clinical nuclear medicine. Program Directors are required to complete an Evaluation of Clinical Competence form to confirm that applicants from their program are competent in clinical nuclear medicine. These reports will be reviewed by the Board before accepting applicants to take the certifying examination.
2. If a residency program director’s evaluation indicates an applicant’s competence in clinical nuclear medicine is unsatisfactory, the applicant will not be admitted to the examination. An applicant may appeal an unsatisfactory evaluation by a program director in writing within 30 days of receipt of notification. The appeal should state that a request is made for a review of the decision not to be admitted to the certification examination and why the applicant considers the decision to be in error. If, as a result of the appeal, the Board finds that the applicant’s competence in clinical nuclear medicine is satisfactory, the applicant will be admitted to the next examination for which he/she applies. Applicants whose competence in clinical nuclear medicine is judged unsatisfactory by their program director must spend an additional year in training in an accredited nuclear medicine program before applying to take the certification examination again.
   
   Applicants submitting false credentials are subject to disqualification from examination or revocation of certification.
   
   All preliminary and nuclear medicine residency training should be completed prior to September 1st of the year the candidate takes the certifying examination.

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Follow the procedure described in the credentialing FAQ . Credentialing issues should be resolved at the time that you apply for your ACGME approved nuclear medicine training.

G. Licensure requirement

If an applicant plans to practice medicine in the United States, the applicant must pass USMLE 3 before their application to take the certification examination will be accepted.

A valid, unrestricted license to practice medicine in a state, territory, possession, or province of the country they will practice in is required of all applicants for the certifying examination. If an applicant is licensed in more than one such jurisdiction, each license must be valid and unrestricted. A copy of every license held by the applicant must be submitted to the Board.

If an applicant does not possess an unrestricted license at the time of application for the certification examination, the ABNM may allow the applicant to take the examination provided that the applicant is applying for and is expected to obtain an unrestricted license. The results of the certification examination will not be released until the applicant provides the ABNM with a copy of the unrestricted license. If the applicant does not obtain a license by the ABNM deadline (December 31 of the year of the exam), the results of the examination will be null and void.

Applicants who are still in training or who will practice medicine at a teaching institution at the time of the exam, may take the exam with an institutional license.

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