A physician, dentist, or podiatrist who: (1) Meets the requirements in §§ and (a), (a), (a), (a), (a), (a), (a), or (a); or (2) Is identified as an authorized user on— ◦ (i) A Commission or Agreement State license that authorizes the medical use of byproduct material; ◦ (ii) A permit issued by a Commission master material licensee that is authorized to permit the medical use of byproduct material; ◦ (iii) A permit issued by a Commission or Agreement State specific licensee of broad scope that is authorized to permit the medical use of byproduct material; or ◦ (iv) A permit issued by a Commission master material license broad scope permittee that is authorized to permit the medical use of byproduct material. Authorized User

Candidates seeking certification for diagnostic radiology in 2011 and forward must meet the specific training and experience requirements described in 10 CFR (c)(1)(i), (c)(1)(ii) and 10 CFR (c)(1) and (c)(2), and 10 CFR (c)(1), (c)(2) and (c)(3) Radiation safety, radionuclide handling and quality control and related topics specified in 10 CFR , 10 CFR , and 10CFR must be covered ABR Requirements

NRC Recognized Specialty Boards Evaluated and Certified by NRC!

Specialty Boards Recognized By NRC ◦ CBNC with “for Physicians Residing in the United States” from October 29, 2000 until 2006 ◦ CBNC with “for Physicians Trained in the United States” from 2006 forward ◦ ABNM with “United States” from October 20, 2005 forward ◦ AOBR in Diagnostic Radiology from July 1, 2000 forward ◦ AOBNM in Nuclear Medicine from May 18, 2006 forward ◦ ABR in Diagnostic Radiology with “AU Eligible” from June 2006 forward ◦ Any recognized board for

Specialty Boards Recognized By NRC ◦ AOBR in Diagnostic Radiology from July 1, 2000 forward ◦ ABR in Diagnostic Radiology with “AU Eligible” from June 2006 forward ◦ ABR in Diagnostic Radiology with “AU Eligible” from June 2011 forward (same as ) ◦ ABR in Diagnostic Radiology with “AU Eligible” from June 2011 forward

Specialty Boards Recognized By NRC ◦ ABNM with “United States” from October 20, 2005 forward ◦ ABR in Radiation Oncology with “AU Eligible” from June 2007 forward ◦ AOBR in Radiation Oncology from May 1, 2007 forward ◦ These also satisfy and

Review of Part 35 Training Requirements : Training for imaging and localization studies

Review of Part 35 Training Requirements : Use of unsealed radioactive material for imaging and localization studies for which a written directive is not required. ◦ Includes generators : Use of unsealed radioactive material for which a written directive is required : Other medical uses of radioactive material or radiation from radioactive material. (such as SIRS)

Review of Part 35 Training Requirements : Training for use of unsealed radioactive material for which a written directive is required : Training for the oral administration of sodium iodide I-131 requiring a written directive in quantities less than or equal to 1.22 gigabecquerels (33 millicuries) * Imaging and localization studies using more than 30 µCi of I-131 must meet these requirements in addition to : Training for the oral administration of sodium iodide I-131 requiring a written directive in quantities greater than 1.22 gigabecquerels (33 millicuries) : Training for the parenteral administration of unsealed radioactive materials requiring a written directive : Evaluated as applicable for each use.

Supervisors, Preceptors, and Written Attestations All work experience must be supervised by a qualified AU. This means the supervising AU meets the qualifications described in the appropriate sections of Part 35. Part 35 requires written attestation in many of the pathways. Preceptor must meet the qualifications described in Part 35. Can have multiple supervisors and/or preceptors. No longer need to be board certified.

Training Requirements

Recognized board certificationWritten Attestation AU under hours of training and experience, including a minimum of 80 hours of classroom and laboratory training (see for detailed T&E requirements) Written Attestation Work experience eluting generator systems

Training Requirements *, , *Includes imaging and localization studies using greater than 30 µCi of I-131

Recognized board certificationWritten Attestation Three cases of: Oral administration of greater than 33 mCi of I-131 (three of these satisfies the ≤ 33 mCi requirement) Parenteral administration of any beta emitter, or a photon-emitting radionuclide with a photon energy less than 150 keV, for which is a written directive is required Parenteral administration of any other radionuclide, for which a written directive is required AND/OR

hours of training and experience, including a minimum of 200 hours of classroom and laboratory training (see for detailed T&E requirements) Written Attestation Work experience including 3 cases

(≤ 33 mCi I-131) 1. Recognized board certification Written Attestation Work experience including 3 cases: Oral administration of less than or equal to 33 mCi of I-131 Oral administration of greater than 33 mCi of I-131 (three of these satisfies the ≤ 33 mCi requirement)

(≤ 33 mCi I-131) AU under or Work experience including 3 cases: Oral administration of less than or equal to 33 mCi of I-131 Oral administration of greater than 33 mCi of I-131 (three of these satisfies the ≤ 33 mCi requirement) 80 hours of classroom and laboratory training, applicable to the medical use of sodium iodide I-131 for procedures requiring a written directive Written Attestation

(> 33 mCi I-131) 1. Recognized board certification Written Attestation Work experience including 3 cases: Oral administration of greater than 33 mCi of I-131

(> 33 mCi I-131) AU under hours of classroom and laboratory training, applicable to the medical use of sodium iodide I-131 for procedures requiring a written directive Work experience including 3 cases: Oral administration of greater than 33 mCi of I-131 Written Attestation

(other than I-131) Recognized board certification for or hours of classroom and laboratory training, applicable to parenteral administrations, for which a written directive is required, of any beta emitter, or any photon-emitting radionuclide with a photon energy less than 150 keV, and/or parenteral administration of any other radionuclide for which a written directive is required Work experience including 3 cases: Written Attestation

(other than I-131) AU under hours of classroom and laboratory training, applicable to parenteral administrations, for which a written directive is required, of any beta emitter, or any photon-emitting radionuclide with a photon energy less than 150 keV, and/or parenteral administration of any other radionuclide for which a written directive is required Work experience including 3 cases:Written Attestation AU under or

Classroom and laboratory training in the following areas: ◦ (A) Radiation physics and instrumentation; ◦ (B) Radiation protection; ◦ (C) Mathematics pertaining to the use and measurement of radioactivity; ◦ (D) Chemistry of byproduct material for medical use; and ◦ (E) Radiation biology;Courses

The work experience must involve: ◦ (A) Ordering, receiving, and unpacking radioactive materials safely and performing the related radiation surveys; ◦ (B) Performing quality control procedures on instruments used to determine the activity of dosages, and performing checks for proper operation of survey meters; ◦ (C) Calculating, measuring and safely preparing patient or human research subject dosages;Training

◦ (D) Using administrative controls to prevent a medical event involving the use of unsealed byproduct material; ◦ (E) Using procedures to contain spilled byproduct material safely and using proper decontamination procedures; ◦ (F) Administering dosages of radioactive drugs to patients or human research subjects; and ◦ (G) Eluting generator systems appropriate for preparation of radioactive drugs for imaging and localization studies, measuring and testing the elute for radionuclide purity, and processing the elute with reagent kits to prepare labeled radioactive drugs;

40 hour hot lab rotation covers (1 st year): ◦ (A) Ordering, receiving, and unpacking radioactive materials safely and performing the related radiation surveys; ◦ (B) Performing quality control procedures on instruments used to determine the activity of dosages, and performing checks for proper operation of survey meters; ◦ (C) Calculating, measuring and safely preparing patient or human research subject dosages; ◦ (D) Using administrative controls to prevent a medical event involving the use of unsealed byproduct material; ◦ (E) Using procedures to contain spilled byproduct material safely and using proper decontamination procedures;

Basic Sciences (Thu 3 rd year) ◦ Physics & Instrumentation27 ◦ Mathematics7 (5) ◦ Chemistry3 (2) Total37 (34)

Physics (Thu 2 nd year) ◦ Physics & Instrumentation1 (0) ◦ Clinical2 ◦ Radiation Protection3 ◦ Radiobiology1 Total:7 (6)

Core lectures (Fri) – ◦ Clinical38 ◦ Radiation Protection2 Total40

T&E Forms

Authorized Users All T&E must be obtained in the last seven years. There are FOUR forms to document NEW AU Training and Experience. ◦ RHB 313A(AUD) ◦ RHB 313A(AUT) ◦ RHB 313A(AUS) ◦ RHB 313A(AU) If the user has been board certified or listed on a license over seven years ago, the user must have had related continuing education and experience since the required T&E was completed. There is ONE form to document REFRESHER AU Training and Experience. ◦ RHB 313A(CE)

RHB 313A AUD for 200. AUT for 300. ◦ I-131 > 30 µCi for imaging and localization studies AU for 200 and 300

RHB 313A(AU) Designed for , , and

RHB 313A(AU) This is the link to the CFR 35. Medical Guide will be referenced here in the future.

RHB 313A(AU) Medical License Check the box with the appropriate authorization

RHB 313A(AU) The form will walk you through the different pathways. Choose the appropriate pathway and complete the required sections.

RHB 313A(AU)

Supervising Individual Information

RHB 313A(AU) Clinical Cases Supervising Individual Information

RHB 313A(AU) End of Part I!

RHB 313A(AU) Preceptor Attestation must be completed for , , and (required for and on form 313A(AUS)). Preceptor must still meet the qualifications described in Part 35 for each authorization!

RHB 313A(AU) There are multiple sections! Complete for each requested authorization. Follow the instructions for each authorization.

RHB 313A(AU) Choose the appropriate pathway

RHB 313A(AU) Complete the second section if required.

RHB 313A(AU) Preceptor Qualification Submit a copy of the RML if it is not a CA license. If listed on a broad scope license, provide a copy of the license and a letter from the RSO, verifying the preceptor’s authorizations for the dates training took place.

Summary If you qualified for “greater” authorizations, you are also qualified for the “lower” authorizations, i.e. qualified for = qualified for , , , , and If you are requesting authorization for imaging and localization studies and wish to use > 30 µCi of I-131, you must also meet the qualifications for and complete the T&E form(s) for and Preceptor attestation is required for every pathway except current AU