Background
Methods
Recommendations for basic training in CMR
Level 1: General training to provide a working knowledge of CMR methods and diagnostic utility
• CMR safety: magnetic fields, and contraindications | |
• CMR contrast agents: mechanisms, safety, and applications | |
• Blood flow imaging and quantitative analysis of velocity-encoded images | |
• CMR of cardiovascular structure and anatomy | |
• CMR of right and left ventricular function | |
• CMR of myocardial infarction, scarring, and viability assessment | |
• CMR of myocardial fibrosis and edema | |
• CMR stress testing | |
• CMR of vascular pathology, including aortic disease | |
• CMR of valvular heart disease | |
• CMR of pediatric and adult congenital heart disease | |
• CMR in cardiomyopathies and heart failure | |
• CMR in arrhythmia | |
• CMR of pericardial disease | |
• CMR for cardiac masses and tumors |
Track A (formal fellowship or residency training)
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A minimum of 4 weeks of cumulative (need not be consecutive) exposure to the methods and applications of CMR.
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Training must be under the aegis of a Level 2 or preferably Level 3 qualified mentor.
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Training must provide exposure to the topics listed in Table 1.
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Exposure to a minimum of 50 comprehensive mentored cases.
Track B (course-based training)
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The course must include a minimum of 2 full days of dedicated, live instruction in the indications, methods, and applications of CMR.
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The course director must be Level 2 or preferably Level 3 qualified.
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The course must cover the topics listed in Table 1. These topics may be presented as either didactic lecture or as case studies.
Criteria for the practice of CMR
Level 2: Specialized training designed to provide the skills necessary to independently interpret CMR studies
General criteria
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Hold a valid unrestricted medical license or registration.
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Board certification or equivalent specialist medical qualification in adult or pediatric cardiovascular medicine, adult or pediatric radiology, or nuclear medicine.
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Completion of an accredited training program and board eligibility or equivalent in adult or pediatric cardiovascular medicine, adult or pediatric radiology, or nuclear medicine.
Specific criteria
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At least 12 weeks of dedicated CMR training under the supervision of a Level 2 or Level 3 (preferred) qualified mentor including a minimum of 6 weeks full-time equivalent training in a CMR laboratory and up to 6 weeks of training outside of a CMR laboratory. Both in-lab and out-of-lab training time is defined as a minimum of 35 h/week and may be spread over more than 12 weeks as long as the total time requirements are met. Training outside of a CMR laboratory may consist of coursework or case studies provided on-line or via CD/DVD, time at major medical meetings that have significant content devoted to CMR, or remote mentoring. The 12 weeks of dedicated CMR training need not be continuous or at a single institution but must be completed within 4 years.
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At least 50 h of CMR related coursework within the training program, or external CME certified coursework within the timeframe of the training program.
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Supervised interpretation of at least 150 CMR studies representing the range of CMR applications and pathologies observed in practice. CMR studies should include a mix of the cardiac and vascular indications listed in Table 1. For at least 50 studies, the trainee must be present during the scan as the primary operator or alongside the technologist, perform the image analysis, and make the initial interpretation. Supervised interpretation means that detailed feedback of the interpretation is provided by a SCMR Level 2 or Level 3 or international equivalent qualified mentor.
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CME in CMR for at least 20 h every 2 years (subject to audit).
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Primary interpretation of at least 100 cases every 2 years (subject to audit).
Criteria for advanced training in CMR
Level 3: Advanced training for those who ultimately wish to be responsible for the operation of a CMR laboratory and to participate in CMR teaching and research
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A total of at least 12 months training in CMR under the aegis of a Level 3 qualified mentor to be completed within 3 years.
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Supervised interpretation of a total of at least 300 CMR studies representing the range of CMR applications and pathologies observed in practice. For at least 100 studies, the trainee must be present during the scan as the primary operator or alongside the technologist, perform the image analysis, and make the initial interpretation.
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Active participation in the local quality assurance or improvement program for the acquisition, post-processing, and reporting of CMR studies.
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Active participation in basic or clinical CMR research or teaching during the training period.
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CME in CMR for at least 40 h every 2 years (subject to audit).
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Be the primary interpreter of at least 200 cases every 2 years (subject to audit).
Proof of training for Level 2 and Level 3
Legacy criteria for Level 2 and Level 3
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Board certification in cardiovascular medicine, radiology, or nuclear medicine.
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Two years or more of substantial activities in CMR including at least two of the following:
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○ Documented involvement in the performance and interpretation of at least 200 CMR studies.
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○ CMR research activities verified by publication record.
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○ Acknowledged clinical teacher of CMR with at least two or more trainees.
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Active participation in CME and local quality assurance programs as required for Level 2 or Level 3 requirements above.