NMTCB Continuing Competence Policy

Rationale: The NMTCB entry-level examination is a test of knowledge. The knowledge base for nuclear medicine technology continues to change. Therefore, persons certified by the NMTCB must demonstrate a continued accumulation of knowledge about the field.

Definition of terms:

• NMTCB Certificate: A certificate granted by the Nuclear Medicine Technology Certification Board (NMTCB) signifying recognition that an individual has met certification qualifications set from time to time by the NMTCB, including, but not limited to education, experience, examination, and good moral character.
• Certificant: An individual who holds any NMTCB certificate.

Types of NMTCB Certificates:

• Active: A duly issued NMTCB certificate currently in good standing.
• Inactive: A duly issued NMTCB certificate which is no longer active and is not in good standing due to non-payment of renewal fees.
• Retired: An inactive certificate of a certificant who has claimed retirement from the field of nuclear medicine technology.
• Emeritus: An inactive certificate of a certificant with either 15 years active certification, or 10 years active certification and over the age of 62.
• Probation: The certificant maintains certification, but specific requirements must be met within a given time frame in order to return to Active status. If the probation requirements are not met, the certificant may be subject to further administrative discipline.
• Suspension: The certificant has his/her certification removed. There is a possibility of the certification being reinstated after specific requirements have been met.
• Revoked: The certificant has had his/her certification removed with no possibility of reinstatement.

The Nuclear Medicine Technology Certification Board (NMTCB) was founded in 1977 to establish and maintain a voluntary program for certification of nuclear medicine technologists by nuclear medicine technologists. The standards established by the NMTCB include educational requirements, practical experience, and successful completion of an appropriate competency-based examination.

The NMTCB certifies individuals whom have developed the requisite body of knowledge to practice nuclear medicine technology, and registers those individuals who meet these criteria. A certificate granted by the NMTCB signifies recognition that an individual has met certification qualifications set forth by the NMTCB, including, but not limited to education, experience, examination, and good moral character.

The NMTCB's ongoing purpose is to establish and maintain professional standards of practice which assure that nuclear medicine technologists who hold a Certified Nuclear Medicine Technologist (CNMT) credential from the NMTCB are properly educated, hold valid/current certifications, practice within their scope of practice, and continue to receive ongoing training throughout their careers. Through the certification process, a certificant is responsible to the certification board for the services and care that he or she provides while employed or practicing as a CNMT.

The NMTCB entry-level examination for CNMTs is a test of knowledge. There is a common set of core knowledge, skills, and abilities consistent with contemporary practice that all nuclear medicine technologists should be able to demonstrate as a part of continuing competence. However, the knowledge base for nuclear medicine technology continues to change. Therefore, persons certified by the NMTCB must also demonstrate a continued accumulation of knowledge about the field. The purpose of this requirement is to assist in assuring safe and effective practices in the provision of nuclear medicine technology to the public.

Knowledge and skills required for competent and professional performance in nuclear medicine technology evolve and change over time. The purpose of recertification is to:

1. Encourage continued professional development and
2. Ensure continuing competence in the field of nuclear medicine technology.

NMTCB approaches continuing competence with a multi-step approach. NMTCB ensures an active CNMT’s continuing competence by requiring a recertification process that includes prescriptive amounts of continuing education. Twenty-four continuing education hours are required from each CNMT certificant over the course of every two years. The annual renewal statement requires certificants to attest to their current CE status. Excess CE credits (more than the number of hours required for the current CE Cycle) may not be carried over into the next CE Cycle.

Certificants must document involvement in educational activities in order to demonstrate continued competence in the field of nuclear medicine and/or the specialty area in which they are certified by the NMTCB. Continuing competence is defined as the ability to provide service at specified levels of knowledge and skill, not only at the time of initial certification, but throughout an individual's professional career.

Continuing competence of health care professionals is of the utmost importance to a diverse range of stakeholders including the public, health care providers, regulatory bodies, employers, insurers, and professional associations. These individuals rely on the NMTCB certification to denote that the technologist who is credentialed as a CNMT has been assessed in terms of their competence to practice the profession of nuclear medicine technology.

Nuclear Medicine Technologists (CNMT)

NMTCB certificants will be required to demonstrate continued competence by completing a combination of the following in order to achieve a total of 24 hours of acceptable Continuing Education:

• Obtaining continuing education (CE) credits from NMTCB approved CE organizations related to nuclear medicine; equivalent to one (1) hour of CE for each month of the CE Cycle (i.e., 24 CE credits per 2 year CE cycle). Excess credits may not be carried over into the next reporting cycle.
• Taking and passing an additional post-primary or specialty examination offered by the NMTCB (NCT, PET, NMTCB(CT), NMTCB(RS), or NMAA exam), or post primary exam offered by the ARRT, ARDMS, or AHRA. Successful completion of one of these examinations will be recognized as equivalent to 24 hours of CE.
• Obtaining a grade of C or better from an accredited post-secondary institutions in academic courses that are Radiological Health Sciences, Patient Care, and Nuclear Medicine Technology. Courses related to Business/Management, Technology, and/or Education related to healthcare will be considered. The equivalent of 16 CE hours will be recognized for successful completion of one semester college credit or 12 CE hours per quarter college credit.
• Successful completion of Advanced Cardiac Life Support (6 CE hours per two-year cycle)/Pediatric Advanced Life Support (6 CE hours per two-year cycle). Both Advanced Cardiac Life Support and Pediatric Advanced Life Support (maximum of 9 CE hours per two-year cycle). Note: Successful completion of Basic Life Support (BLS)/CPR training or BLS/CPR instructor training is NOT recognized as meeting the CE requirements of the NMTCB.

Computed Tomography Technologists (NMTCB(CT))

• Certification must be renewed annually and the NMTCB(CT) certificant must consistently maintain certification in their primary nuclear medicine, radiography, or radiation therapy credentials as either "active", "in compliance" or "in good standing".
• Biennial continuing education requirements:
  • The NMTCB(CT) certificant is required to obtain a total of 12 hours of CE specific to CT in each 2 year CE cycle.

Nuclear Medicine Advanced Associates (NMAA)

• Certification must be renewed annually and the NMAA certificant must consistently maintain NMTCB (CNMT) certification and/or R.T.(N) ARRT and/or CAMRT nuclear medicine credentials either as "active", "in compliance" or "in good standing".
• NMAA certification is valid for up to 10 years. After 10 years, reaffirmation of competence will be required. Certificants may recertify anytime between 8 and 10 years without penalty.
• Biennial CE requirements:
  • 24 category A+ and/or American Medical Association (AMA) approved continuing medical education (CME) hours.

Nuclear cardiology technologists (NCT)

• Certification must be renewed annually and the NCT certificant must consistently maintain NMTCB (CNMT) certification and/or R.T.(N) ARRT and/or CAMRT nuclear medicine credentials either as "active", "in compliance" or "in good standing."
• NCT certification is valid for up to 7 years. Specialty certificants who want to recertify for an additional seven years will be required to (1) successfully pass the specialty examination OR (2) display 42 hours of acceptable specialty-specific continuing education (the equivalent of 6 hours per year of certification). CE activities must be obtained from a CE approval organization that is recognized by NMTCB. CE are submitted at the time of the recertification application.
• Biennial CE requirements:
  • The NCT certificant is not required to obtain biennial CE in order to maintain this specialty credential, but if wanting to recertify for an additional seven years utilizing the CE alternate recertification pathway they must show 42 hours of acceptable specialty-specific continuing education.

Positron Emission Tomography (PET)

• Certification must be renewed annually and the PET certificant must consistently maintain their NMTCB (CNMT) certification, R.T.(N) ARRT, CAMRT nuclear medicine credentials and/or CAMRT(RT), CAMRT(RTT), R.T.(R) or R.T.(T) as either as "active", "in compliance" or "in good standing."
• PET certification is valid for up to 7 years. Specialty certificants who want to recertify for an additional seven years will be required to (1) successfully pass the specialty examination OR (2) display 42 hours of acceptable specialty-specific continuing education (the equivalent of 6 hours per year of certification). CE activities must be obtained from a CE approval organization that is recognized by NMTCB. CE are submitted at the time of the recertification application.
• Biennial CE requirements:
  • The PET certificant is not required to obtain biennial CE in order to maintain this specialty credential, but if wanting to recertify for an additional seven years utilizing the CE alternate recertification pathway they must show 42 hours of acceptable specialty-specific continuing education.

The NMTCB uses a biennial (two year) CE Cycle based on the certificant's birth month and shall use an odd year-even year system based on the initial certification year for assigning CE Cycles. The NMTCB requires certificants to record the hours of CE obtained during the CE Cycle. The annual renewal statement requires certificants to attest to their current CE status. Excess CE credits (more than the number of hours required for the current CE Cycle) may not be carried over into the next CE Cycle.

Certificants are responsible for keeping records of CE hours obtained.

Biennial CE Requirements:

1. New Certificants
   • The first CE Cycle for new certificants in an even numbered year begins on the first day of the month of certification and is pro-rated to the last day of the month immediately preceding their birth month in the next even numbered year. The CE requirement of this first CE Cycle is equivalent to one CE per month of the cycle as described.
   • The first CE Cycle for new certificants in an odd numbered year begins on the first day of the month of certification and is pro-rated to the last day of the month immediately preceding their birth month in the next odd numbered year. The CE requirement of this first CE Cycle is equivalent to one CE per month of the cycle as described.
2. Subsequent CE Cycles will run from the first day of the certificant's birth month to the last day of the month immediately preceding the birth month in the next even or odd year. As this period is 24 months, 24 hours of CE must be obtained during this cycle.
3. Certificants are permitted to make a one-time change to their CE Cycle (i.e. from Even to Odd or from Odd to Even)
4. Certificants are responsible for keeping records of involvement in educational activities. The following documentation of CE activity is required:
   • For sponsoring organizations on the NMTCB’s annual list of approved CE organizations, the date, title, reference number, and number of hours of each CE activity.
   • For academic courses, a grade transcript from an accredited post-secondary school must be submitted indicating the course title, number of credits, and the grade received (must be a C or better).
   • For ACLS and/or PALS certification, a dated, signed copy of the ACLS and or PALS card(s).
5. The certificant must verify biannually the appropriate number of CE hours have been obtained for renewal.

Military Waiver

The NMTCB will waive the requirement for active duty military service personnel to obtain CE hours while deployed overseas. To apply for this waiver a military waiver form must be completed and sent it along with a copy of the deployment orders to the NMTCB office.

Audits

Audits of CE hours shall be conducted as follows:

• A certificant who checks that he/she will not meet the CE requirements by the date specified will be automatically audited and will not receive a card.
• Every year, a random sampling of reporting certificants shall be randomly chosen for an audit. These individuals will be asked to provide documentation of their educational activities. The audited individuals must submit their documentation within 60 days of the postmark on the letter from the NMTCB.
• Falsification of CE documents may result in revocation of one's certification(s), monetary fines, and/or disqualification from NMTCB examinations.
• The NMTCB reserves the right to require that those selected for CE audit must submit a copy of original documentation of participation in CE activities.

Certificants who are unable to document their educational activities shall be on probation for six months, during which time they must obtain additional CE hours to meet 24 hours for the audited cycle. The certificant must obtain 24 new CE hours for the next cycle (those earned to meet probation requirements do not count for the next cycle as well). The certificant will also be charged a $65 reinstatement fee in addition to any outstanding renewal fees.

Six months after being notified of non-compliance with the CE policy, if the NMTCB does not receive necessary documentation, a certificant’s credential(s) shall be suspended. If documentation is not received within six months after suspension occurs, the certificant’s credential(s) can be reinstated only by meeting the current eligibility requirements for and successfully completing the entry-level examination.

In addition, NMTCB also requires those participating in the CNMT credentialing process to answer certain ethics questions during each annual renewal. The NMTCB monitors each adherence to legal and ethical standards, including but not limited to the Code of Ethics of the Society of Nuclear Medicine and Molecular Imaging Technologist Section.

The NMTCB Continuing Competence policy has been developed to include a list of core competencies that all nuclear medicine technologists, regardless of specialty or setting, are expected to acquire and maintain throughout their careers. The NMTCB's Continuing Competence Policy has been tailored so CNMT certificants are required to take part in planned learning experiences that must relate to the following areas of the practice, whether the certificant is currently working in an imaging practice, research setting, education, management, or some other professional area.

Many organizations offer continuing education opportunities online or through meetings or journal activities. Many of these organizations only prepare the activities and are not approval organizations. However, most organization have their activities approved by a recognized continuing education approval organization. Before participating in a continuing education activity, please check with the sponsor to be certain that the activity is approved by one of the organizations listed below.

The following organizations meet the NMTCB's criteria for awarding continuing education credits, therefore educational activities approved by any of these groups will be accepted by the NMTCB. The NMTCB will not recognize continuing education hours that are not approved by one of the organizations listed. Please note that the NMTCB accepts all CE approved by these organizations, including approved vendor applications training. Click on each organization's name to visit their website (this list is reviewed and updated on an annual basis):

• The American Association of Physicists in Medicine (AAPM)
• The American Academy of Health Physics (AAHP)
• American College of Healthcare Executives (ACHE)
• American College of Radiology (ACR)
• American Healthcare Radiology Administrators (AHRA)
• American Medical Association (AMA) including AMA PRA Category 1 CE
• American Society of Nuclear Cardiology (ASNC)
• American Society for Therapeutic Radiology and Oncology (ASTRO)
• American Society of Radiological Technologists (ASRT)
• American Academy of Physician Associates (AAPA)
• Canadian Association of Medical Radiation Technologists (CAMRT)
• Nuclear Regulatory Commission (NRC)
• British Nuclear Medicine Society (BNMS)
• European Association of Nuclear Medicine (EANM)
• World Federation of Nuclear Medicine and Biology (WFNMB)
• Australian and New Zealand Society of Nuclear Medicine (ANZSNMT)
• Accreditation Council for Pharmacy Education (ACPE)
• Association of Vascular and Interventional Radiographers (AVIR)
• Radiological Society of North America (RSNA)
• Society of Nuclear Medicine and Molecular Imaging (SNMMI). Also known as VOICE credits.
• Society of Nuclear Medicine and Molecular Imaging Technologist Section (SNMMITS). Also known as VOICE credits.
• Medical Dosimetry Certification Board (MDCB)
• Society for Vascular Ultrasound - No longer accepted after June 1, 2017
• With the exception of Basic Life Support (BLS) and CPR, continuing education activities approved by the following state licensing agencies will be accepted:
  
  1. California
  2. Florida
  3. Illinois
  4. Kentucky
  5. Massachusetts
  6. New Mexico
  7. Oregon
  8. Puerto Rico
  9. Texas
• The Section for Magnetic Resonance Technologists (SMRT)

NOTE: Technologists should contact organizations directly from which they are acquiring continuing education hours to submit a request for addition to the NMTCB approved list if the organization is not currently listed. NMTCB will not contact individual organizations. Click here for more information

Sources of CE Equivalency: The NMTCB does recognize certain activities as being the equivalent to a specific number of CE hours, even though these are not approved by one of the recognized organizations listed above.

1. Specialty examination: successful completion of any post-primary specialty examination offered by the NMTCB, American Board of Science in Nuclear Medicine (ABSNM), American Registry of Radiologic Technologists (ARRT), American Registry for Diagnostic Medical Sonography (ARDMS) or American Healthcare Radiology Administrators (AHRA). Successful completion of a specialty exam will be recognized as the equivalent of 24 hours of CE. Note: The entry level examinations for the NMTCB and the ARRT (Radiography, Nuclear Medicine Technology, Radiation Therapy, Sonography or Primary Magnetic Resonance Imaging) are not considered the equivalent to CE hours.
2. Certain college level courses: Official grade transcripts from an accredited post-secondary school must be submitted as proof of successful completion (grade of C or better) of college courses related to the Radiological Health Sciences, Patient Care, and Nuclear Medicine Technology. Courses related to Business/Management, Technology, and/or Education related to healthcare will be considered. The equivalent of 16 CE hours will be recognized for successful completion of one semester college credit or 12 CE hours per quarter college credit.
3. Successful completion of American Heart Association Advanced Cardiac Life Support (ACLS) will be recognized as the equivalent of 6 CE hours per 2-year cycle. A signed and dated copy of the ACLS certification card must be submitted for the credits to be recognized. Successful completion of Basic Life Support (BLS) or CPR training is NOT recognized as meeting the continuing education requirements of the NMTCB. Certification or licensure as a BLS or CPR instructor also is NOT recognized as meeting the continuing education requirements of the NMTCB.
4. Successful completion of American Heart Association Pediatric Advanced Life Support (PALS) will be recognized as the equivalent of 6 CE hours per 2-year cycle. A signed and dated copy of the PALS certification card must be submitted for the credits to be recognized. Successful completion of Basic Life Support (BLS) or CPR training is NOT recognized as meeting the continuing education requirements of the NMTCB. Certification or licensure as a BLS or CPR instructor also is NOT recognized as meeting the continuing education requirements of the NMTCB.
5. Successful completion of both ACLS and PALS (as described above) will be recognized as the equivalent of 9 CE hours per 2-year cycle. A signed and dated copy of the ACLS and PALS certification cards must be submitted for the credits to be recognized. Successful completion of Basic Life Support (BLS) or CPR training is NOT recognized as meeting the continuing education requirements of the NMTCB. Certification or licensure as a BLS or CPR instructor also is NOT recognized as meeting the continuing education requirements of the NMTCB.

Certificants who have not maintained Active status continually: The NMTCB provides limited mechanism for certificants who have let their certification lapse.

In order to return to Active status after less than 5 years, a certificant may reactivate by completing both of the following requirements:

• Paying back dues up to a total of no more than the current examination fee, plus a $65 reactivation fee, AND
• Documentation of completion of 12 continuing education credits for each year he/she was inactive

In order to return to Active status after 5 years or more, you are no longer considered a certificant and must pass the entry-level examination in order to reactivate. To reactivate, you must submit a new application to the NMTCB under current eligibility requirements.