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Winter 2015 Newsletter

Message from the Chair
Interim Executive Director's Report
Meet the New Director
Accreditation... Where to Begin?


Marcia Hess Smith, CNMT
Congratulations Computed Tomography Technologists!
The Nuclear Medicine Technology Certification Board (NMTCB) recently offered the first computed tomography (CT) exam for nuclear medicine technologists (NMTs).  On November 15th, a total of 102 individuals passed the first exam with an average passing scaled score of 81.75 (a scaled score of 75 was needed to pass).  They all now hold the credential of NMTCB(CT).
Of the 102 new CT credentialed individuals, 94 individuals are certified as CNMTs and eight (8) are registered ARRT(N).  Thirteen individuals hold the Positron Emission Tomography (PET) credential and six hold the Nuclear Cardiology Technologist (NCT) credential.  Seven individuals hold four NMTCB certifications (CNMT, NCT, PET, and NMTCB(CT)). 
The next CT exam will be offered April 17, 2015.  The application deadline for this exam is March 1st.  As with the other NMTCB exams, we have high standards for eligibility to sit for the NMTCB(CT) exam.  All examinees must show proof of education specific to CT.  Fortunately, most new NMT graduates meet these educational requirements.  All others are required to have a minimum of 35 educational contact hours specific to CT.  At least four hours must be in each of the following categories:  contrast administration, cross-sectional anatomy, x-ray physics, CT radiation safety.  In addition to classroom hours, examinees must also have 500 clinical hours. 
For maintenance of certification, anyone holding the NMTCB(CT) credential must earn 12 continuing education hours specific to CT every two years.  This is in addition to the 24 hours required to maintain the CNMT credential.
The NMTCB is working with the American College of Radiology (ACR), the Joint Commission and the Intersocietal Accreditation Commission (IAC) to incorporate the NMTCB(CT) credential into their respective accreditation standards.  We are also working with states and the Conference of Radiation Control Program Directors (CRCPD).
Many NMT educational programs have adjusted their curriculum to meet the educational and clinical requirements for students to be eligible to sit for the NMTCB(CT) exam upon graduation.  The NMTCB will be offering a $30 discount (from the $180 application fee) for new graduates who apply to take the NMTCB(CT) exam at the same time as the CNMT exam. 
The vision of the NMTCB is to be recognized as the certification organization of choice for nuclear medicine and molecular imaging.  We currently offer five examinations for nuclear medicine professionals:  Certified Nuclear Medicine Technologist (CNMT), Positron Emission Tomography (PET), Nuclear Cardiology Technologist (NCT), Computed Tomography (NMTCB(CT)) and Nuclear Medicine Advanced Associate (NMAA).  We work hard to keep our finger on the pulse of the profession to make examinations that are both relevant and necessary for nuclear medicine professionals.


Katie Neal, BS, MS

This has been an incredibly active and exciting year for the NMTCB!  As we close the curtain on 2014, I would like to take the opportunity to look back on just a few of the many activities that the NMTCB took part in over the past twelve months.
Certainly, the most exciting news was the recent development of the NMTCB(CT) credential.  The NMTCB had previously confirmed that there is a specific demand within the nuclear medicine field for an entry-level computed tomography (CT) credential. Responding to this expressed need, the NMTCB developed a new post-primary certification exam for CT.  As part of our mission as an organization, we felt compelled to answer this particular need in order to be able to assist nuclear medicine technologists in being able to practice and advance in our field.  The new CT credential was purposefully designed to establish the competency of a nuclear medicine technologist to perform CT procedures.

A very big “thank-you” goes out to all the nuclear medicine professionals who assisted us in the development and extensive review of this new CT exam. Particularly, the NMTCB would like to acknowledge the following individuals who either helped in the content development process or supported the item development effort by writing and evaluating exam questions: 
Jennifer A. Rice, Vicki Barnosky, Tessa Van Der Lee, Christina Gregg, Seyed Mohammadi,  Jon Shepard, Aarti Patel, Jonathan Rohe, Dr. Marques Bradshaw, Tina Thomas, Brandi Huber, Dr. Mark Langston, Dr. Yifang (Jimmy) Zhou, Misty Ehret, Kay Lockhart, Jason Asbury, William Paz, Tom Jessie, Michael Kroeger, Janet Nguyen, Jeffrey Willoughby, Amy Brady, Jimel Carpenter, Marcia Hess Smith, Cybil Nielsen, Ada Courtney, Angela Macci Bires, Cindi Luckett-Gilbert, Bryan Kerr, and Tony Knight.

A total of 131 eligible applicants sat for the initial NMTCB(CT) examination in November 2014, with 102 individuals successfully passing the test.  Our next delivery of the NMTCB(CT) exam is scheduled for Friday, April 17, 2015.  Applications for the NMTCB(CT) exam and the current eligibility requirements can be found at

In other Board news, the NMTCB was once again in attendance at the 61st SNMMI Annual Meeting in St. Louis, MO.   Thank you to all the attendees who stopped by our exhibit booth.  We also took the opportunity to discuss our new NMTCB(CT) credential while we were at the annual meeting, and we announced that we would begin taking applications for the new CT exam while at the St. Louis meeting in June 2014. 

Also while at the SNMMI annual meeting, our organization took the opportunity to host an NMTCB Board of Directors reunion for past and present Directors.  During the reception for the Directors, I took a moment to look around the room at the dedicated individuals who have been such a large part of this organization, whether as a former or current Director on the NMTCB Board. By my estimate, we had well over 700 years of combined professional nuclear medicine experience represented in that one room. It was both a humbling and awe inspiring occasion, just being able to listen to and socialize with some of the true pillars of the nuclear medicine community.

Paul Christian, Dr. Stan Goldsmith, Kristen Waterstram-Rich, and Dr. Jim Conway enjoy the NMTCB Board of Directors reunion while attending the SNMMI Annual Meeting in St. Louis.

Additionally, during the 2013 year we sent out a Nuclear Medicine Task Analysis survey to our certificants. The survey was sent by email invitation to all NMTCB certified nuclear medicine technologists for whom an email address was available.  The focus questions on the survey were developed by centering our study on the content of the current NMTCB task list, our detailed equipment and procedures lists, and the NMTCB’s Components of Preparedness (COPS) document.  All of these documents can be found at, and are very useful for educators and candidates preparing for the examination.

As part of the 2013 Task Analysis survey, we asked nuclear medicine technologists to rate the frequency with which they performed each task, as well as indicating which equipment, pharmaceuticals, and procedures were routinely utilized at their facilities. Once the responses to the survey were gathered, we assessed the results for each item’s criticality in current practice of nuclear medicine technology, and then incorporated those results in the Task Analysis report we published in 2014. Through these types of surveys, the NMTCB can elicit feedback from the current field in order to incorporate updates to our examination content so that we are able to maintain the high standards of reliability and validity for the examinations we offer. (The full Task Analysis report can be found on the NMTCB website:

In closing, I would like to take this opportunity to thank all of the NMTCB Directors, both past and present, who have served on our Board over the years.   The NMTCB is able to advance and succeed in our field primarily due to the dedication and support of these committed individuals. While the field of nuclear medicine is continuously evolving and developing, it’s nice to know we have one steadfast constant: the incessant support of the dedicated Directors who tirelessly devote their time and energy towards the goal of making the NMTCB the perpetual certification organization of choice for nuclear medicine and molecular imaging.


Misty Ehret, CNMT, RT(CT) 

I am so thrilled to be the newest member of the Board of Directors for the NMTCB.  I graduated from the University of Louisville in 2000 with a BS in Nuclear Medicine.  My career started in the general nuclear department at a local hospital.  

In 2001 I began working in an outpatient PET facility that became the first in Kentucky to offer Rb82 and N13 stress tests.  Over the past thirteen years I have been able to cross train and obtain my CT certification as well as my PET certification. In 2012 I started pursuing my MBA. 

As a full time working mom and wife it can be challenging to juggle everything, but somehow I manage.  When I’m not working, I love to travel with my husband Jeff and daughter Coral.  I also love reading good books and trying my hand at anything crafty.

Accreditation...Where to Begin?

Jimel Carpenter, CNMT, NCT

As a nuclear medicine technologist there are not many things that cause your heart rate to quicken, and your mouth to suddenly become dry, more than the talk of an upcoming date with an accrediting body. As an individual that has recently experienced the pleasure of going through this process for a large facility with five nuclear cardiology imaging centers, I can assure you that those feelings in many cases are warranted. Whether your position within the organization is that of a staff technologist, manager, administrator, or physician, we all have reason to wonder whether we measure up.

Having said all of that, there is hope. Surprisingly, most facilities do actually perform nuclear medicine technology in all its various forms in a way that is consistent withcurrent industry standards. Where we fall down however, may be in both documentation and organization. Both of these qualities are very important in the pursuit of accreditation.

In many cases, the nuclear medicine imaging departments that are part of a hospital were not mandated to obtain modality specific credentialing. For years the hospital wide generic accreditations offered by agencies, such as The Joint Commission, were enough to cover the bulk of nuclear medicine facilities. However, those of us that have worked in a stand-alone imaging center, or those associated solely with a physicians practice, most likely have gone through the accreditation process. As this iteration of healthcare continues to evolve, an accreditation that specifically examines your modality will become increasingly critical. There are nuances in the CMS guidelines that affect reimbursable items based on whether a procedure is performed in a hospital setting or in an office. In addition, the Joint Commission seems to have taken an interest in modality specific regulation when they released their proposed standards for imaging equipment, which included nuclear medicine. On top of all of that, it is commonly believed that most insurers will eventually require modality specific accreditation. Understanding the guidelines and the decision making for your specific facility may propel you into the accreditation market in the near future.  

At some point you or someone in your leadership structure will decide whether or not now is the time for accreditation. This brings us to the purpose for the article. If you currently don’t have modality specific accreditation, there is a very good chance that accreditation is in your future. There are currently a couple of options for nuclear medicine modality specific options for accreditation. The most popular modality specific accreditors are currently the (IAC) Intersocietal Accreditation Commission, and the (ACR) American College of Radiology. For the purposes of this article I will try to stay away from any specific references to any particular accrediting body, as I share a few tidbits that may assist you as you begin this journey. There are three phases that should be considered when beginning the accreditation process. The first is the planning and background research. The second facet is gathering and assembling. The final phase is the submission.

Planning and Research
As we come to terms with the reality that accreditation is on the horizon for us, and that for some reason we are one of the key persons responsible for making it happen, it is impera
tive to come up with a realistic sequence and timeline. For peace of mind, and the least stressful experience, the process has to be started approximately a year in advance of your anticipated submission date, or a year in advance of the expiration of your current accreditation. The first thing I would implore you to do is to set aside some significant undistracted time to spend on the website of the accrediting agency that you are considering. This is probably the most important step in making the most efficient use of your time and resources in this effort. As the key person in implementing the accreditation plan for your department or departments, you absolutely have to have an intimate knowledge of all the requirements for accreditation. Many people incorrectly assume that just getting most of the requirements right will earn accreditation. Each standard must be documented and demonstrated in the manner that the agency requires. All of the agencies that offer modality specific accreditation have user friendly websites that are packed with great information. Spending time understanding the requirements of the process will save you immeasurably as you prepare you submission packet.  Create a written timeline of when you will have specific tasks completed and post it prominently in your department so that the entire staff is aware of what is going on. Be sure to address any quality control or camera maintenance requirements that you are not currently compliant with. It takes time to schedule preventative maintenance, so give yourself a cushion.

Next, understand the financial impact and costs associated with the accrediting process. Make sure that you have the support of leadership in the proper places to approve the costs which are significant. You may have to assess whether this will affect the timing of when you are planning to make your submission. Also, during this time you also should carefully develop your team to get things done. Both a medical and technical director has to be identified. These are not just ornamental positions; they should both be qualified individuals that have a sincere desire to accomplish the goal of accreditation. They also have to be your biggest cheerleaders when trying to get everyone at your facility to make their required contributions to the effort. If you work at a small facility with one doctor and one camera, this step may not be such a big deal. However, I can tell you that if you are in a large facility with multiple sites, cameras, technologists, and physicians, these positions are crucial to the overall success of the endeavor.

Gathering and Assembling
Once you have your leading team, timeline, and funding for accreditation you should begin the most labor intensive part of the process: gathering and assembling your documentation. If you work in one of those imaging departments that is less than five years old, and every document that you can think of is readily available and in the most updated electronic format: good for you... Otherwise, if you are like ninety-nine percent of the rest of the world, roll up your sleeves and get busy!  Most nuclear medicine departments have been around for twenty or more years and have some, if not
all, protocols and documents that haven’t been updated in that amount of time. All modality specific accreditation requires a comprehensive procedure and camera specific procedure manual.

One key point to remember is that you can’t do it all by yourself. In most cases we work with other experienced and qualified nuclear medicine professionals that are quite capable to rewrite a clinical procedure if given the time. So my suggestion is to use the power of delegation and assign duties to those that you feel are capable and reliable enough to get the job done. Check back frequently with these individuals on their progress and give feedback along the way. This will keep them on track and reduce the amount of revisions you will have to do for the final submission.  At this point, if not earlier, I recommend letting both technologists and physicians know what the CE/CME requirements are. If you are in a large facility this can be a major hurdle. The technical director and medical director should both lead by example with continuing education compliance, and reminders should be shared with the staff as often as possible. Don’t let non-compliance catch you off guard at the time of submission. This is not a requirement that will be overlooked. Gather documentation of professional licenses, board certifications, BLS, and/or ACLS certifications. Beware this may take significantly more time than anticipated.  While in this phase of preparation, take a look at your final reports to make sure they meet all requirements of accreditation. This is an often overlooked requirement that will most likely catch up to you eventually. One final note for this section is to keep in the back of your mind any studies that are good candidates for the case study requirements and set aside for future use.

The Submission
Surprisingly, if you have done the leg work of the other two phases of preparation, the submission should be the easiest part of the process. Be aware that all application fees are due when the packet is submitted, so don’t forget to request funding far enough in advance. Most agencies have gone to an electronic application, so that makes many of the tasks much easier. However, that also means that none of the requirements can be omitted. To complete this process you will more than likely need access to a copier, scanner, and a CD burner. This all sounds very basic, but due to security of computer networks at most healthcare facilities, some of the necessary devices may be restricted from connecting to your imaging system. It is also a great idea to back up all electronic files in multiple locations, just in case of some type of catastrophic failure.

The time requirement of the submission phase varies based on the size and staff of your department so plan accordingly. Most accrediting agencies request submission of completed packets three months prior to the date you desire accreditation. There is still a lot of work to be done in this phase. Any procedures, protocols, and documentation prepared by coworkers should be reviewed and edited so that there is uniformity and consistency in how documents are written and formatted. Give yourself plenty of time so that any missing or incomplete elements of the submission can be addressed. Take pride in the department you represent and submit the best most complete packet you are capable of. In closing, I have learned from experience that accreditation is a wonderful testament to the quality of care being offered at a given facility. It attests to the fact that the staff is appropriately credentialed, equipment is being properly maintained, and that there are processes in place that ensure consistency and quality in results. In a healthcare environment that appears to be moving in that direction, being proactive in pursuit of accreditation will position your department for continued success and maximum profitability. And although my most recent experience with accreditation is in the area of nuclear cardiology and cardiac PET, I hope the observations I have shared will benefit any nuclear medicine department considering accreditation.
Chair of the Board
Marcia Hess Smith, BS, CNMT

Chair Elect
Cindi Luckett-Gilbert, MHA, CNMT, PET, FSNMT
Jon Baldwin, DO
Cybil Nielsen, MBA, CNMT, FSNMMI-TS

Jon Baldwin, DO
Alicia Baldwin, DO
Amy Brady, M.A.Ed., CNMT
Jimel M. Carpenter, CNMT, NCT
Ada Courtney, CNMT, PET
Misty Ehret, CNMT
Mary Beth Farrell, CNMT, NCT, FSNMMI-TS
Bennett Greenspan, MD, FACNM, FACR
Marcia Hess Smith, BS, CNMT
George Hinkle, RPh, BCNP
Cindi Luckett-Gilbert, MHA, CNMT, PET, FSNMT
Angela Macci Bires, Ed. D, MPM, CNMT
Cybil Nielsen, MBA, CNMT, FSNMMI-TS
Gregory G. Passmore, PhD., CNMT
James Patton, PhD
Jon Shepard, MS, DABR, DABSNM
Richard Siska, CNMT, NCT, NMAA, MIS, BSNM
Steven Wozniak, BS, CNMT, PET
Interim Executive Director
Katie Neal, BS, MS
Database Manager
Alfred L. Shellman
Certificant Services Manager
Bridget Williams
Examinations Manager
Elizabeth Rhodes, BS, MBA
Administrative Assistant
Barbara T. Dixon

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