Cardiovascular Magnetic Resonance Training Guidelines (2018)

Certification Committee of the Society for Cardiovascular Magnetic Resonance

Reviewed and summarized by Medscape editors

September 14, 2018

The cardiovascular medicine training guidelines were released on August 16, 2018, by the SCMR.[1]

Level 1: Basic Training in CMR

Level 1 training is intended to provide introductory knowledge in CMR. Competency represents knowledge of indications for and capabilities of CMR, but not sufficient for independent practice and clinical interpretation of CMR. Requirements can be met through track A, which is tailored for fellows or residents in training, or track B, which is designed for physicians who have completed medical training.

Track A (formal fellowship or residency training) includes the following requirements, typically during the course of residency or fellowship training: (1) A minimum of 4 weeks of cumulative (need not be consecutive) exposure to the methods and applications of CMR; (2) Training must be under a Level 2 or preferably Level 3 qualified mentor; (3) Exposure to a minimum of 50 comprehensive mentored cases; (4) Training must include exposure to topics such as safety, contrast agents, blood flow imaging, structure and anatomy, ventricular function, myocardial infarction, stress testing, valvular heart disease, congenital heart disease, cardiomyopathies, and cardiac tumors.

Track B (course-based training) can be completed by meeting the following requirements, typically attained during a dedicated CMR training course: (1) The course must include a minimum of 2 full days of dedicated, live instruction in the indications, methods, and applications of CMR; (2) The course director must be Level 2 or preferably Level 3 qualified; (3) The course must include the following topics, which may be presented as either didactic lecture or as case studies: safety, contrast agents, blood flow imaging, structure and anatomy, ventricular function, myocardial infarction, stress testing, valvular heart disease, congenital heart disease, cardiomyopathies, and cardiac tumors.

Level 2: Practice of CMR

For a physician to perform and interpret CMR independently, the following criteria are required:

Hold a valid unrestricted medical license or registration.

Board certification or equivalent specialist medical qualification in adult or pediatric cardiovascular medicine, adult or pediatric radiology, or nuclear medicine OR Completion of an accredited training program and board eligibility or equivalent in adult or pediatric cardiovascular medicine, adult or pediatric radiology, or nuclear medicine.

At least 12 weeks of dedicated CMR training under the supervision of a Level 2 or preferably Level 3 qualified mentor, including a minimum of 6 weeks of 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 hr/wk 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 does not need be continuous or provided at a single institution, but it must be completed within 4 years.

At least 50 hours of CMR-related coursework within the training program, or external CME certified coursework within the timeframe of the training program.

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 above (see Level 1, Tracks A and B). 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 an SCMR Level 2 or Level 3 or international equivalent qualified mentor.

CME in CMR for at least 20 hours every 2 years (subject to audit).

Primary interpretation of at least 100 cases every 2 years (subject to audit).

Level 3: Advanced Training in CMR

Requirements for those who wish to be responsible for the operation of a CMR laboratory and to participate in CMR teaching and research include the following, in addition to Level 2 general criteria and training:

At least 12 months of training in CMR under a Level 3 qualified mentor completed within 3 years.

Supervised interpretation 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, must perform the image analysis, and must make the initial interpretation.

Active participation in the local quality assurance or improvement program for the acquisition, post-processing, and reporting of CMR studies.

Active participation in basic or clinical CMR research or teaching during the training period.

CME in CMR for at least 40 hours every 2 years (subject to audit).

Be the primary interpreter of at least 200 cases every 2 years (subject to audit).

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