Training in Cardiovascular Magnetic Resonance : SCMR Guideline

The Society for Cardiovascular Magnetic Resonance (SCMR) has released Guidelines for Training in Cardiovascular Magnetic Resonance (CMR).

The guideline is published in the Journal of Cardiovascular Magnetic Resonance.

Level 1: General Training

Level 1 training is intended to provide introductory knowledge in CMR. Level 1 competency represents knowledge of the indications for and capabilities of CMR, but not to the extent that is sufficient for independent practice and clinical interpretation of CMR.

Requirements can be met through either of two tracks. Track A is tailored for fellows or residents in training, and Track B is designed for physicians who have completed medical training. The mentored cases and time spent in training in Track A can also be applied towards Level 2 training requirements.

Track A (formal fellowship or residency training)

It is recommended that all training programs (adult and pediatric cardiovascular medicine, radiology, and nuclear medicine) incorporate basic training in CMR to familiarize the trainee with the indications, methods, and applications of CMR. Level 1 CMR training can be completed by meeting the following requirements, typically during the course of residency or fellowship training:

• A minimum of 4 weeks of cumulative (need not be consecutive) exposure to the methods and applications of CMR.


• Training must be under a Level 2 or preferably Level 3 qualified mentor.


• Exposure to a minimum of 50 comprehensive mentored cases.


• 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.

Official verification of SCMR Level 1 training may be sought by providing a letter from the trainee’s laboratory director verifying that the above requirements have been met.

Track B (course-based training)

This track is designed primarily for physicians who have completed medical training. Level 1 CMR training can be completed by meeting the following requirements, typically attained during a dedicated CMR training course:

• The course must include a minimum of 2 full days of dedicated, live instruction in the indications, methods, and applications of CMR.


• The course director must be Level 2 or preferably Level 3 qualified.


• 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: Specialized training

For a physician to perform and interpret CMR independently, the following criteria (divided into general and specific categories) are required:

General Criteria

• 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.

Specific Criteria

Initial training:

• 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 online 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.


• At least 50 h 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. 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.

Maintenance of skills:

• CME in CMR for at least 20 h 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

Initial training:

In addition to Level 2 general criteria and training:

• 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.


• 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.


• 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.

Maintenance of skills:

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


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

For further reference follow the link: https://doi.org/10.1186/s12968-018-0481-8