Except as provided in Sections
335.9060,
335.9070,
335.9080
and
335.9160,
a licensee shall require the authorized user of unsealed radioactive material
for the uses authorized under Section
335.5010
to be a physician who:
a) Is certified
by a medical specialty board whose certification process has been recognized by
the Agency, the U.S. Nuclear Regulatory Commission or an Agreement State and
who meets the requirements in subsection (b)(2)(F). To be recognized, a
specialty board shall require all candidates for certification to meet the
following requirements:
1) Successfully
complete residency training in a radiation therapy or nuclear medicine training
program or a program in a related medical specialty that includes 700 hours of
training and experience as described in subsection (b)(1) through (b)(2)(E).
Eligible training programs shall be approved by the Residency Review Committee
of the Accreditation Council for Graduate Medical Education, the Royal College
of Physicians and Surgeons of Canada, or the Council on Postdoctoral Training
of the American Osteopathic Association;
2) Pass an examination administered by
diplomates of the specialty board that evaluates knowledge and competence in
radiation safety, radionuclide handling, quality assurance and clinical use of
unsealed radioactive materials; or
AGENCY NOTE: Specialty boards whose certification processes
have been recognized by the Agency, the U.S. Nuclear Regulatory Commission or
an Agreement State will be posted on the NRC's website.
b) Has successfully completed 700
hours of training and experience, including a minimum of 200 hours of classroom
and laboratory training, in basic radionuclide handling techniques applicable
to the medical use of unsealed radioactive material requiring a written
directive. The training and experience shall include:
1) Classroom and laboratory training in the
following areas:
A) Radiation physics and
instrumentation;
B) Radiation
protection;
C) Mathematics
pertaining to the use and measurement of radioactivity;
D) Chemistry of radioactive material for
medical use;
E) Radiation biology;
and
2) Work experience
under the supervision of an authorized user who meets the requirements in this
Section, Section
335.9160
or equivalent U.S. Nuclear Regulatory Commission or Agreement State
requirements. A supervising authorized user who meets the requirements in
subsection (b) shall have experience in administering dosages in the same
dosage category or categories (i.e., subsection (b)(2)(F)) as the individual
requesting authorized user status. The work experience shall involve:
A) Ordering, receiving and unpacking
radioactive materials safely, and performing the related radiation
monitoring;
B) Performing quality
control procedures on instruments used to determine the activity of dosages,
and performing checks for proper operation of survey instruments;
C) Calculating, measuring and safely
preparing patient or human research subject dosages;
D) Using administrative controls to prevent a
medical event involving the use of unsealed radioactive material;
E) Using procedures to contain spilled
radioactive material safely and using proper decontamination
procedures;
F) Administering
dosages of radioactive drugs to patients or human research subjects involving a
minimum of three cases in each of the following categories for which the
individual is requesting authorized user status:
i) Oral administration of less than or equal
to
1.22
GBq (33 mCi) of sodium iodide I-131 for which a written directive is
required;
ii) Oral administration
of greater than
1.22
GBq (33 mCi) of sodium iodide I-131;
AGENCY NOTE: Experience with at least 3 cases described in
subsection (b)(2)(F)(ii) satisfies the requirement in subsection
(b)(2)(F)(i).
iii)
Parenteral administration of any radioactive drug that contains a radionuclide
that is primarily used for its electron emission, beta radiation
characteristics, alpha radiation characteristics, or photon energy of less than
150 keV, for which a written directive is required; and
3) Written attestation that the
individual has satisfactorily completed the requirements in subsections (b)(1)
and (b)(2) and is able to independently fulfill the radiation safety-related
duties as an authorized user for the medical uses authorized under Section
335.5010
for which the individual is requesting authorized user status. The attestation
shall be signed by either:
A) A preceptor
authorized user who meets the requirements in this Section, Section 335.9160,
or equivalent U.S. Nuclear Regulatory Commission or Agreement State
requirements and has experience in administering dosages in the same dosage
category or categories as the individual requesting authorized user status;
or
B) A residency program director
who affirms in writing that the attestation represents the consensus of the
residency program faculty where at least one faculty member is an authorized
user who meets the requirements in this Section, Section
335.9160
or equivalent U.S. Nuclear Regulatory Commission or Agreement State
requirements, has experience in administering dosages in the same dosage
category or categories as the individual requesting authorized user status, and
concurs with the attestation provided by the residency program director. The
residency training program shall be approved by the Residency Review Committee
of the Accreditation Council for Graduate Medical Education, the Royal College
of Physicians and Surgeons of Canada, or the Council on Postdoctoral Training
of the American Osteopathic Association and shall include training and
experience specified in subsections (b)(1) and (b)(2).