Medical Imaging Specialty Certificates – United States

Please note: When we refer to a Bachelor's degree, NMT program, etc., these must be obtained from a recognized, accredited institution in the certification body's country (unless otherwise noted); programs must be completed; ethical and practice standards must be/have been adhered to.

Several bodies handle medical imaging certification in the United States:

• American Registry of Radiologic Technologists (ARRT);

• American Registry for Diagnostic Medical Sonography (ARDMS);

• Nuclear Medicine Technology Certification Board (NMTCB);

• American Registry of Magnetic Resonance Imaging Technologists (ARMRIT).

American Registry of Radiologic Technologists (ARRT)

The ARRT was formed in 1922 and now has more than 275,000 individuals registered. There are five primary, and 12 post-primary qualifications.

Primary:

• Radiography (R)

• Nuclear Medicine Technology (N)

• Radiation Therapy (T),

• Sonography (S),

• Magnetic Resonance Imaging (MR).

As an example, a registered nuclear medicine technologist has credentials RTN(ARRT).

Post-Primary:

• Bone Densitometry (BD)

• Breast Sonography (BS)

• Cardiovascular-Interventional Radiography (Note: No longer available for new candidates)

• Cardiac-Interventional Radiography (CI)

• Computed Tomography (CT)

• Magnetic Resonance Imaging (MR) (Primary and Post-Primary Tracks)

• Mammography (M)

• Quality Management (QM)

• Sonography (S) (Primary and Post-Primary Tracks)

• Vascular Sonography (VS)

• Vascular-Interventional Technology (VI)

• Registered Radiologist Assistant (RRA, new in September 2005).

To write the exams in the primary categories, one must complete a formal education program in the discipline.

To write a post-primary exam (except Registered Radiologist Assistant; see below), one must hold one ARRT primary registration (e.g., radiography). Additionally, candidates must demonstrate core clinical experience/competencies, which vary according to specialty. For example, those who want to write the mammography exam must complete training and experience requirements. Training requirements include: complete 40 hours of training within the 24 months immediately prior to application; perform a minimum of 25 supervised mammography exams; have at least eight hours of training in each mammography module used by technologists. Experience requirements include: perform an additional 75 exams (i.e., additional to the 25 supervised exams); perform a number of QC procedures; observe, assist with, or particpate in at least four interventional/special procedures (e.g. stereotactice procedures, ductography); review at least 20 mammographies with a Radiologist to evaluate technique, breast anatomy, and pathology.

Registered Radiologist Assistants (RRAs) are advanced level radiological technologists. According to the ARRT, "their role falls between the traditional roles of the radiologist and the radiographer." RRAs function under the supervision of an MD with US Board Certification in Radiology (or equivalent). The RRA exam was first held in October 2005. The exams will be held typically in February, July, and October, and the cost is US$150. Requirements to write the RRA exam include: completion within the past five years of an accredited RA program; or, until December 31, 2007, have a baccalaureate degree; be ARRT certified and registered in radiography; complete the ARRT didactic coursework addressing the topics listed in the ARRT Content Specifications for the RA Examination (which should be covered as a part of a nationally-recognized curriculum); complete a preceptorship similar to a physician residency, during which one must complete procedures from nine mandatory and 15 elective types of procedures, and document these in a portfolio; meet the ARRT's ethics requirement. This credential will require 50 CE credits within a two-year period.

The certification exams are computer-based and offered year-round. Since January 2004, the tests have been offered by Pearson VUE, which is the electronic testing business of Pearson Education. Pearson VUE has more than 200 test centers in the USA, as well as international sites, including those in Toronto, Winnipeg, and Vancouver, Canada. The fee for primary qualification exams is US$150 and for post-primary qualification exams ranges between US$150 and US$300 (as of 2007).

People with ARRT certification must fulfill registration requirements annually. Therefore, in addition to complying with ARRT rules and standards of ethics, one must complete CE requirements (which are linked to a two-year cycle in relation to the registrant's birth month). The CE requirements may be fulfilled by:

• Obtaining 24 CE credits (even if you hold more than one credential, e.g., radiography and nuclear medicine, you still only need to obtain 24 credits)

Or …

• Passing a primary exam in a different discipline (e.g., if you have primary radiography credentials, you could pass the primary exam in radiation therapy or in nuclear medicine technology).

Or …

• Passing a post-primary exam in an appropriate category (e.g., if you have primary radiography credentials, you could pass the post-primary exam in mammography).

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American Registry for Diagnostic Medical Sonography (ARDMS)

The ARDMS was incorporated in 1975 and, to date, has certified more than 50,000 people. They offer three basic credentials as well as specialty examinations in three of these fields:

1. RDMS (Registered Diagnostic Medical Sonographer) with specialty exams in:

• Abdomen (AB)

• Breast (BR)

• Neurosonology (NE)

• Obstetrics and gynecology (OB/GYN)

• Fetal echocardiography (FE)

2. RDCS (Registered Diagnostic Cardiac Sonographer) with specialty exams in:

• Adult echocardiography (AE)

• Pediatric echocardiography (PE)

• Fetal echocardiography (FE)

3. RVT (Registered Vascular Technologist) with a specialty exam in:

• Vascular technology (VT)

Note: The ARDMS also offers the RPVI credential, Registered Physician in Vascular Interpretation.

Note: The ROUB (Registered Ophthalmic Ultrasound Biometrist) credentialing program was purchased from the ARDMS by the Joint Commission on Allied Health Personnel in Ophthalmology (JCAHPO). For more information, see the JCAHPO website.

For example, to earn the RDMS credential, one must take the physical principles and instrumentation exam in Ultrasound Physics and Instrumentation (UPI) plus one specialty examination (i.e., abdomen, breast, neuro, obs/gyn, or fetal echocardiography) within a five-year period of having written the first exam. The exams can, but do not have to be, written at the same time. However, even if a candidate passes the principles and instrumentation exam, they do not earn their basic credential until both exams are completed successfully. A candidate may choose to take all the specialty exams pertaining to the basic credential.

All candidates (except MD/DO candidates) wanting to write any of the four basic exams (RDMS, RDCS, or RVT) must have fulfilled one of the following:

• Have graduated from a two-year, patient-centered allied health program (e.g., sonography, respiratory therapy physical therapy, nursing) and have 12 months of full-time clinical ultrasound/vascular experience.

Or …

• Have graduated from a ultrasound/vascular technology program.

Or …

• Have a Bachelor's degree plus 12 months of full-time clinical ultrasound/vascular experience.

Or …

• Have a Bachelor's degree in sonography or vascular technology (note: the exam can be taken one year prior to completion of the degree, as long as the candidate has 12 months of clinical experience).

Starting on January 1, 2005, all applicants will be required to submit an ARDMS clinical verification form in addition to the educational and clinical documents already required, and listed in the Information and Examination Application Booklet.

The exam is in a computerized format so is available year-round at Promissor test centers. The 2007 fee for US applicants is US$200 and for Canadian applicants is US$267.

Registration is for three years. To renew, candidates must complete Continuing Medical Education, as follows: holders of RDMS, RDCS, or RVT credentials must complete at least 30 CME credits.

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Nuclear Medicine Technology Certification Board (NMTCB)

The NMTCB was founded in 1977 and certification (CNMT) began on Sept. 15, 1978. There are four routes for initial eligibility for the certification exam:

1. Completion of a recognized nuclear medicine technology program (Bachelor's, Associate's, or certificate) in the US or Canada (see list of acceptable schools) with approximately 1,000 hours of clinical training.

Or …

2. Alternate eligibility (and non-US-trained candidates) qualifications have three parts:

• Completion of one of a Bachelor's or Associate's degree in physical or biological sciences; or a Bachelor's or Associate's degree in another discipline with courses in algebra, physics, chemistry, human anatomy, and physiology; or national certification as a medical technologist (MT), radiographer (RT), sonographer (RDMS), or radiation therapist (RTT); or licensure as a RN; or hold registration with the CAMRT.

• Four years of full-time (four years at 2,000 hours/year, for a total of 8,000 hours) of supervised clinical experience in NMT.

• Completion of at least 15 hours of course work from a college/university, NMT program, or recognized CE body (e.g., VOICE/ECE) in each of: radiopharmacy, nuclear medicine instrumentation, and radiation safety.

Or …

3. Completion of an NMT program in another country.

The CNMT credentialling exam is offered via computer at ACT Centers in the United States. The fee is US$145 (2007).

The NMTCB recently instituted its CE requirement to maintain certification. Individuals must either complete 24 hours of CE credits within each two-year period or complete a specialty exam offered by the NMTCB (the nuclear cardiology or PET exam) or the ARRT (e.g. the MRI exam).

The NMTCB recently started a Cardiology Specialty Exam for the NCT credential. The next test will be on October 6, 2007 (the deadline for applying was in April 2007), and the cost is $150. (As a reference, in 2006, 219 candidates took the exam, with 128 passing and 91 failing.) This test, too, is computerized and is offered at ACT Centers. To write this exam, one must have active NMTCB, ARRT(N), or CAMRT(RTNM) membership and have at least two years of full-time (4,000 hours) clinical experience in NMT.

The NMTCB offered its first sitting of the PET Specialty Exam in September 2004. The next exam will be September 29, 2007 (the deadline for applying was in April 2007). (As a reference, 171 candidates took the 2006 PET exam, and 104 passed and 67 failed.) The exam fee is $200. To write this exam, one must:

1. Have active NMTCB, ARRT(N), or CAMRT(RTNM) membership, and have a minimum of 700 hours of clinical experience on a dedicated PET scanner or on a PET/CT scanner.

Or …

2. Have active ARRT(T), ARRT(R), CAMRT(RTR), or CAMRT (RTT) membership, and have a minimum of 700 hours of clinical experience on a dedicated PET scanner or on a PET/CT scanner, and have completed at least 15 hours of coursework in each of: radiopharmacy, nuclear medicine instrumentation, and radiation safety.

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American Registry of Magnetic Resonance Imaging Technologists (ARMRIT)

The American Registry of Magnetic Resonance Imaging Technologists (ARMRIT) was established in 1991, and is curently applying for accreditation with the National Commission for Certifying Agencies (NCCA). For more information, see the ARMRIT.

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If you are interested in learning about specialty certification options in Canada, read Medical Imaging Specialty Certificates – Canada.

Updated on August 16, 2007.

Medical Imaging Specialty Certificates – United States

American Registry of Radiologic Technologists (ARRT)

American Registry for Diagnostic Medical Sonography (ARDMS)

Nuclear Medicine Technology Certification Board (NMTCB)

American Registry of Magnetic Resonance Imaging Technologists (ARMRIT)

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Cynthia M Piccolo

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