Section 144-220-G-H-690 - Training for use of remote afterloader units, teletherapy units, and gamma stereotactic radiosurgery unitsExcept as provided in G.57, the licensee shall require an authorized user of a sealed source for a use authorized under G.600 to be a physician who:
A. Is certified by a medical specialty board whose certification process has been recognized by the Agency, the Nuclear Regulatory Commission, or an Agreement State and who meets the requirements in G.690.C. The names of board certifications which have been recognized by the Agency, the NRC, or an Agreement State will be posted on the NRC's Medical Uses Licensee Toolkit Web page. To be recognized, a specialty board shall require all candidates for certification to: (1) Successfully complete a minimum of three years of residency training in a radiation therapy program approved by the Residency Review Committee of the Accreditation Council for Graduate Medical Education or Royal College of Physicians and Surgeons of Canada or the Council on Postdoctoral Training of the American Osteopathic Association; and(2) Pass an examination, administered by diplomates of the specialty board, which tests knowledge and competence in radiation safety, radionuclide handling, treatment planning, quality assurance, and clinical use of stereotactic radiosurgery, remote afterloaders and external beam therapy; orB.(1) Has completed a structured educational program in basic radionuclide techniques applicable to the use of a sealed source in a therapeutic medical unit that includes: (a) 200 hours of classroom and laboratory training in the following areas:(i) Radiation physics and instrumentation;(ii) Radiation protection;(iii) Mathematics pertaining to the use and measurement of radioactivity; and(iv) Radiation biology; and(b) 500 hours of work experience, under the supervision of an authorized user who meets the requirements in G.57, G.690 or equivalent Nuclear Regulatory Commission, or Agreement State requirements, at a medical institution that is authorized to use byproduct materials as described in G.600, involving: (i) Reviewing full calibration measurements and periodic spot-checks;(ii) Preparing treatment plans and calculating treatment doses and times;(iii) Using administrative controls to prevent a medical event involving the use of radioactive material;(iv) Implementing emergency procedures to be followed in the event of the abnormal operation of the medical unit or console; (v) Checking and using survey meters; and(vi) Selecting the proper dose and how it is to be administered; and(2) Has completed three years of supervised clinical experience in radiation oncology, under an authorized user who meets the requirements in G.57, G.690 or equivalent Nuclear Regulatory Commission or Agreement State requirements, as part of a formal training program approved by the Residency Review Committee for Radiation Oncology of the Accreditation Council for Graduate Medical Education or Royal College of Physicians and Surgeons of Canada or the Committee on Postdoctoral Training of the American Osteopathic Association. This experience may be obtained concurrently with the supervised work experience required by G.690.B(1)(b); and (3) Has obtained written attestation that the individual has satisfactorily completed the requirements in G.690.B(1), (2), and C; and is able to independently fulfill the radiation safety-related duties as an authorized user of each type of therapeutic medical unit for which the individual is requesting authorized user status. The attestation must be obtained from either: (i) A preceptor authorized user who meets the requirements in G.57, G.690 or equivalent Nuclear Regulatory Commission or Agreement State requirements for the type(s) of therapeutic medical unit for which the individual is requesting authorized user status; or(ii) 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 G.57, G.690, or equivalent Nuclear Regulatory Commission or Agreement State requirements, for the type(s) of therapeutic medical unit for which the individual is requesting authorized user status, and concurs with the attestation provided by the residency program director. The residency training program must be approved by the Residency Review Committee of the Accreditation Council for Graduate Medical Education or the Royal College of Physicians and Surgeons of Canada or the Council on Postdoctoral Training of the American Osteopathic Association and must include training and experience specified in G.690.B(1) and (2) of this section.C. Has received training in device operation, safety procedures, and clinical use for the type(s) of use for which authorization is sought. This training requirement may be satisfied by satisfactory completion of a training program provided by the vendor for new users or by receiving training supervised by an authorized user or authorized medical physicist, as appropriate, who is authorized for the type(s) of use for which the individual is seeking authorization.10-144 C.M.R. ch. 220, § G-H-690