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ERC

GENERAL OBJECTIVES:

On completion of this rotation, the resident will have learned best practices in the basic sciences related to single photon (SPR) and positron emitting (PER) radiopharmaceutical sciences.  The resident should have a working knowledge and understanding of the instrumentation and procedures related to radiation protection and safety, radiopharmaceutical production techniques and processes, radiopharmaceutical and instrument quality assurance practices and related professional, ethical and regulatory standards. 
 
The resident will demonstrate the ability to:
1.            select the appropriate instrumentation for monitoring radiation safety,
2.            select the appropriate methodology for quality control of a radiopharmaceutical,
3.            evaluate the quality control data determining an acceptable radiopharmaceutical,
4.            select the appropriate methodology for determining acceptable function of radiation safety and quality control instrumentation
5.            understand how the Canadian Nuclear Safety Commission (CNSC) regulations impact the operation of a radiopharmacy/nuclear medicine department
6.            understand how the Health Canada (HC) regulations impact the operation of a radiopharmacy/nuclear medicine department
7.            understand how the Transport Canada (TC) regulations impact the operation of a radiopharmacy/nuclear medicine department
 
At the beginning of the rotation each resident will be given:
 
1.            An introduction to the ERC
2.            A resident schedule
3.            A list of clinical competencies for Nuclear Medicine Residents
 
 
 
 
 
Prerequisites:
 
·         Residents should have a fundamental knowledge of basic nuclear medicine imaging procedures and basic knowledge of the common SPR and PER radiopharmaceuticals available in the Edmonton region, equivalent to one full year of training in general nuclear medicine. 
 
 
SPECIFIC OBJECTIVES
 
 
At the completion of this rotation, the resident will have acquired the following competencies and will function effectively as:
 

Medical expert/clinical decision-maker

 
            Specific Requirements:
 
Basic science knowledge:
 
·         Have a basic understanding of the chemistry fundamentals involved in the preparation of SPR and PER radiopharmaceuticals.
 
·         Have a basic understanding of the chemistry fundamentals involved in the quality control procedures of SPR and PER radiopharmaceuticals.
 
·         Have a basic understanding of the function and operation of instruments used in radiopharmacy (i.e. dose calibrators, gamma counters, chromatogram scanners, and survey meters).
 
·         Have an understanding of the radiation safety principles behind the As Low as Reasonably Achievable (ALARA) concept.
 
·         Have an understanding of the major radiopharmaceuticals used in everyday practice.
 
Regulatory Knowledge:
 
 
1.    Understand the CNSC regulations governing facilities handling open source radionuclides.
2.    Understand the HC regulations governing facilities responsible for radiopharmaceutical preparation.
3.    Understand the regulations for transportation, shipping and receiving of class 7 dangerous goods.
 

Communicator

 
Specific Requirements:
 
·         Have the ability to evaluate quality control data, compare to specifications and recommend next steps in event of Out of Specification (OOS) products.
·         Have the ability to recognize and correct unsafe laboratory practices.
·         Effectively work with others, in a laboratory setting, in a safe and productive manner.
 

Collaborator

 
Specific Requirements:
 
·         Consult effectively with other physicians and health care professionals.
·         Have the ability to function as a member of a multidisciplinary health care team.
·         The resident should be able to effectively supervise technical staff.
 

Manager

 
Specific Requirements:
 
·         Understand quality assurance issues related to the daily routine operation a radiopharmacy, including, but not limited to, radiopharmaceutical preparation and related instrumentation.
·         Understand quality assurance issues related to radiation protection, including, but not limited to, handling open source radionuclides and related instrumentation.
·         The resident should understand the daily workflow related to radiopharmaceutical preparation in a small radiopharmacy or nuclear medicine department.
 

Health Advocate

 
Specific Requirements:
·         Describe and explain the benefits and risk of diagnostic and therapeutic radionuclides and radiopharmaceuticals.
·         Educate and advise on the use and misuse of open source radionuclides.
 

Scholar

 
Specific Requirements:
·         Competence in evaluation of the medical literature.
·         Demonstrate ability to be an effective teacher to medical students, fellow residents, technologists, and clinical colleagues.
 

Professional

 
Specific Requirements:
·         Punctuality, attendance, reliability and respect in the workplace.
·         Be able to accurately assess one’s own performance, strengths, and weaknesses.
·         The resident should be aware of his/her own limitations, especially with initial interpretation of clinically relevant radiopharmaceutical quality control results.  The resident should recognize the need to call for help when appropriate.
 
ROTATION DUTIES FOR RESIDENTS
 
SPR Preparation
 
1.    The resident will participate in the preparation of practice and selected clinical radiopharmaceuticals.
2.    The resident will participate in the quality control of practice and selected clinical radiopharmaceuticals.
3.    When scheduling permits, the resident will observe the of radiopharmaceutical kit manufacture (Clean Room).
4.    When scheduling permits, the resident will observe the quality control of radiopharmaceutical kit manufacture (Chemistry Department).
5.    The resident will participate in the area and environmental radiation monitoring of the designated radiation areas.
6.    The resident will participate in the preparing documentation and packaging of radiopharmaceuticals for transport.
 
PER Production
 
1.    The resident will observe the preparation of the automatic synthesis units for FDG and NaF production.
2.    The resident will participate in the quality control of practice and selected clinical PERs.
3.    When scheduling permits, the resident will observe the production and quality control of selected research PERs.
 
 
RESIDENT EVALUATIONS
 
The Resident’s day-to-day performance will be evaluated.  The end of rotation evaluation will be done by a committee of the Radiopharmacy Director or designate and technologists involved with the rotation during the month.  It is the responsibility of the Resident to ensure that the end of rotation evaluation is both completed by the committee and reviewed with the Resident by the nuclear medicine supervisor within two weeks of completing the rotation.  
 
SUGGESTED READING:
 
·         Please see other program documents regarding reading list.