According to NRC 10 CFR part 35.690, if you are not a board certified radiation oncologist, the law requires that you have the following training in order to be listed as an AU in the HDR material license and to treat patients with HDR independently:

You must have completed a structured educational program in basic radionuclide techniques applicable to the use of a sealed source in a therapeutic medical unit that includes:

(i)  200 hours of 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; and
(D) Radiation biology; and

ii) 500 hours of work experience, under the supervision of an authorized user who meets the requirements in §35.690 or, equivalent Agreement State requirements at a medical institution, involving—
(A) Reviewing full calibration measurements and periodic spot-checks;
(B) Preparing treatment plans and calculating treatment doses and times;
(C) Using administrative controls to prevent a medical event involving the use of byproduct material;
(D) Implementing emergency procedures to be followed in the event of the abnormal operation of the medical unit or console;
(E) Checking and using survey meters; and
(F) Selecting the proper dose and how it is to be administered;
(G) Device operation
(H) Safety procedures for the device use
(I) Clinical use of the device

For more information, visit: http://www.nrc.gov/reading-rm/doc-collections/cfr/part035/part035-0690.html

Considering the above guidelines, these are some useful tips to the following groups of individuals:

For ASTRO: Inform all the Radiation Oncology Residency Program Directors about the law.

For Residency Program Directors:  If you don’t have an HDR in your facility, try to get one. HDR training should be a part of every physics residency program.

For Residents: If your program does not have an HDR after-loader or offer HDR after-loader training, make arrangements with sites nearby that possess an HDR after-loader and arrange to complete your 500 hours training there during your residency program.

For Medical Physicists: Share this information with your radiation oncologist colleagues. If you are responsible for amending the material license and are expecting a new radiation oncologist to join the group, be sure he or she has all the relevant paper work (documenting the necessary training) available before leaving his/her institution.

Finally, there is a similar law for medical physicist to be listed as an Authorized Medical Physicist that was previously posted on this blog. Click on this link for further information.

SEC. 135. IMAGING PROVISIONS.

(a) Accreditation Requirement-

(1) ACCREDITATION REQUIREMENT- Section 1834 of the Social Security Act (42 U.S.C. 1395m) is amended by inserting after subsection (d) the following new subsection:

(e) Accreditation Requirement for Advanced Diagnostic Imaging Services-

(1) IN GENERAL-

(A) IN GENERAL- Beginning with January 1, 2012, with respect to the technical component of advanced diagnostic imaging services for which payment is made under the fee schedule established under section 1848(b) and that are furnished by a supplier, payment may only be made if such supplier is accredited by an accreditation organization designated by the Secretary under paragraph (2)(B)(i).

(B) ADVANCED DIAGNOSTIC IMAGING SERVICES DEFINED- In this subsection, the term ‘advanced diagnostic imaging services’ includes–

(i) diagnostic magnetic resonance imaging, computed tomography, and nuclear medicine (including positron emission tomography); and…

The Intersocietal Accreditation Commission (IAC) in an article in their Autumn 2008 newsletter wrote that they were very pleased by the passage of this bill. They stated: “This powerful legislation includes a provision requiring the accreditation of imaging facilities as well as the elimination of a scheduled 10.6% payment cut for physicians.” 

In another paragraph they wrote: “The passage of this bill marks a turning point in recognizing the importance of quality standards and accreditation for medical imaging on a nationwide basis. The portion of the legislation requiring accreditation stipulates that the accreditation programs must evaluate that physicians and staff maintain the proper level of training and education; that laboratories use imaging equipment which adheres to strict standards of performance and operates under proper safety guidelines; and that all laboratories establish and maintain a quality assurance program, thereby upholding the standards of quality care for patients, particularly senior citizens.” Here is a link to the IAC website: www.intersocietal.org.
 
The passage of this bill is also a good news for the Medical Physics community, especially for those of us who are Diagnostic Imaging physicists. The question, however, is whether there will be enough qualified diagnostic medical physicists in 2012 to provide this service on a national basis? So if you are a medical physics student and have yet to choose your area of speciality, this seems to be an opportune time to be a diagnostic imaging physicist.

http://www.nrc.gov/reading-rm/doc-collections/cfr/part035/part035-0051.html

I found this link to be quite useful, and I refer to it many times, so I am putting it here for your reference. This is especially useful for and applicable to new physicists who need to do HDR or for the RSOs who need to amend the material license to include new physicists in the license. I am guessing that all the agreement states have adopted this regulation from the NRC (or something similar to it).

Further, if you are changing your job and are already listed as an AMP in the material license in your present job, it’s important to take a copy of the material license with you to your new job! Believe me, this will save you, the RSO, and the institution a lot of time and possibly spare all of you a headache.