Nuclear Subspecialty App

Nuclear Radiology Subspecialty Application
Before you begin this form

You must have the following documents scanned and saved to your computer, as you will need to attach these within the application. You cannot save the application and return to it later:

If applying via the Standard/Fellowship Pathway:
- A copy of your fellowship certificate or an official letter (on letterhead) signed by your program director, documenting your ACGME-accredited nuclear radiology fellowship training, including dates.
If applying via the Alternate/Practice Pathway:
To be eligible for nuclear radiology subspecialty certification via this pathway, the institution must have either an ACGME- or RCPSC-accredited nuclear medicine residency (fellowship), nuclear radiology fellowship, or an established 16-month ABR Pathway in Nuclear Radiology for its diagnostic radiology residency or integrated interventional radiology residency.
- An official letter (on letterhead) signed by your department chair documenting your faculty experience. An official letter (on letterhead) from your department head, documenting your post-training practice experience, with dates and percentage of time devoted to the subspecialty.
  - two consecutive years at 1.0 FTE, with at least 75 percent of clinical responsibility in the discipline,
    or
  - or at a single institution for three consecutive years at 1.0 FTE, with at least 50 percent of clinical responsibility in the discipline.
- Note: Part-time diplomates working ≥ 0.6 FTE are also eligible. Please contact an ABR certification manager at information@theabr.org for details.
Application & Exam Fees

Note: Candidates taking the September 2022 Diagnostic Radiology (DR) or Interventional Radiology/Diagnostic Radiology (IR/DR) Certifying Exam can apply for the January 2023 Nuclear Radiology Exam. The application will be held for review/processing once the DR and IR/DR Certifying results are available.
- If you were previously approved by the ABR or the Nuclear Radiology exam, please contact the office at 520-790-2900 for instructions. This application is only for first-time applicants.
- Within 7-10 business days after submitting your application, you will receive an email from ABR staff notifying you that your application has been received, and instructions on paying the $640 application fee via myABR.
- Once the application fee has been paid, your application will be processed and reviewed.
- If your application is approved, you will receive an email notifying you of the approval, and instructions on paying the $1280 exam fees via myABR. The exam fee must be paid in order to register for the exam.
- If your application is not approved, you will receive an email outlining the reason your application was not accepted. You would then re-apply in the future when you meet the application requirements.
More information is available on the ABR website:
- Requirements and Registration
- Dates, Locations and Fees
Name *

First Name Middle Name Last Name
ABR ID *
Street Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *

Area Code Phone Number
Email *
example@example.com
When did you receive your primary radiology certification?
Month/Year
My name at the time of this certification was: *

The same Different
If different, what was your name?
Before submitting an application, you must have attested in myABR to completion of the following MOC parts:

o Part 1: Professionalism and Professional Standing (state medical license)
o Part 2: Lifelong Learning and Self-Assessment
o Part 4: Improvement in Medical Practice (practice quality improvement project or activity)
I have completed my MOC attestations. *

Yes No

Please indicate the pathway under which you are applying and fill out the appropriate section below: *

Standard Pathway Alternate Pathway

Fellowship Program (Standard Pathway Only)
Institution *
City and State *
Began Fellowship *

Month Day Year
Date
Completed Fellowship *

Month Day Year
Date
Please list contact information for the program director of your nuclear radiology fellowship:
Name *

First Name Last Name
Phone Number

Area Code Phone Number
Email *
example@example.com
Submit one official letter (on letterhead) from your program director, documenting your ACGME-accredited nuclear radiology fellowship training, including dates, or submit a copy of your fellowship certificate. *

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Cancel of

Faculty Program (Alternate Pathway Only)
Please list contact information for the chair of your department:
Name

First Name Last Name
Phone Number

Area Code Phone Number
Email *
example@example.com
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Faculty Member Experience (Alternate Pathway Only) *

	Institution (Please list current institution first.)	City/State	Average hours per week or percentage of time in n uclear	From	To
A
B
C
D

Submit one original letter (on letterhead) from your department chair, with dates documenting your faculty experience and percentage of time spent in nuclear radiology. *

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Cancel of

PLEASE READ CAREFULLY BEFORE SIGNING

Agreement for Candidates and Diplomates
Should be Empty:

Nuclear Radiology Subspecialty Application

Fellowship Program (Standard Pathway Only)

Faculty Program (Alternate Pathway Only)

PLEASE READ CAREFULLY BEFORE SIGNING