EACVI/EANM Certification in Nuclear Cardiology (NC)

• Cardiovascular Imaging Recommended Reading
• EACVI webinars (live, online seminars)
• Educational and preparatory courses organised by, or in collaboration with, the EACVI
• EACVI core syllabus
• EACVI textbooks and an ESC textbook on imaging 

Exam results

The passing score of the exam is established using referenced methodologies, that are widely used in the certification. The passing score links the score required to pass the exam to the minimum level of knowledge required for nuclear cardiology practice.

Following the exam, psychometric analysis of the questions is conducted and items that do not meet psychometric standards are removed from the exam. In addition, any items that have been flagged during the exam administration are reviewed and if these items are deemed to be defective for any reason they are removed from the exam.

Results are subjected to multiple levels of verification before being reported to candidates.

Examination results are communicated to candidates in the eight weeks after the examination.

Candidates will receive an email containing their results letter on the date of the result release. Successful candidates for the exam will also receive a certificate of completion of the written exam.

The candidate’s results are also made available through the candidate’s My ESC account.  

Appeal

ESC/EACVI aims to deliver examinations of the highest quality and provide the best level of service for all candidates. To ensure that all candidates are assessed fairly, there is a procedure to allow candidates to appeal against their exam results.

Please find more information here.

Policies for Online Proctoring Examinations

For more information, please refer to the ESC online proctoring examination terms & conditions. 

Logbook

Once candidates have passed the exam, they can then apply for the logbook part of the programme to prove their practical experience in the nuclear cardiology field. No late submissions will be accepted and, if the deadline is not respected, the candidate will have to repeat the exam to apply for certification.

Eligibility

The EACVI/EANM NC logbook part of the programme is accessible to all successful candidates for the exam. 

Access to the logbook platform is granted to candidates only after having successfully passed the written exam.

Requirements

Candidates should possess the necessary level of knowledge, practical experience, and skills to deliver a safe and effective clinical service in nuclear cardiology, including justification and authorisation of referrals, supervision of cardiovascular stress tests and image acquisition, and independent reporting of the findings. You should be authorised to do so in the course of your primary employment. If you are not currently employed or practicing in nuclear cardiology, you should have been engaged in this field for at least one year within the past five years.

Candidates must provide the following documents:

• A signed supervisor letter confirming the appropriate level of knowledge, skills and practical experience of the candidate
• 10 clinical reports of unknown studies (refer to the section below for more information)
• A letter from the supervisor confirming the authenticity of reports and ensuring that they were generated by the candidate alone without consultation or second opinion. 

Note: 

• The letter can optionally be expanded with additional information that is considered relevant to the candidate's practice. Examples of this might be the number of studies that the candidate has performed annually, details of teaching, training and research activity, if any, etc.

Clinical reports of unknown studies

Candidates are requested to download planar projection data for 10 nuclear cardiology studies (provided in the logbook platform), to reconstruct and view the data using whichever hardware and software is available to the candidate routinely, and to upload clinical reports.

The reports will be scored independently for accuracy by at least two examiners who deem their interpretation of the findings to be “correct”.

The primary consideration will be whether the study is normal or abnormal, with abnormal subdivided into inducible perfusion abnormality, myocardial scar, or a combination of the two. Consideration will be given to a description of the site, extent and depth of abnormalities, and also to a description of LV function and regional myocardial motion and thickening assessed from the ECG-gated images. Allowance will be made for different processing techniques providing different values for LVEF. The report conclusion should contain clinically relevant statements that answer the question raised by the study indication. In case of doubt, the report conclusion should suggest the most likely finding and should try not to be equivocal.

Note: These studies should not be shared or made public. Any discrepancy to this rule will lead the candidate to fail his/her Nuclear Cardiology Certification. 

Data format and handling

The planar projection data to be downloaded consists of four DICOM files for stress and rest MPS studies, each with summed and ECG-gated data to allow reconstruction of perfusion and LV function images respectively. The file names and DICOM header should make it clear which dataset is which. All MPS studies have been acquired using a conventional gamma camera with two heads positioned at 90° and acquired over 180° from RAO to LPO. The matrix size and image scaling will be apparent from the DICOM header if required.

Candidates may seek assistance from a colleague with the downloading and reconstruction of the data, but the studies should be viewed and reported by the candidate himself/herself without assistance or a second opinion as if the candidate is reporting clinical studies alone. Candidates can use motion correction if available but it will not be possible to use more advanced techniques such as resolution recovery or attenuation correction. In some cases, comments are provided with the findings after attenuation correction.  

The examiners will use their best endeavours to answer technical questions concerning the studies but will not provide assistance locally for data handling or processing.

Report Template

Candidates must use the report template provided in the platform. This contains patient demographic information, presenting clinical information, imaging protocol, and findings during stress. The report fields for findings and conclusions are to be completed by the candidate. Once completed, the candidate should upload the report in PDF or DOCX format. 

Scoring of reports

Each report will be reviewed and scored by at least two examiners. They will use the following scoring rule:

• Score 3: Correct conclusion containing all clinical relevant findings from the study.
• Score 2: Correct conclusion but missing some clinically relevant findings, or where there may be clinically unimportant differences with the examiners’ opinions.  An example might be inferior attenuation reported as scar, or vice versa, or where clinically unimportant inducible perfusion abnormalities are not mentioned.  
• Score 1: An example might be not mentioning a mild regional wall motion abnormality or a mild inducible perfusion abnormality that is likely to be treated medically.
• Score 0: Incorrect conclusion that is likely to affect patient management. An example might be reporting a normal study as abnormal or vice versa.

Not complying with the below regulations will result in the logbook being returned to the candidate for modification and as such, delay the grading process.

• The application must be submitted in English. 
• The application must not include any patient data, to comply with GDPR. 
• The application must be submitted no later than two years after having received the exam results. 
• The candidate is asked to use the 10 nuclear cardiology studies provided on the platform. In any case, the candidate should use his/her studies. 

Both the supervisor and the candidate are fully responsible for providing the correct information. 

Supervisor

The supervisor should be someone who has known you professionally for at least one year in the past five years and who is a trainer, supervisor, mentor, manager or colleague. They should themselves currently be authorised to provide a nuclear cardiology service independently in the course of their primary employment. The supervisor does not need to be EACVI/EANM certified, and the candidate does not need to upload any documentation regarding the supervisor’s qualifications. 

The supervisor should be prepared to be contacted to confirm that the authenticity of his/her statement.

The supervisor needs to provide a letter of support, certifying the accuracy of the application content and that the candidate has done all the procedures listed in the logbook.

Logbook results

As soon as the logbook is compliant with the requirements, the application is sent for grading to members of the EACVI/EANM NC Certification Committee. Graders may require additional information from the candidate to provide their grading. 

Results are sent by email within three months of submitting the e-Logbook. Please note that some delays in grading can occur due to the high volume of applications received throughout the year. 

Appealing the logbook

Candidates who fail to complete the logbook part may raise an appeal.

Please find more information here.

There is a two-year window to complete the logbook part of the programme. In exceptional circumstances, candidates may request an extension to submit their application.

To ensure the process remains fair and robust, extensions will generally only be given in the following circumstances: parental leave, less than full-time work or illness of the candidate.

Extension requests must be accompanied by a signed letter from your supervisor briefly explaining the situation and stating the duration of the extension required. Requests cannot be considered without this letter. The request must be submitted before the deadline.

Please note that extension requests are not guaranteed and are reviewed on a case-by-case basis by the certification committee.    

Use the “Contact Us” to submit such requests and further information.

Recertification

EACVI/EANM NC recertification is not yet available. Once the recertification process is established, eligible candidates will be contacted in due course, and sufficient time will be provided for the application. You will not need to retake the exam. 

Certification result and list of certified candidates

Candidates will be granted certification in nuclear cardiology once they have completed the two parts of the programme (exam and logbook). The certification is valid for five years after which the candidate must apply for recertification to keep the certification valid. 

EACVI is pleased to list all their NC certified candidates.