Nuclear Medicine CQR and Structured Education

Female X-ray technician


To ensure quality healthcare, the American Registry of Radiologic Technologists® (ARRT®) has implemented a system of periodic evaluation consisting of Structured Education and Continuing Qualification Requirements (CQR). Radiologic Technologists certified before January 1, 2011, are not affected by these new requirements. Technologists who were certificate on or after 1/1/2011 receive a time-limited 10-year license. Once the 10 years are up, certification can be renewed for another 10 years by completing the CQR process. In addition, compliance with the ARRT® rules and regulations includes an annual renewal process and biennial continuing education requirements. R.T.®s in Nuclear Medicine require specific CE credits related to their certification. The ARRT® calls this structured education.


The old idea of “once certified, forever qualified” is no longer valid. Advancements in healthcare technology and medical science have made it necessary for R.T.®s to undergo continuing education and assessment to provide quality care to patients and do justice to the profession.

Completing CQR is mainly a quality control method for periodic assessment of skills and knowledge, but it also builds confidence. Time-limited certification ensures accountability and alignment with changing standards. Any gaps in an R.T.®‘s knowledge are identified and skills and experience are compared to peers. Completion of CQR is evidence that an RT is up-to-date on the latest standards and best practices. Here are some important facts about CQR:

  • CQR is applicable to certifications on or after 1/1/2011.
  • CQR must be completed once every 10 years after credentials are obtained.
  • The CQR process can be completed over a period of three years.
  • The Structured Self-Assessment (SSA) is a survey to identify gaps in knowledge; it is not a test.
  • CQR credits can be applied for biennial CE requirements.
  • CQR does not cost the R.T.® any money in most cases.

There are three components of CQR:

  1. Professional Profile: This consists of the R.T.®‘s achievements at work and professional development. This is a reflective exercise that provides the big-picture about how qualifications have been maintained and new skills developed since initial certification. The types of procedures performed and the number of procedures performed is documented for comparison to others in the profession. Based on the answers provided in the professional profile survey, a list of optional clinical education resources is offered. These free resources can address any gaps in knowledge for procedures that the R.T.® does not perform frequently. The resources help prepare the R.T.® for the next stage of the CQR, the structured self-assessment. The professional profile usually takes about 15-20 minutes to complete.
  2. Structured Self-Assessment (SSA). This unique process is not a test and an R.T.® cannot fail the SSA. It is essentially a survey to evaluate the strengths and identify gaps in skills and knowledge related to a credential. SSA is conducted at Pearson VUE centers or can be taken online with a remote proctor monitoring the R.T.® via webcam. The SSA takes approximately 2 hours to complete.
  3. Structured CE. R.T.®s who participate in SSA receive a list of learning opportunities identified by the assessment. The third and final component of the CQR is the completion of prescribed continuing education (CE) activities in the areas identified by the SSA. These activities are likely valid for biennial CE requirements. It may also be possible to distribute the recommended CE credits across two biennium, thereby bringing down additional CE costs.

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In addition to the CQR process which must be completed every 10 years, an R.T.® must complete continuing education requirements every two years, consisting of 24 CE credits (50 credits for R.R.A.s). For Nuclear Medicine R.T.®s, 16 out of the required 24 credits must be directly related to this discipline. CE activities include textbook study, seminars, lectures, classroom learning, and online courses. Some activities are worth more than one credit. CE activities need to be reported every biennium (every two years) as part of the annual renewal process. The dates for the annual renewal and CE biennium deadline are separate.

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The Nuclear Medicine Technology Certification Board (NMTCB) offers certification exams and certification renewals. To be awarded certification, R.T.®s are tested on their knowledge of radiation physics and detection, radiation safety and regulations, radiopharmaceutical and pharmaceutical agents, operation of instruments, quality control, and clinical procedures.

(See for details).

What you need to do:

R.T.®s certified in 2010 or earlier don’t need to do anything.
R.T.®s certified in 2011 or later need to watch out for CQR .
R.T.®s planning to pursue additional credentials with the ARRT®‘s postprimary pathway need credits approved in specific categories.

The CQR compliance window starts seven years after certification. For example, if an R.T.® earned their certification in 2012, the compliance phase will begin in 2019 and the technologist will have three years to complete the professional profile, structured self-assessment, and targeted continuing education by 2022, in time for the 10-year CQR.

Learn more about ARRT® Examination Content Specifications and CQR Structured Self-Assessment Content Specifications.