The nuclear cardiology fellowship program is accredited by the ACGME and endorsed by the American Board of Medical Specialties (ABMS), American College of Cardiology (ACC) and American Society of Nuclear Cardiology (ASNC). Fellows will reach the ACC Core Cardiology Training (COCATS) Level II, providing attestation for meeting the requirement for authorized user status regarding nuclear cardiology procedures according to the Nuclear Regulatory Commission (NRC) and Certification Board of Nuclear Cardiology (CBNC).  This fellowship is currently only offered to WashU Medicine cardiology fellows.

Level II training provides trainees with expertise to practice clinical nuclear cardiology as a subspecialty by providing training and supervision for performing and interpretating the following: myocardial perfusion single-photon emission computed tomography/computed tomography (SPECT/CT) and/or positron emission tomography/computed tomography (PET/CT); cardiac function assessment with gated SPECT and/or PET; and gated equilibrium radionuclide angiography, as well as other conventional and PET cardiac imaging such as amyloidosis, viability and sarcoidosis. Additionally, Level II training will provide the requisite training for clinicians to learn emerging nuclear cardiology procedures with appropriate additional clinical training and experience.

The requirements for COCATS level II are based in part on National Regulatory Commission (NRC) regulations are the following:

• At least 4 months of training
• Minimum of 700 hours of work experience in nuclear cardiology, inclusive of radiation safety
• Didactic instructions/lectures, clinical study interpretation and hands-on involvement in clinical cases

To qualify to become authorized users of radioactive materials for Level II in accordance with the regulations of the NRC and/or the Agreement States, the required training includes clinical skills, knowledge and hands-on experience in radiation safety.  Classroom and laboratory training needs to include extensive review of radiation physics and instrumentation, radiation protection, mathematics pertaining to the use and measurement of radioactivity, chemistry of byproduct material for medical use, radiation biology, effects of ionizing radiation, and radiopharmaceuticals.