Those sitting for the Certification Board of Nuclear Cardiology (CBNC) exam include people from very different backgrounds including cardiologists, radiologists, and nuclear medicine physicians. Therefore, there is no cookie cutter approach to studying for the nuclear cardiology boards. If you are a cardiologist, you may need to focus more on imaging, physics, and radiation safety whereas if you are a radiologist or nuclear medicine physician, you may need to focus more on reading EKG’s and the clinical aspects of cardiology associated with nuclear stress testing. Regardless of your background, we all have one goal in common: to pass the exam.
Some physicians (such as medical residents) currently have a daily opportunity to review and interpret scans under the tutelage of certified physicians. They will also have the ability to shadow technologists to view every step of image acquisition and processing, whereas other physicians may not have the same opportunities and must rely more on books and nuclear cardiology board review questions. It is best to get your hands on as much information as possible whatever your particular scenario may be.
Talking to other imaging physicians, referring physicians, cardiologists, technologists, pharmaceutical representatives, and even patients is very helpful in understanding all aspects of nuclear cardiology and the various types of stress tests which may be performed. It is essential to understand protocols, tracers, software, and hardware being used at your site as well as sites other than your own, since these topics are all fair game for board questions. For example, understanding cardiac PET/CT or SPECT/CT may be necessary even if it is not performed at your institution. Recently in nuclear cardiology there has been a shift to emphasis on new hardware (i.e. solid state detectors), new software (i.e. wide beam reconstruction), and novel tracers (Flurpiridaz F18) which can minimize radiation dose to the patient, minimize imaging time, and improve image quality. Therefore reading recent nuclear cardiology articles in journals accessible to you may be helpful.
If I had to narrow it down to one sentence, I believe that the most important part of the nuclear cardiology boards is to understand imaging protocols (including indications and contraindications), radiotracers (half lives, metabolism, and excretion routes), and imaging artifacts (false positives and false negatives). Let’s be reasonable. We all have time constraints and our time is valuable and therefore we need to make the best of it. One of the best places to start your CBNC studies is to review the CBNC website in depth. There is an exam content outline, which will help you to focus your efforts. In addition, Prometric testing offers a “test drive” which allows candidates to schedule a generic sample test at a testing center (for a fee) where you will be able to go through the Prometric scheduling, registration and check-in process and will be able to participate in a 15 minute sample test that introduces electronic testing utilities that examinees will encounter during the exam. This may eliminate some of the unfamiliarity or anxiety during an actual exam. The certification exam is composed of up to 175 multiple-choice questions. Examinees will have four and one-half hours to complete the exam without any scheduled breaks. Time is usually not an issue for most people. My last piece of advice is to know yourself and know your strengths and weaknesses. Best of luck!
About the author: Dr. Wosnitzer is a nuclear medicine physician with board certifications in nuclear medicine and nuclear cardiology. He currently practices at a private imaging center in New York with interests in neurodegenerative diseases, cardiac imaging, and bone health.
BoardVitals offers a Nuclear Cardiology question bank with 300 board review questions written and reviewed by physicians who have recently taken the exam.