The RRC for Diagnostic Radiology requires 3 months of breast imaging.  The latest RRC regulations state “There must be a minimum of 12 weeks of clinical rotations in breast imaging.  Each resident should have documentation of the interpretation/multireading of at least 240 mammograms within a 6-month period within the last 2 years of the residency program.”  The RRC regulations are posted on the ACGME website as “Effective 7/01”, with several editorial changes since.  The exact date when the 12 week requirement went into effect is not noted.  It is expected that all residents who graduate in 6/06 or later will have three months of breast imaging.  Because MQSA governs x-ray mammography experience, it is expected that all breast imaging rotations will include mammography.

The Mammography Quality Standards Act (MQSA) regulations are more complicated and depend upon whether or not the resident passes their board examinations on their first attempt.  If a resident conditions any section of the oral board examination, the FDA considers this as not having passed the board examination on the first attempt.  Therefore, the resident falls into category C.b, below.  This is difficult to predict for any resident, so it is prudent to give the residents the experience necessary should they condition any section or fail their oral examination.  However, it may be difficult to incorporate a breast imaging rotation into the last six months of every resident’s schedule.

Residents completing radiology residency must fulfill the following requirements as initial qualifications for interpreting mammograms:
 (A) Be licensed to practice medicine in a State.
 (B) Have a minimum of 60 hours of documented medical education in mammography, which shall include: Instruction in the interpretation of mammograms and education in basic breast anatomy, pathology, physiology, technical aspects of mammography, and quality assurance and quality control in mammography. Hours spent in residency specifically devoted to mammography will be accepted if documented in writing by the appropriate representative of the training institution.
(C) Be board certified in Diagnostic Radiology. 
            a) If the radiologist has become appropriately board certified at the first allowable time, they must have interpreted or multi-read at least 240 mammographic examinations under the direct supervision of an interpreting physician in any 6-month period during the last 2 years of a diagnostic radiology residency.
            b) If they are not board certified at the first allowable time, the radiologist must have interpreted or multi-read at least 240 mammographic examinations within the 6-month period immediately prior to the date that the physician qualifies as an interpreting physician. This interpretation or multi-reading shall be under the direct supervision of an interpreting physician.

There are alternate pathways for those who are unable to become board certified (refer to www.FDA.gov for these MQSA regulations.