The Mammography Quality Standards Act (MQSA) guidelines require 25 supervised mammography clinical exams in order to achieve your mammography clinical requirements. This is a mandatory prerequisite for achieving certification as a Radiologic or Mammography Technologist. Therefore, one of the biggest concerns of prospective students who wish to enter this field is understandably where they are able to obtain these 25 essential exams and whether or not the course that they are taking includes clinical training.
Clinical experience is an important step on the pathway to obtaining an American Registry of Radiologic Technologists (ARRT) credential, once you have achieved ARRT approved formal mammography training. This may be in the form of an Associate of Applied Science in Radiologic Technology, or a Post-Associate Mammography Certificate Program. In order to successfully complete your clinical experience requirements, it is required that you perform and document a specific number of clinical procedures before you can apply for your certification. In our guide, we are going to take you through where you can obtain your mammography hours, and if they are limited only through post-secondary education programs.
What Are the Requirements to Perform Mammography Independently?
Under the MQSA regulations, you do not need to be ARRT-Registered in Mammography (otherwise known as obtain an “M”) to perform mammography independently. You do need to be a licensed x-ray technologist who has obtained 40 hours of mammography continuing education and performed your required 25 mammograms in the presence of a qualified mammographer. The 25 supervised mammograms will count as 12.5 hours toward the 40 required. Your state may require you to obtain your “M” in order to perform mammography, however, this is usually an employer/faculty issue and not a state issue. You are more likely to be hired by an employer to perform mammograms if you are ARRT-registered.
What is the Purpose of Obtaining My Mammography Clinical Hours?
Candidates who are applying for certification and registration to work as a Mammographer or Radiologic Technologist Technician must meet the Professional Requirements specified in the ARRT Rules and Regulations.
The purpose of obtaining the 25 required clinical exams is to verify that the candidates have not only completed a subset of the clinical procedures within a discipline, but that they are successfully able to perform these fundamental procedures. The successful completion of clinical exams also proves that the candidate in question has mastered the knowledge and cognitive skill necessary in order to successfully complete their examination. Clinical hours provide the basis for a successful workplace setting once certification is complete, and the assurance that the applicant has acquired the full range of clinical skills that are needed in a variety of settings.
What Are the Requirements for Completing My Mammography Clinical Hours?
The clinical requirements for successful completion of the required mammography clinical hours are periodically updated. This is based upon a practice analysis, which regularly examines the job responsibilities typically required of mammographers. After collecting their data, an advisory committee determines the number of clinical procedures that are required in order to demonstrate that the candidates have received adequate experience in performing the tasks required of the profession.
Currently, the ARRT’s Mammography Clinical Experience Requirements detail that 25 clinical exams must be documented as part of the application for certification and registration process. These 25 mammography clinical exams must be performed no more than 24 months before you submit your application in order to achieve your certification.
Completing Your Clinical Hours as a California Resident
It is important to note that if you are a resident of California and plan on entering mammography in California, you must also perform 25 supervised mammograms under direct supervision of a qualified mammographer under MQSA regulations. However, you must not perform your 25 supervised mammograms until you have taken, and passed the California Certification exam, unless you are enrolled in an approved x-ray school program.
How Many Repetitions of Each Procedure is Required?
Candidates for Mammography certification must perform a minimum of 75 repetitions of the various mammography procedures outlined below. These procedures are then documented, verified, and submitted through the ARRT’s online portal. While these are the minimum requirements for obtaining your certification, the ARRT still encourages candidates to reach beyond these minimum requirements in their education and experience.
The successful completion of each procedure has to be verified by either a certified and registered supervising mammographer, a Mammography Quality Standards Act (MQSA) qualified supervising mammographer, or an MQSA qualified interpreting physician.
Specific Procedural Requirements for Completing Mammography Clinical Hours
In order to receive your 25 required clinical exams, specific procedures must be performed as outlined by the ARRT and the MQSA. By laying out the exact procedures that are required, the ARRT is then able to confirm that the applicant has, without question, obtained the skills necessary in order to practice as a certified Mammography or Radiologic Technician. It is not enough to simply shadow a practicing professional and not perform the necessary procedures.
Initial MQSA Requirements
All candidates must meet all initial MQSA requirements, which are outlined by the FDA MQSA. These include, but are not limited to, the completion of 25 directly supervised mammograms. The FDA requires that they then be documented and verified via the online tool, however the ARRT does not require online entry of these 25 mammograms, but rather confirmation that the candidate is MQSA compliant. You may check this in the policy guidance help system.
Mammographic Imaging Requirements
The candidate must also perform mammographic imaging in the form of screening and/or diagnostic on 75 patients. These particular 75 mammograms are on top of the 25 mammograms that are required by the initial MQSA requirements, and must be performed on patients – meaning, they cannot be simulations of any kind. These mammograms must address the following tasks, which can be found in their entirety on the ARRT’s Mammography Clinical Experience Requirements.
Patient Preparation/Education Tasks
The candidate must be documented as having familiarized the patient with the equipment and process when receiving a mammogram, stressing the need for compression and by providing general psychological support. Preparation and education tasks also include thoroughly documenting relevant patient and family clinical history, documentation of the location of concerning areas of the breast, and the capability to thoroughly respond to patient’s questions regarding the procedure.
Mammographic Imaging Tasks
The candidate must be documented as having the capability to select the appropriate equipment for the patient, as well as which tasks need to be performed. Mammographic imaging tasks also include adjusting exposure factors, the correct positioning of the patient, and evaluating the images to ensure that they are of diagnostic quality for the doctor to examine.
Quality Control (QC)
The candidate is required to participate in the performance, evaluation, and recording of all Quality Control tests. The QC tests that will be performed are indicated in the 2018 ACR Digital Mammography Quality Control Manual or may also be according to equipment manufacturer’s recommendations. This will include the quality control of phantom image quality, compression thickness indicator, and compression force.
Mammographic Image Evaluation
The candidate must, in collaboration with an MQSA qualified interpreting physician, review a minimum of 10 mammographic cases for breast anatomy, pathology, and image quality. They must also establish corrective action, as per EQUIP (Enhancing Quality using the Inspection Program) regulations. It is also important that a candidate obtain shadowing experience for mammography.
Obtaining Hours When Working in A Digital Mammography Center
In the case of employment in a digital mammography unit, you can obtain your 25 supervised mammograms on either a digital or an analog unit. Before you can perform mammograms on a digital mammography unit, you must have obtained 8 hours in digital mammography training, which is not required to be hands on.
Are There Daily Limits for the Number of Hours I Can Report?
There are limits to the number of clinical experience entries you can report for each day. Studies have shown that candidates are able to learn more effectively when participating in a larger number of shorter clinical training sessions over a longer period of time, rather than fewer, longer sessions over a short period of time. For that reason, the number of clinical experience hours you can report each day are limited.
The limits given are dependent on the discipline. In the case of the 75 mammographic imaging requirements, there must only be a maximum of 16 entries recorded per day.
Can I Receive My Clinical Hours Through My Associate or Post-Associate Program?
Now that we’ve established what your mammography clinical hours are and the purpose they serve in your certification, it’s important to understand where you are eligible to receive your mammography clinical hours. The vast majority of physically attended Associate of Applied Science in Radiologic Technology and Post-Associate Mammography Certificate Programs will offer clinical placement at their partnering facilities in order to complete your hours under clinical supervision. Not having to worry about where you will receive your clinical hours is a great benefit of attending a program that already offers this crucial step in completing your candidacy as a Mammography/Radiologic Technologist.
Where Can I Get My Mammography Clinical Hours If I’m Taking an Online Program?
Attending an online program can be a great option for those who opt to complete their clinical practicum from home. However, the process in completing your mammography clinical hours is not always straightforward when you choose to participate in an online program. There are three approved options when it comes to receiving your mammography clinical hours when taking an online course, with some being more difficult to obtain than others.
Complete Your Hours with Your Current Employer
Obtaining your hours by way of your current employer is a highly popular option, which of course will only be possible if you are already working as a Radiologic Technologist or another related modality and are beginning your cross training in mammography. In this case, you will be eligible and able to receive your clinical hours at the hospital or clinic you are already employed at, making getting your mammography clinical hours much more convenient.
Find a Clinical Site to Complete Your Hours
This option is the most uncommon for those looking to obtain their clinical hours, as the majority of mammography clinics do not allow non-employees to perform mammograms, regardless of if they are under supervision by a certified and registered supervising mammographer or other similarly qualified professional. This is due to the fact that allowing a non-employee to perform these crucial procedures is considered a huge malpractice liability, never mind those who have yet to receive their certification.
In the case that a candidate is able to find a mammography clinic or hospital that will allow you to complete your clinical hours on their premises, there will be a number of requirements for you to be able to legally do so. This will include paying for and passing a background check, acquiring malpractice insurance, and obtaining a bond at a minimum. If you do wish to find these types of clinical sites and feel that you have no other option, it’s best to look into a “for profit” mammography clinic such as Solis Mammography.
Use a Clinical Training Network to Complete Your Hours
Using a clinical training network is one of the best ways to go about completing your clinical hours if you are taking an online course and a method that is widely used. Clinical training networks are companies that have already done all of the hard work that is indicated in option 2, and have an agreement with a national network of these sites.
There are companies that have done all the legwork described in option 2 and have access to a national network of these sites. Pulse Radiology offers the number one rated online MRI and CT program for radiologic technologists, and has an agreement with various hospitals and clinical settings (including RadComm) in order to achieve your clinical hours through their program. This program is a great option for those who are looking for the convenience and home access of online learning but don’t have access to a clinical site.
Updated Mammography Clinical Experience Requirements
As of July 1, 2020, the ARRT Board of Trustees has approved changes to the Mammography Clinical Experience Requirements. This is in accordance with the job analysis that was talked about towards the beginning of this article, that ensures that the certification examination content specifications and the clinical requirements remain relevant to the current and ever-changing industry.
Overview of the Major Changes to the Clinical Experience Requirements
Below you can find the following key changes to the clinical experience requirements, which are referenced from ARRT’s educational update of May 2020:
- The number of repetitions for phantom image quality was increased from five to 10.
- A compression thickness indicator and facility quality control review were added.
- The number of repetitions for repeat analysis was decreased from two to one.
- Localization imaging, surgical specimen imaging, and stereotactic specimen imaging was added in the elective procedures area.
- Ductography and galactography were removed.
- The Mammography image evaluation was decreased from 10 to one and clarification was added.
Do I Have to Be an RT For One Year Before I Can Enter Mammography?
While the ARRT rule previously stated that you needed to be a Radiologic Technician for one year before applying to sit for their mammography certification exam, that rule is no longer valid. Currently, you may enter into mammography directly from x-ray school if you have met the standards defined by MQSA to perform mammography and have performed certain clinical experience requirements.
Final Thoughts on Receiving Your Mammography Clinical Hours
Receiving your mammography clinical hours is an integral part of not only fulfilling the requirements to become a certified Mammography Technologist, but to enjoy a long and fulfilling career in this important field. For many patients, annual mammograms can trigger fear and anxiety, especially so when there have been unusual findings in their exam.
Your role as a Mammography Technologist allows you to care for patients when they’re feeling their most vulnerable, as well as acting as a valuable source of information for those who are unsure about the procedure. You are serving as the front line of screening for both men and women for breast cancer as well as other medical conditions, as well as working side by side with physicians to review results and keep records of the procedures. Receiving your mammography clinical hours is the last step before taking your examinations to become ARRT-certified and it’s highly important to make sure they are done correctly and are properly accounted for.
We wish you the very best in completing your cynical hours and in your career in this rewarding and important field.