Del Mar College Dental and Imaging Technology Department Computed Tomography Certificate Program Application Information Packet Radiologic Technology Program Enhanced Skills Certificate- Computed Tomography Faculty David Arreguin, DDS Dental and Imaging Technology Department, Chairperson Raquel Tapia, MS, R.T.(R)(CT) Radiologic Technology Program, Director Computed Tomography Instructor Ismael Garcia, BAAS, R.T.(R) Associate Professor of Radiologic Technology Radiation Safety Officer Melinda Wren, MS, R.T.(R) Instructor and Clinical Coordinator of Radiologic Technology Maria Velma Pena, BS, R.T.(R) Instructor and Lab Coordinator of Radiologic Technology Pollie Martinez Dental and Imaging Technology, Administrative Assistant I 2 Dear Prospective Student, Thank you for your interest in the Computed Tomography Certificate Program offered at Del Mar College. The Computed Tomography Program was developed to offer further training in the computed tomography specialty area, in an effort to meet the growing healthcare needs of the community. The goal of the program is to provide curricula and clinical settings that will enable program students to develop hands-on training and prepare for the advanced certification in computed tomography by the American Registry of Radiologic Technologists (ARRT). The program will be offered to a limited to number of individuals, who meet specific qualifications for entrance into the program. Refer to the “Requirements for Enrollment into the Computed Tomography Certificate Program (Registry Prep)” for program qualifications. The number of individuals selected into the program is limited to the number of clinical facilities available for program students. Students will be selected into the program once a year. The deadline to submit an application will be JANUARY 15TH. The program will consist of two semesters of classes. The first semester of the program will begin in the first summer session (around the first week of June). It will consist of two, twelve-week courses (one classroom and one clinical course). The second and last semester, will take place in the fall semester, which will also consist of two, sixteen-week courses (one classroom and one clinical course). For employed Computed Tomography technologists, wanting to prepare for the advanced certification in Computed Tomography by the ARRT, you do not need to take the clinical courses; however, you will not receive a certificate for completion of the Computed Tomography Certificate Program. If you meet the application criteria listed on page four and are interested in pursuing enrollment into this program, please contact Raquel Tapia, Computed Tomography Instructor at 361-698-2828 or 361-698-2858 to set up a faculty interview. Again, thank you for your interest into the Computed Tomography Certificate Program. As Director of the Radiologic Technology Program, I am eager to meet with you and review you application. Raquel Tapia, MS, R.T.(R)(CT)(ARRT) Director of Radiologic Technology Program Dental and Imaging Technology Dept. Del Mar College HS 3, Rm. 142 3 Requirements for Enrollment into the Computed Tomography Certificate Program (Registry Prep): Please review all prerequisite requirements for consideration into the Computed Tomography Certificate Program. Applications must include documentation to verify student eligibility for CT Program enrollment. ALL documentation should be submitted with the application (part Two) by the deadline of JANUARY 15TH. Incomplete applications will not be considered for review. • • • • • • • Must be enrolled at Del Mar College as a current or prospective student Graduate of at least a 2-year JRCERT accredited medical radiography program in ionizing radiation Must hold current certification in Radiography, Nuclear Medicine, or Radiation Therapy by the American Registry of Radiologic Technologists or the Nuclear Medicine Certification Board Must possess a current, unrestricted licensure of Medical Radiologic Technologist by the Texas Department of State Health Services Must conduct an in person interview with the Computed Tomography Instructor prior to application deadline. For appointment scheduling, call 698-2858 or 698-2828. Must submit all official transcripts prior to application deadline of January 15, 2009. Must have a minimum Cumulative GPA of 2.0. 4 Tech Prep Enhanced Skills Certificate Radiologic Technology (Computed Tomography Registry Preparation) These courses will prepare a Registered Radiographer, Nuclear Medicine Technologist, or Radiation Therapist for advanced medical imaging in computed tomography and prepare for the advanced certification exam in computed tomography. Individuals must be a graduate of at least a 2-year accredited program in ionizing radiation and possess a current ARRT or NMCB certification in Radiography, Nuclear Medicine, or Radiation Therapy. Applicants must also submit evidence of current licensure as a Medical Radiologic Technologist by the Texas Department of State Health Services and a current Healthcare Provider CPR card by the American Heart Association. Summer Semester (12 Week): CTMT 2332 Principles of Computed Tomography CTMT 2460 Clinical- Radiologic Science Technology/Science Radiographer Fall Semester (16 Week): CTMT 2236 Computed Tomography Equipment and Methodology CTMT 2563 Clinical- Radiologic Science Technology/Science Radiographer 5 DEL MAR COLLEGE DEPARTMENT OF DENTAL AND IMAGING TECHNOLOGY POLICY FOR CRIMINAL BACKGROUND SCREENING Del Mar College adheres to the policies of all clinical facilities with which the programs are affiliated for student clinical learning experiences. Many clinical facilities and school districts require criminal background screening of all students. Purpose Some clinical agencies used by Del Mar College stipulate in the clinical affiliation agreements with Del Mar College that students’ criminal background be prescreened before they are permitted into the clinical facility. This prescreening requirement is the same as that required of employees of public and private clinical agencies. The rationale for this requirement for clinical students is based on the concept of due diligence and competency assessments of all individuals whose assignments bring them in contact with patients and employees. Competency assessment extends beyond technical skills to include an individual’s past behavior as indicated by their criminal history. This approach ensures uniform compliance with Joint Commission standards pertaining to human resource management. Moreover, the public is demanding greater diligence in light of the national reports of deaths resulting from medical errors. Successful completion of a background check does not guarantee licensure or employment after graduation. Full acceptance into the program is contingent upon satisfactory results. Timing All background checks will be conducted as a condition of full acceptance into the Del Mar College programs. Verification must be received from the designated company prior to being fully admitted to the program. The results will be accepted for the duration of the student’s enrollment in the program if the participating student has not had a break in the program and if the student has had no convictions while enrolled. A break in enrollment is defined as nonattendance of one full semester or more. Attendance must be verifiable through the College. The Department of Dental and Imaging Technology will designate the company selected to do the criminal background screening. The Program will not accept criminal background screening results from any company other than the designated by the Department of Dental and Imaging Technology. The student will pay for the cost of the criminal background screening at the time of the screening. The cost is non-refundable. Process Criminal background checks will be performed by an external vendor and will review the student’s criminal history. The check should include the cities and counties of all known residences. Criminal background checks must include a person’s criminal history for seven years prior to the date of application. The following histories will disqualify an individual from consideration for full admission in the program. 6 • Misdemeanor convictions/deferred adjudication or felony convictions/deferred adjudication involving crimes against persons; • Misdemeanor convictions/deferred adjudication related to moral turpitude; • Misdemeanor/felony convictions/deferred adjudications for the sale, possession, distribution, or transfer of narcotics or controlled substances; • Registered sex offenders. Individuals with any of the above histories will not be eligible to enroll in the program and if the history is discovered or a conviction occurs after enrollment, the student will be required to withdraw from the program. A student who is convicted of a criminal offence while enrolled in the program must report the conviction to the Program Director within three days of the conviction. The term conviction for these purposes includes probated sentences and deferred adjudications. Notes: 1. The student should be aware that the disqualifications listed above are used for employment eligibility by most hospitals in Texas. 2. Completion of a specific program will be determined by student’s ability to successfully complete the required clinical rotations. 3. Clinical rotations are completed at sites specified by and contracted with Del Mar College. Del Mar College will not locate or provide alternative sites for clinical rotations for student ineligible to attend clinical rotations at specific sites. Compliance and Record Keeping • The vendor will notify Del Mar College Program Director of all individuals who fail a criminal background check. • Verification sent by the vendor to Del Mar College will include only the student’s name and social security number. • The Del Mar College Program Director will send verification on adherence to the policy to the clinical affiliate prior to the clinical rotation start date. Verification is accomplished by sending a letter from the Program Director stating that these standards has been met by the student, listing the student’s full name and clinical rotation start date. If more than one student is attending a clinical rotation, a comprehensive list with all of the student’s names may be submitted. Notes: Verification information will be filed in a secured area to ensure confidentiality. In the event that the student feels that an error has been made in the results of the criminal background check, it is the responsibility of the student to contact the external vendor for a verification check and the student is responsible for any cost associated with this check. Other than error relative to identify, there will be no appeal of this policy. 7 RADIOLOGIC TECHNOLOG PROGRAM DENTAL AND IMAGING TECHNOLOGY STUDENT TEXAS IMMUNIZATION REQUIREMENTS The following requirements apply to all students enrolled in health-related programs in Texas schools, which will involve direct patient contact in program-affiliated medical care facilities. This includes Computed Tomography Majors. YOU MUST BEGIN IMMUNIZATION STEPS NOW IN ORDER TO MEET THE JUNE 1st DEADLINE (for first day of class). Students who were born on or after January 1, 1957, must show, prior to first patient contact, acceptable written evidence of vaccination of two doses of measles - containing vaccine administered since January 01, 1968. Serologic confirmation of immunity to measles is acceptable. Evidence of immunity must consist or a laboratory report that indicates either confirmation of immunity or infection. A. Students must show, prior to program admission, written evidence of vaccination of one dose of rubella (German measles) vaccine. Serologic confirmation of immunity to rubella is acceptable. Evidence of immunity must consist or a laboratory report that indicates either confirmation of immunity or infection. B. Students born on or after January 1, 1957, must show, prior to first patient contact, written evidence of vaccination of one dose of mumps vaccine. Serologic confirmation of immunity to mumps is acceptable. Evidence of immunity must consist of a laboratory report that indicates either confirmation of immunity or infection. C. Students shall receive a complete series (three injections) of Hepatitis B vaccine prior to first patient contact. Serologic confirmation of immunity to Hepatitis B is acceptable. Evidence of immunity must consist of a laboratory report that indicates confirmation of immunity. D. Students shall receive two doses of Varicella (Chicken Pox) vaccine, prior to first patient contact, unless the first dose was received prior to thirteen years of age. A written history by a physician or parent may be used to validate Varicella disease or immunity in lieu of the vaccine. Vaccination, of necessary, must take place before the student is accepted into the program of study. One dose of Tetanus-diphtheria toxoid is required within the last ten years. 8 Pregnancy Policy The intent of this pregnancy policy is not meant to be discriminatory in any manner. A woman who has voluntarily informed her Program Director, in writing of her pregnancy and the estimated date of conception is considered a declared pregnant student. A woman who does not wish to declare a pregnancy will continue the program without any modifications, continue to wear her primary radiation monitoring device at the level of the collar, and her occupational dose limit will apply. This policy will be implemented at the time a written declaration is received. The student, after counseling with the Program Director and Radiation Safety Officer, may elect to one of the following: 1. Withdraw from clinical education with an “Incomplete” but remain in all didactic activities for semesters in which pregnancy exists. 2. Remain in the program without any modifications (ex. change in clinical rotation schedule) under the following conditions: a. The student will be issued a secondary, fetal film badge to be worn on the abdomen in addition to her own. She will wear both film badges at all times in the clinical or laboratory settings. The equivalent dose limit to the embryo/fetus will not exceed 0.5 rem (5.0 mSv) for the entire pregnancy or 0.05rem (0.5mSv) for the monthly dose. *If a woman chooses not to declare pregnancy, the occupational dose applies. b. The student will supply the Program Director a statement of health from an attending physician attesting to the student’s health and ability to continue with the program. 9 Del Mar College Computed Tomography Tech-Prep Enhanced Skills Program Application (Computed Tomography Registry Preparation) Application Deadline: JANUARY 15TH. Instructions: Please PRINT or TYPE all information on this form. Complete all items. Information must be current and accurate. If the applicant’s name, mailing address, or phone numbers change after this application has been filed, it is the responsibility of the applicant to update and forward the appropriate information to the Computed Tomography Instructor IMMEDIATELY. Part One Name in Full____________________________________________________________ First Middle Last Social Security #:_________________________Student I.D.#__________________ Mailing Address________________________________________________________ Number Street ________________________________________________________ City, State Zip Code Home Phone____________ Cell Phone___________ Business Phone__________ Electronic Mail _________________________________________________________ Emergency Contact_______________________________________________________________ Name Relation to Student Phone _____________________________________________________________________ Physical Address City, State Zip Part One Application Information: 1. Must be a graduate of at least a 2-year JRCERT/JRCNMT accredited medical radiography program in ionizing radiation. Degree(s) Received: Circle all that apply: Associate Degree in Applied Science in Radiologic Technology Associate Degree in Applied Science in Nuclear Medicine Technology Associate Degree in Applied Science in Radiation Therapy Other ____________________________________________________________ 2. Must possess a current certification in at least one of the following: a) Radiography by the American Registry of Radiologic Technologists ARRT#_______________________ Expiration Date___________________ b) Nuclear Medicine by the American Registry of Radiologic Technologists or the Nuclear Medicine Technology Certification Board 10 ARRT#_______________________ Expiration Date____________________ c) Radiation Therapy by the American Registry of Radiologic Technologists ARRT#_______________________ Expiration Date____________________ 3. Must possess current, unrestricted licensure of Medical Radiologic Technologist by the Texas Department of State Health Services TDH#__________________________ Expiration Date______________________ The following items must be submitted before the application deadline of JANUARY 15 to have a complete application for the Admissions Committee to review. Current Healthcare Provider CPR Card_______ Expiration Date____________ All Official College Transcripts_________ 11 Selection Process: Selection into the Computed Tomography Program will be based on grades, medical imaging experience, experience in the computed tomography field, and the goal statement of the application. A committee will review all applications after the application deadline. Make sure all required material is submitted with the application. Incomplete applications will not be reviewed for consideration. Part Two I. Grades: BIOL 2401__________________ BIOL 2402__________________ Cumm. GPA_________________ (Multiple Trascripts will be averaged.) II. Experience: Medical Imaging Experience: How long have you worked as a Registered Radiographer, Nuclear Medicine Technologist, or Radiation Therapist? _______________Years ____________ months Experience working in Computed Tomography: How long have worked as a Computed Tomography Technologists? ______________ Years _____________ months If you have experience working as a Computed Tomography Technologists, do plan on taking (Check One): Classroom courses only_____________ Classroom and clinical courses _________________ Experience in Cross-training/Practicum in Computed Tomography: ______________ Months or ______________ Hours BIOL2401/2402 Grades: A = 4 points B = 3 points C = 2 points D = 0 points GPA Points: 3.5-4.0 = 5 POINTS 3.0-3.49 = 4 POINTS 2.5-2.99 = 3 POINTS 2.0-2.49 = 2 POINTS 12 Part Three Goal Statement: Provide a brief explanation describing your motivation for completing the Computed Tomography Certificate Program. Additional pages may be attached, if needed. Interview with the Computed Tomography Instructor Faculty Signature Date I,_____________________ ,hereby acknowledge that the above information provided is accurate. Applicant Signature Date 13