UBC Postgraduate Program in Cardiology
Goals and Objectives, Nuclear Medicine
July 1, 2013
Roles
Medical
Expert/
Clinical
Decision
Maker
Objectives
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Learn the indications for a variety of
nuclear cardiology tests, including
rest and exercise myocardial
perfusion imaging (sestamibi and/or
thallium), Dipyridamole and
Dobutamine stress studies,
qualitative and quantitative analysis,
radionuclide cineangiography using
gated equilibrium techniques and
myocardial infarct imaging with
technetium pyrophosphate.
Learn the advantages,
disadvantages and limitations of a
variety of nuclear cardiology tests,
including rest and exercise
myocardial perfusion imaging
(sestamibi and/or thallium),
Dipyridamole and Dobutamine
stress studies, qualitative and
quantitative analysis radionuclide
cineangiography using gated
equilibrium techniques and
myocardial infarct imaging with
technetium pyrophosphate.
Learn the technique of performance
of a variety of nuclear cardiology
studies, including rest and exercise
myocardial perfusion imaging
(sestamibi and/or thallium),
Dipyridamole and Dobutamine
stress studies, qualitative and
quantitative analysis radionuclide
cineangiography using gated
equilibrium techniques and
myocardial infarct imaging with
technetium pyrophosphate.
Learn to interpret a variety of
nuclear cardiology studies, including
rest and exercise myocardial
perfusion imaging (sestamibi and/or
thallium), Dipyridamole and
Dobutamine stress studies,
Strategies
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Discuss the expectations and
responsibilities of the Trainee in the
Nuclear Cardiology Laboratory with
the supervising Attending
Cardiologist.
Study appropriate references and/or
do literature searches to become
familiar with the basic science and
clinical aspects of Nuclear
Cardiology.
Attend and participate in the
performance of a variety of stress
testing and Nuclear Cardiology
studies.
Attend and participate in the
interpretation sessions with the
Attending Nuclear Cardiologist and
Nuclear Medicine physician.
UBC Postgraduate Program in Cardiology
Goals and Objectives, Nuclear Medicine
July 1, 2013
Communicator 
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Collaborator
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Manager
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qualitative and quantitative analysis
radionuclide cineangiography using
gated equilibrium techniques and
myocardial infarct imaging with
technetium pyrophosphate.
To be able to obtain appropriate
information from the patient and/or
family relevant to the performance
of a planned Nuclear Cardiology
study.
To be able to describe the
indications, rationale, conduct and
possible outcomes, including
potential complications of the
planned Nuclear Cardiology Study
to the patient and family.
Learn to write a preliminary Nuclear
Cardiology report.
Learn to discuss report of Nuclear
Cardiology studies with patients,
family and referring physicians,
including an assessment of the
significance of the findings when
appropriate.
Learn to work cooperatively with
other Health Care Professionals
who are involved in the care of
patients in the Nuclear Cardiology
Laboratory.
Learn to work cooperatively with the
staff in the Nuclear Cardiology
Laboratory to facilitate appropriate
and efficient patient care.
Learn the cost effectiveness of the
various procedures performed in the
Nuclear Cardiology Laboratory.
Learn to manage the Nuclear
Cardiology Laboratory resources
effectively and efficiently.
To gain an understanding of waiting
lists for various types of Nuclear
Cardiology studies
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When appropriate
communicates the result of a
nuclear cardiology study verbally
to the Referring Physician
and/or House-Staff Team.
When appropriate, discusses
the findings of the nuclear
cardiology study with the patient
and family.
Respect the roles of all
members of the Health Care
Team in the Nuclear Cardiology
Laboratory.
Seek consultation from other
members of the Health Care
Team in the Nuclear Cardiology
Laboratory when appropriate.
Review literature and /or discuss
with the Attending Cardiologist
in the Echocardiography
Laboratory regarding the cost
effectiveness of procedures to
be done in the Nuclear
Cardiology Laboratory.
UBC Postgraduate Program in Cardiology
Goals and Objectives, Nuclear Medicine
July 1, 2013
Health
Advocate
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Scholar
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Professional
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Learn strategies to effectively
educate patients who have cardiac
pathology and their families
regarding the pathophysiology of
the patient’s illness and the
importance of compliance and the
potential for future risk.
Learn strategies to educate patients
and their families regarding healthy
cardiac behaviors.
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Enhance knowledge base regarding
a variety of cardiac conditions seen
in the Nuclear Cardiology
Laboratory.
Develop a strategy for literature
review/search for a variety of
cardiac conditions seen in the
Nuclear Cardiology Laboratory.
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To deliver care of the highest quality
with integrity, honesty and
compassion.
To learn the ethical, legal and
professional obligations in the
context of patient management in
the Nuclear Cardiology Laboratory.
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Initiate discussion or be
available for patients and their
families to discuss the patient’s
illness with regards to
pathophysiology of their disease
and the importance of
compliance to the prescribed
regimen as it relates to their
procedure in the Nuclear
Cardiology Laboratory.
Initiate or be available to discuss
with patients and their families
regarding healthy cardiac
behaviors as appropriate.
Establish and maintain
reference resources including
textbooks, journals and internet
(e.g. Medline) relevant to the
care of patients undergoing
nuclear cardiology studies.
Establish and adhere to a study
program as it relates to the care
of patient undergoing nuclear
cardiology studies.
Maintain professional
relationships with all members of
the Health Care team.
When appropriate seek advice
and assistance.
Present and discuss case/s
seen in the Nuclear Cardiology
Laboratory at Cardiology
Rounds with a focus on the legal
or ethical aspects of the case.
UBC Postgraduate Program in Cardiology
Goals and Objectives, Nuclear Medicine
July 1, 2013
Nuclear Medicine, Revised Rotation
Monday
0830-1200hr
ETT (a)
12 lead ECG
Holter
Tuesday
0800-0900hr
Nuclear
Rounds, VGH
0900-1200
Tech/Blood
Pool
Scan/lecture (b)
Wednesday
0830-1200hr
ETT (a)
12 lead ECG
Holter
Thursday
0730-0830
CVS Rounds, SPH
0830-1200hr ETT
(a)
12 lead ECG
Holter
Friday
0800-0900hr
Designated Reading (d)
Rounds preparation time (e)
0900-1100hr
Interpretation of Congenital
Echocardiograms
1100-1200hr
Resident presentation of topic
1200-1300hr
Cardiology Rounds
1300-1400hr
Office(f)
1400-1530hr
Nuclear
Interpretation (i)
Dr. Kiess
1400-1530hr
Nuclear
Interpretation (i)
Dr. Kiess
1300-1700hr
Academic halfday(h)
1300-1700hr
Cardiology
Academic Half
Day, (protected
time)
1300-1700hr
Nuclear Interpretation (j)
a) Residents supervise ETT, Exercise, Dobutamine and
b)
c)
d)
e)
Persantine MIBI scans.
 Practical experience, indications for termination of test,
side effects, etc.
 Allow residents to correlate exercise electrogram to
perfusion scan and understand relative merits of the
two tests.
Tech/Blood Pool
 Residents assigned to a technician - learns protocol
aspects of imaging, i.e. need for patients to have hands
over head etc, learns about artifacts etc. Some time for
nuclear lectures are available.
Designated reading time and time to prepare Residents’
Rounds
Residents will prepare one topic for presentation to Dr. Kiess
or one of the other nuclear physicians every week. Should
attempt to have other cardiology residents booked at SPH
attend this session.
Residents will see 1-2 new patients during each clinic. Patients
will only be booked if they undergo a nuclear imaging test.
This will allow the resident to correlate the Hx/PE/ECG and
clinical pretest likelihood of CAD to the nuclear imaging
results, and provide a clinical context to nuclear imaging.
UBC Postgraduate Program in Cardiology
Goals and Objectives, Nuclear Medicine
July 1, 2013
f) Academic Half-day
 A number of nuclear didactic and graphics sessions
have been incorporated.
 Attendance at half-day is mandatory.
g) Nuclear Interpretation - Dr. Kiess
 Emphasis on perfusion scans and clinical correlation.
h) Nuclear Interpretation - Nuclear Physicians
 Different emphasis.
 Focus on methodological issues etc.
 Will also incorporate V/Q scans etc. which are highly
relevant to the cardiologists as these tests are often
ordered in the differential of chest
pain/SOB/pathological hypertension etc.
Residents shall not follow in-hospital patients with the exception of
congenital heart patients and pregnant women with heart disease.
This is the only opportunity the residents have to deal with
hospitalized congenital patients.
Residents will review a set of 5 videotapes produced by the ACC.
Those are of excellent quality; begins at a very basic level and
progresses to a high level of knowledge. These tapes are
available through Dr. Tony Fung (VGH).
A reading list will also be provided by Dr. Marla Kiess.