Additional Training Preceptor Letter Template for Candidates who have failed 3 or more times.
(please submit on letterhead)
DateTo: Certification Board of Nuclear Cardiology
Dr.________________(full name) completed a 4 week preceptorship in nuclear cardiology under my supervision at ____________________(name of institution) from _________(start date) to ____________(end date). Preceptorship dates must begin after the date of the third failed examination attempt.
I attest that the cumulative total hours that Dr._____________(full name) trained with me is no less than 160 hours. In addition, Dr. ___________(full name) interpreted a minimum of 100 nuclear cardiology cases under my preceptor supervision.
Signature of Preceptor
[Print] Name of Preceptor:
Title of Preceptor:
Authorized User Number of Preceptor:
*Name of Board that Certified Preceptor:
**Preceptor’s Certificate Number or Year Certified:
*Note: The Preceptor must be board certified by CBNC, Nuclear Medicine or Radiology (Nuclear Medicine or Radiology may be either through the American Board of Medical Specialties or the Bureau of Osteopathic Specialists of the American Osteopathic Association)
** Board Certificate number of the Preceptor or Year Certified by Board (if there is no certificate number on the certificate)