The short answer
Where can I find radiation safety CME?
Medical and technologist societies offer accredited continuing medical education (CME) in radiation safety, and several good courses are free, such as a 3-credit course from the Society for Cardiovascular Angiography & Interventions (SCAI). Check that the credit fits your license and that the course covers protecting the staff, not only the patient.
- Cost
- Often free
- Several society courses with credit cost nothing, and others are free to members.
- Required?
- Depends on where you work
- Some states set training hours for fluoroscopy users, and hospitals decide who is qualified to use the equipment.
- Credit
- Differs by role
- Physicians need AMA PRA Category 1 Credit™, technologists Category A, nurses contact hours.
- The gap
- Ergonomics
- Accredited courses on injury from heavy protective garments are still rare.
The evidence
Why it is worth the time
Most of the dose the team receives is radiation scattered from the patient, so habits that lower the patient's dose usually lower everyone else's too. Studies of training show what a course can change, and how far it still has to reach.
A short course changed practice
At 32 German heart centers, cardiologists who took a 90-minute course in dose-saving technique cut their patients' median dose-area product, a measure of radiation dose, by 48.4%. Colleagues who could not attend showed no significant change. Less dose to the patient means less scatter for the team.
Practice beat lectures for staff dose
In a two-year randomized crossover trial of 39 staff from cath labs and orthopedic operating rooms, virtual reality training lowered the radiation recorded on their dosimeters more than traditional lectures did.
Mwangi and Tanaka, Journal of Medical Radiation Sciences, 2025
Training reaches only part of the team
In an international survey of interventional radiology and cath lab staff, 53% of respondents had received radiation protection training, most of it in-house.
O'Rourke et al., Journal of Medical Imaging and Radiation Sciences, 2024
Refresher courses lapse
In a national survey of vascular surgeons in Spain, 94.1% of trainees had formal radiation safety training during residency, but only 15.8% of trainees and 44.9% of consultants had taken an updated course.
Martínez del Carmen et al., Journal of Endovascular Therapy, 2026
Ergonomics education gets used
In a 2026 study of 306 cath and electrophysiology lab workers, run with American College of Cardiology chapters, limited knowledge of ways to reduce harm was linked to musculoskeletal pain or injury (adjusted odds ratio 4.62). On follow-up, 75.9% reported adopting ergonomic techniques from the study's educational video.
The requirements
Who requires it
No single federal rule in the United States sets radiation safety training for everyone who works with fluoroscopy. The requirement usually comes from your state, your hospital, or the body that credentials you.
Your state
States regulate the use of X-ray equipment. A few set training or continuing education for the people who use fluoroscopy, others set rules only for technologists, physician assistants or nurse practitioners, and many leave training to the facility. Six examples:
- California
- A fluoroscopy supervisor and operator permit, which requires passing a state exam, and 10 approved continuing education credits in the two years before it expires, 4 of them in radiation safety for the clinical uses of fluoroscopy.17 CCR 30403ORSIF state page
- Massachusetts
- Physicians who are not board certified in radiology: 2 hours of radiation safety training a year to perform fluoroscopy, and 4 hours a year to supervise it.105 CMR 120.405ORSIF state page
- Maryland
- Everyone who energizes a fluoroscope: at least 4 hours of training before clinical use, then at least 1 hour of in-service training or CME every 24 months.COMAR 26.12.01.01, section F.5(n)ORSIF state page
- Rhode Island
- At least 4 hours of training before anyone operates or supervises fluoroscopy, at least 8 hours (with 1 hour hands-on) for fluoroscopically guided interventional work, and every 24 months either 2 hours of in-service training or CME in fluoroscopic radiation safety.216-RICR-40-20-4.3.3ORSIF state page
- Ohio
- At least 2 hours of fluoroscopy-specific radiation protection training for everyone who operates fluoroscopy equipment or is likely to receive more than 1 millisievert a year from it, and 1 hour of retraining for anyone whose yearly dose passes 30% of the limit.OAC 3701:1-66-07ORSIF state page
- Texas
- A 2013 rule requires physicians other than radiologists and radiation oncologists to complete 8 hours of Category 1 CME in radiation safety and 1 hour of machine training before fluoroscopically guided interventional procedures. The state has delayed enforcing it indefinitely.25 TAC 289.227(m)(9)(E)ORSIF state page
Your hospital
Medicare's hospital rules let only staff whom the medical staff designates as qualified use radiologic equipment, and its surveyor guidance expects training and demonstrated competence before that designation, then periodic training. The technical standard of the American College of Radiology (ACR) and the American Association of Physicists in Medicine (AAPM) recommends that every facility have a policy for granting fluoroscopy privileges and that physicians' CME include radiation protection.
The Joint Commission
From January 1, 2019, the Joint Commission required documented annual training for everyone who uses fluoroscopic equipment, physicians included, then removed the requirement later that year. Its hospital standards now require organizations to define and verify the qualifications and education of imaging staff. Its Sentinel Event Alert 47, revised in February 2019, still suggests annual education, review and competency testing, as advice rather than a standard.
Federal agencies
Federal rules say little. The ionizing radiation standard of the Occupational Safety and Health Administration (OSHA), which has not been meaningfully updated in over fifty years, requires the employers it covers to instruct workers in a radiation area in its hazards and in precautions to reduce exposure. The Food and Drug Administration (FDA) regulates fluoroscopy equipment, not the people who use it. The Department of Veterans Affairs sets its own rule: refresher training every 2 years for everyone who operates or supervises fluoroscopy, and safety training every 2 years for everyone who works in the room.
Outside the United States
European Union law requires employers to train exposed workers and requires continuing education for practitioners after they qualify. The International Commission on Radiological Protection (ICRP) suggests 20 to 30 hours of radiation protection training for interventional cardiologists and other interventionalists, 8 to 12 hours for nurses who assist, and updates at intervals of no more than 36 months.
Before you enroll
How to tell a good course
A course worth your hours does most of these things.
It carries the credit you need
Look for the provider's credit statement: AMA PRA Category 1 Credit™ for physicians, Category A or A+ for technologists, contact hours for nurses. A jointly accredited provider can award credit to several professions at once.
It covers the team, not only the patient
Many fluoroscopy courses teach patient dose. Look for distance, shielding, dosimeters and protective garments for everyone in the room. The ICRP calls initial and continuing training in occupational protection a requirement.
It covers the eye, pregnancy and dosimeters
Current guidance, such as the 2026 guideline of the Society of Interventional Radiology (SIR) and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE), covers protecting the lens of the eye, working while pregnant and wearing dosimeters correctly.
It treats protective garments as a hazard too
The ALARA+ framework and the 2026 SIR and CIRSE guideline count musculoskeletal injury from heavy protective garments as an occupational hazard. Few courses cover it yet.
It is current
Check the release, review and expiration dates. Eye lens guidance has changed: the ICRP recommends 20 millisieverts (mSv) a year for the lens, while the Nuclear Regulatory Commission's limit is 150 mSv.
It is independent
Accredited CME must be free of control by companies whose main business is selling health care products, under the standards of the Accreditation Council for Continuing Medical Education (ACCME). An equipment maker's training on its own system is useful, but it is not independent education.
It includes practice
In a randomized trial, virtual reality training lowered staff dose more than lectures did. Hands-on or in-room practice is worth looking for.
It meets your state's rule
If your state sets hours or topics, check that the course says it meets them, and keep the certificate.
Where to look
Courses and resources, by role and topic
These come from professional societies, nonprofits and public agencies. ORSIF lists no course made by a company that sells equipment, protective garments or dosimetry, no provider paid to be listed, and a card says so when a course has industry support. Credit and prices change, so confirm them on the provider's page before you enroll.
Showing 25 of 25 listings
- SCAICourseFree
Radiation Safety for Operators and Patients
Society for Cardiovascular Angiography & Interventions (SCAI)
Eleven recorded talks on the hazards of cath lab work: radiation exposure and protection, orthopedic injury from protective garments and how to prevent it, and pregnancy, for both pregnant team members and pregnant patients.
- Credit
- Up to 3 AMA PRA Category 1 Credits™, plus 3 ABIM and 3 ABP MOC points
- Cost
- Free
- Format
- Online, on demand; sign in to take it
- Until
- September 15, 2029, per the provider
- Suits
- Physicians and fellows, PAs and NPs
Checked November 11, 2026
- RSNACourse
Radiation Dose and Safety in Interventional Radiology (2024)
Radiological Society of North America (RSNA), with the American Association of Physicists in Medicine (AAPM)
One of the RSNA and AAPM physics modules: what drives radiation output in interventional systems, the dose that results for the patient and for the staff, and the safety practices that lower both. Non-members can buy it.
- Credit
- Up to 2.75 AMA PRA Category 1 Credits™ and 2.75 SA-CME
- Cost
- Free for members. $55 for RSNA Basic members and non-members
- Format
- Online, on demand, about 2 hours 45 minutes
- Until
- March 3, 2027, per the provider
- Suits
- Physicians and fellows, PAs and NPs, Physicists and RSOs
Checked November 11, 2026
- IAEAFree trainingInternationalFree
Practical Tutorials and webinar course on radiation protection in interventional procedures
International Atomic Energy Agency (IAEA)
Two free courses. Thirteen short video tutorials (about 2 hours) show how equipment use, protective tools and real-time monitoring change patient and staff dose, with a section on the eye lens. Six recorded webinars (about 6 hours) cover risks to patients and staff and lens dose.
- Credit
- Certificate of completion after the quizzes or final exam; no CME credit
- Cost
- Free. An IAEA account is needed for the certificate
- Format
- Online, on demand; the tutorials are in English, Russian and Spanish
- Suits
- Physicians and fellows, Technologists, Nurses, PAs and NPs, Physicists and RSOs
Checked November 11, 2026
- SCAICourseFree
Journal CME: SCAI/ASE/HRS/SIR/SVS Expert Consensus Statement on Enhanced Radiation Protection: Time for Mandatory and Urgent Action
Society for Cardiovascular Angiography & Interventions (SCAI)
Read the July 2026 consensus statement, endorsed by six societies, that calls for mandatory implementation of enhanced radiation protection devices, then pass a short test.
- Credit
- 1 AMA PRA Category 1 Credit™ and 1 ABIM MOC point
- Cost
- Free
- Format
- Journal article and online test
- Until
- July 14, 2029, per the provider
- Suits
- Physicians and fellows, PAs and NPs
Checked November 11, 2026
- ASRTCourse series
Fluoroscopy: The Series
American Society of Radiologic Technologists (ASRT)
Six reading modules on fluoroscopy radiation protection, regulation, fixed and mobile units, image quality, and protecting the eyes, each sold on its own. The content was last reviewed in 2017, so check newer guidance on the eye lens.
- Credit
- 12.75 Category A+ credits for all six modules, 3 for the eye module alone
- Cost
- Paid. Modules from $30; the regulation module is free with ASRT membership
- Format
- Reading modules with online quizzes
- Suits
- Technologists
Checked November 11, 2026
- Image GentlyCourseFree
Image Gently: Enhancing Radiation Protection in Pediatric Fluoroscopy
Image Gently Alliance, with the American Society of Radiologic Technologists (ASRT)
Three short modules on operating fluoroscopy safely for children. Lower patient dose also means less scatter for the team. The quiz and certificate run through the ASRT store at no charge.
- Credit
- 2 Category A credits for technologists
- Cost
- Free
- Format
- Videos or slides, then one online quiz
- Suits
- Technologists, Physicians and fellows
Checked November 11, 2026
- SCAIWebinarFree
The Avenue Forward: What Can We Do About Orthopedic Injury and Pain?
Society for Cardiovascular Angiography & Interventions (SCAI)
Interventional cardiologists and physical therapists on procedure-specific ergonomics, exercises to prevent and treat injury, working in the lab while pregnant, and what leaders can do to keep the lab safe.
- Credit
- 1 participation credit; not CME
- Cost
- Free
- Format
- Recorded webinar
- Until
- February 19, 2029, per the provider
- Suits
- Physicians and fellows, Technologists, Nurses, PAs and NPs
Checked November 11, 2026
- ALARA+Free readingFree
Radiation Safety Foundations toolkit
ALARA+ Coalition
A short primer for the whole cath lab team on radiation risk and the strain of protective garments, with a readiness checklist on dosimeter use, apron inspection, musculoskeletal symptoms, pregnancy and training. ORSIF is a coalition member.
- Credit
- None
- Cost
- Free
- Format
- Suits
- Physicians and fellows, Technologists, Nurses, PAs and NPs, Physicists and RSOs
Checked November 11, 2026
- Women As OneFree trainingInternationalFree
Radiation Safety in the Practice of Cardiology: What All Care Team Members Should Know
Women As One
An interactive module on radiation basics and protection, building a culture of safety, and what a pregnant team member needs to know, including how national rules differ.
- Credit
- None
- Cost
- Free
- Format
- Interactive slides, best on a computer
- Suits
- Physicians and fellows, Technologists, Nurses, PAs and NPs
Checked November 11, 2026
- AORNCourse series
Periop 303: Advanced Perioperative Education
Association of periOperative Registered Nurses (AORN)
Scenario-based modules for experienced perioperative nurses, built on the AORN Guidelines. One module covers radiation safety for staff and patients, another safe patient handling and movement.
- Credit
- 14.75 nursing contact hours for the full program
- Cost
- Paid. $380 a learner for up to 10 learners, less for larger groups
- Format
- Online modules
- Suits
- Nurses
Checked November 11, 2026
- RSNACourse
Fundamentals of Radiation Protection (2026)
Radiological Society of North America (RSNA), with the American Association of Physicists in Medicine (AAPM)
The principles of radiation protection, regulatory dose limits, and how time, distance and shielding lower dose. General rather than specific to fluoroscopy.
- Credit
- Up to 1.25 AMA PRA Category 1 Credits™ and 1.25 SA-CME
- Cost
- Free for members. $55 for RSNA Basic members and non-members
- Format
- Online, on demand, about 1 hour 30 minutes
- Until
- April 19, 2029, per the provider
- Suits
- Physicians and fellows, PAs and NPs, Physicists and RSOs
Checked November 11, 2026
- SVSCourse
VESAP6, Module 4: Radiation Safety
Society for Vascular Surgery (SVS)
The radiation safety module of the society's self-assessment program for vascular surgeons: reducing exposure during fluoroscopic procedures and operating the equipment safely. It is part of the full program.
- Credit
- Up to 6 AMA PRA Category 1 Credits™ for this module, 102 for the full program
- Cost
- Paid. Full program $625 for SVS members, $825 for others; supported by an industry educational grant
- Format
- Online self-assessment
- Until
- March 26, 2027, per the provider
- Suits
- Physicians and fellows
Checked November 11, 2026
- SIRFree trainingFree
The Fundamentals: Imaging Systems: Fluoroscopy
Society of Interventional Radiology (SIR)
A trainee module: an interactive activity on how fluoroscopy systems work, and five readings, among them the 2010 edition of the SIR and CIRSE occupational protection guideline, on limiting patient and operator dose. About 3 hours.
- Credit
- No credit stated
- Cost
- Free
- Format
- Readings and an interactive activity; free SIR account needed
- Until
- December 31, 2030, per the provider
- Suits
- Physicians and fellows
Checked November 11, 2026
- Image WiselyFree readingFree
RSNA Educational Exhibits on radiation dose
Image Wisely (American College of Radiology, RSNA, ASRT and AAPM)
A monthly exhibit from the RSNA meeting. Recent ones review radiation protection and ergonomics for interventional radiology teams (October 2026) and why the eye lens needs protection (November 2026).
- Credit
- A self-printed attestation certificate for reading selected exhibits; not CME
- Cost
- Free
- Format
- Online exhibits
- Suits
- Physicians and fellows, Technologists, Physicists and RSOs
Checked November 11, 2026
- EuroSafe ImagingFree readingInternationalFree
Ask EuroSafe Imaging: Tips & Tricks for interventional radiology
European Society of Radiology (ESR), EuroSafe Imaging
Short practical guides, written from 2017 to 2020, on protecting the eyes and hands, protective garments, pregnant workers and controlling staff dose during procedures.
- Credit
- None for the free versions; five are also offered as CME-accredited courses on ESR's Education on Demand platform
- Cost
- Free
- Format
- Short online guides
- Suits
- Physicians and fellows, Technologists, Nurses, Physicists and RSOs
Checked November 11, 2026
- CIRSECourseInternational
Radiation safety in IR (2025)
Cardiovascular and Interventional Radiological Society of Europe (CIRSE)
About 90 minutes on the main protection tools (aprons, lead glass eyewear and shields), the parameters that drive occupational and patient dose, and the legal requirements. Designed for trainees, students and young consultants.
- Credit
- 1.5 European CME credits (ECMEC)
- Cost
- Paid. Comes with the CIRSE All-Access Pass: €770 for members, €1,070 for others in 2027
- Format
- Online, on demand
- Until
- June 2, 2030, per the provider
- Suits
- Physicians and fellows
Checked November 11, 2026
- EAPCICourseInternational
EAPCI NAPs Online Course: Radiation and imaging in cardiovascular interventions
European Association of Percutaneous Cardiovascular Interventions (EAPCI), European Society of Cardiology
One module of a nine-module course built on the European cath lab curriculum for nurses and allied professionals, covering radiation safety and protection for patients and personnel.
- Credit
- No credit stated
- Cost
- Paid. €30 a module, €18 for EAPCI members, before VAT
- Format
- Online module
- Suits
- Nurses, Technologists
Checked November 11, 2026
- ASEWebinar
Guidelines in Practice Webinar: Prevention of Work-Related Musculoskeletal Disorders for Cardiac Sonographers
American Society of Echocardiography (ASE)
A webinar on ASE's 2026 guideline on preventing work-related musculoskeletal disorders, with demonstrations of stretching routines, ergonomics, probe grip and scanning mechanics. Written for cardiac sonographers.
- Credit
- 1 AMA PRA Category 1 Credit™; ARDMS and CCI honor it toward registry requirements
- Cost
- Free for members. The listed price for others is $30
- Format
- Recorded webinar
- Until
- September 29, 2029, per the provider
- Suits
- Technologists, Physicians and fellows
Checked November 11, 2026
- SURGhubFree trainingInternationalFree
Introduction to C-Arm Imaging and Radiation Safety in the Operating Room
AO Alliance and the UBC Global Surgery Lab, on SURGhub
A one-hour tutorial for everyone in the operating room who works with a C-arm, from students and nurses to anesthesia and surgeons: how exposure affects staff and patients, which protective equipment to use, and simple steps to reduce it.
- Credit
- Shareable certificate; no CME credit
- Cost
- Free. Sponsored by an imaging equipment maker
- Format
- Online, about 1 hour; free SURGhub account needed
- Suits
- Physicians and fellows, Nurses, Technologists
Checked November 11, 2026
- ASGEWebinar
Safeguarding the Endoscopy Suite: Ergonomic Strategies
American Society for Gastrointestinal Endoscopy (ASGE)
A certified professional ergonomist on preventing musculoskeletal injury in the endoscopy suite, where teams also run fluoroscopy-guided procedures such as ERCP.
- Credit
- No credit
- Cost
- Free for members. $25 for others; co-sponsored by an endoscope maker
- Format
- Recorded webinar, 1 hour
- Until
- December 31, 2028, per the provider
- Suits
- Physicians and fellows, Nurses, Technologists
Checked November 11, 2026
- ASRTCourse
Safety Essentials: Module 04, Patient Transfer and Transport
American Society of Radiologic Technologists (ASRT)
The risk of musculoskeletal disorders and repetitive motion injuries in moving patients, with body mechanics, transfer tools and positioning. About patient handling, not protective garments.
- Credit
- 1.5 ASRT continuing education credits
- Cost
- Paid. $30, or $22.50 for ASRT members
- Format
- Online module
- Suits
- Technologists
Checked November 11, 2026
- ORAUCourse
Medical Radiation Safety Officer Training
Oak Ridge Associated Universities (ORAU)
A five-day lecture and laboratory course for people who have, or will have, radiation safety officer duties at a medical institution. Some background in health physics is expected.
- Credit
- 40 continuing education credits from the American Academy of Health Physics
- Cost
- Paid. $2,195
- Format
- In person, five days; next session September 13 to 17, 2027
- Suits
- Physicists and RSOs
Checked November 11, 2026
- AAPMCatalogFree
Physics Education for Users of Fluoroscopic Equipment in Healthcare Organizations
American Association of Physicists in Medicine (AAPM)
AAPM's guide for building a fluoroscopy training and credentialing program: the reports to draw on, and sources of existing courses, including private companies that sell courses built to meet state rules.
- Credit
- None (a guide)
- Cost
- Free
- Format
- Web page
- Suits
- Physicists and RSOs
Checked November 11, 2026
- SCAICatalogFree
Radiation and Occupational Safety Resource Center
Society for Cardiovascular Angiography & Interventions (SCAI)
SCAI's collection of its clinical documents on radiation and occupational safety, the 2026 consensus statement, the ALARA+ toolkits and its on-demand courses, for physicians, nurses, technologists and administrators.
- Credit
- Varies by item
- Cost
- Free
- Format
- Web page
- Suits
- Physicians and fellows, Technologists, Nurses, PAs and NPs, Physicists and RSOs
Checked November 11, 2026
- SIR and CIRSEFree readingFree
Occupational Protection in Interventional Radiology: A Joint Guideline
Society of Interventional Radiology (SIR) and Cardiovascular and Interventional Radiological Society of Europe (CIRSE)
The 2026 update of the joint guideline on protecting the interventional team: initial and periodic training for everyone in the room, dosimetry, eye lens dose limits, musculoskeletal injury and pregnancy.
- Credit
- None
- Cost
- Free
- Format
- PDF, open access
- Suits
- Physicians and fellows, Technologists, Nurses, PAs and NPs, Physicists and RSOs
Checked November 11, 2026
For your license or credential
What credit you need, by role
Each profession renews under its own rules, so the same course can count for one teammate and not another. Check the credit statement against your own credential.
Physicians
- Credit to look for
- AMA PRA Category 1 Credit™ from an accredited provider. Some activities also count toward board certification: SCAI's carry American Board of Internal Medicine (ABIM) points, and RSNA's modules carry self-assessment CME.
- Renewal
- Set by your state medical board and your specialty board, and in some states by fluoroscopy rules (see Who requires it).
Physician assistants
- Credit to look for
- Category 1 CME. The National Commission on Certification of Physician Assistants (NCCPA) accepts AMA PRA Category 1 Credit™ from accredited providers, so most physician courses here count.
- Renewal
- 100 CME credits every two years, at least 50 of them Category 1.
Nurse practitioners
- Credit to look for
- Contact hours or AMA PRA Category 1 Credit™. The American Nurses Credentialing Center (ANCC) counts both as formally approved hours.
- Renewal
- ANCC certification: 75 contact hours every five years, 25 of them in pharmacology. Other certifying bodies set their own rules.
Nurses
- Credit to look for
- Nursing contact hours from a provider accredited or approved under the ANCC system or by your state board.
- Renewal
- Set by your state board of nursing and by any certification you hold.
Nurse anesthetists
- Credit to look for
- Class A (MAC Ed) credit: activities approved by the American Association of Nurse Anesthesiology (AANA), ANCC or ACCME that include an assessment and relate to anesthesia practice.
- Renewal
- 100 credits every four years, at least 60 of them MAC Ed and 40 MAC Dev, under the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA).
Radiologic technologists
- Credit to look for
- Category A or A+ credit approved by one of the American Registry of Radiologic Technologists' (ARRT) recognized CE approvers, such as the American Society of Radiologic Technologists (ASRT).
- Renewal
- 24 credits every two years for most technologists.
Cardiovascular technologists and specialists
- Credit to look for
- Cardiovascular Credentialing International (CCI) accepts AMA PRA Category 1 Credit™, ANCC contact hours and ARRT Category A, so many courses here count. CCI does not accredit courses itself.
- Renewal
- Registry credentials such as Registered Cardiovascular Invasive Specialist (RCIS): 36 continuing education units every three years, at least 30 of them cardiovascular.
Medical physicists
- Credit to look for
- Continuing education accredited by the Commission on Accreditation of Medical Physics Education Programs (CAMPEP), or Category 1 CME.
- Renewal
- 75 credits over a rolling three-year period for American Board of Radiology (ABR) certification.
Radiation safety officers
- Credit to look for
- The Nuclear Regulatory Commission's training rule for radiation safety officers covers radioactive materials, not X-ray machines, which the states regulate.
- Renewal
- Set by your state radiation control program and your facility.
The gaps
What is still missing
Ergonomics and injury from protective garments
We found few accredited courses on musculoskeletal injury from heavy protective garments. SCAI's free course and webinar come closest. Most other accredited ergonomics courses are written for surgeons, sonographers or endoscopists.
Credit for nurses and technologists
Most free accredited courses we found carry physician credit only. For technologists, the main fluoroscopy series was last reviewed in 2017. For nurses, the main option is a paid perioperative program with one short radiation module.
The eye lens and dosimeters
Apart from one 2017 module for technologists, we found no current United States course devoted to the eye lens, and no independent course on wearing dosimeters correctly or using real-time dosimetry. Both appear only inside broader courses.
Refreshers
In the Spanish survey above, fewer than half of consultants had taken an updated course. The ICRP advises updating radiation protection training at intervals of no more than 36 months.
Free help from ORSIF while you look
ORSIF (Occupational Radiation Safety in Interventional Fluoroscopy) does not offer CME and does not certify anyone. What it offers is free: more than 200 plain-language answers in the FAQs, the State Rules Map, and for members, a research library of more than 800 articles, the SIRP 2025 symposium recordings and an administrator's safety toolkit.
Frequently asked
Common questions about radiation safety CME
Is radiation safety CME required to use fluoroscopy?
It depends on where you work. A few states set training for people who use fluoroscopy: Massachusetts, Maryland, Rhode Island and Ohio set hours, and California requires a permit with continuing education. Hospitals decide who is qualified to use the equipment, and the American College of Radiology recommends a written policy for fluoroscopy privileges. The Department of Veterans Affairs requires refresher training every two years.
Does the Joint Commission require annual fluoroscopy training?
Not today. A Joint Commission requirement for documented annual training of everyone who uses fluoroscopic equipment took effect on January 1, 2019 and was removed later that year. Hospital standards now require organizations to define and verify the qualifications and education of imaging staff. The Joint Commission's Sentinel Event Alert 47 still suggests annual education, review and competency testing, as advice.
Where can I find free radiation safety CME?
The Society for Cardiovascular Angiography & Interventions (SCAI) offers a free on-demand course worth up to 3 AMA PRA Category 1 Credits™ on radiation, orthopedic injury and pregnancy, and a free 1-credit journal activity on the 2026 consensus on enhanced radiation protection. Technologists can earn 2 free Category A credits through Image Gently. The International Atomic Energy Agency offers free tutorials with a certificate but no CME credit.
What credit do technologists, nurses and PAs need?
Radiologic technologists need Category A or A+ credit approved by an American Registry of Radiologic Technologists (ARRT) approver, 24 credits every two years for most. Cardiovascular technologists with Cardiovascular Credentialing International (CCI) registry credentials need 36 units every three years. Nurses need contact hours under their state board's rules. Physician assistants (PAs) need 100 CME credits every two years, at least 50 of them Category 1.
Is there CME on lead apron injuries and ergonomics?
A little. The free course from the Society for Cardiovascular Angiography & Interventions (SCAI) includes two talks on orthopedic injury, and its free webinar The Avenue Forward covers ergonomics and exercise, with participation credit. The 2026 occupational protection guideline from the Society of Interventional Radiology (SIR) and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) covers musculoskeletal injury. Most other accredited ergonomics courses are written for surgeons, sonographers or endoscopists.
How often should I take radiation safety training?
The International Commission on Radiological Protection (ICRP) recommends updating radiation protection training when technique or risk changes significantly, and at intervals of no more than 36 months. Some rules are stricter: Massachusetts requires training every year for physicians who are not board certified in radiology, and Maryland, Rhode Island and the Department of Veterans Affairs require refreshers every two years.
How many hours of radiation safety training do interventionalists need?
The International Commission on Radiological Protection (ICRP) suggests 20 to 30 hours of radiation protection training for interventional cardiologists and other interventionalists, and 8 to 12 hours for nurses who assist in X-ray procedures (Publication 113). Rhode Island requires 8 hours before fluoroscopically guided interventional work, and Texas wrote an 8-hour rule for physicians in 2013 but has delayed enforcing it.
How can I tell whether a course is accredited?
Look for two statements from the provider: an accreditation statement naming the body that accredits it, and a credit designation such as "designates this enduring material for a maximum of 3 AMA PRA Category 1 Credits™." The American Medical Association does not allow providers to say credit has been "applied for." Technologists should look for Category A or A+ credit, and nurses for contact hours.
Does ORSIF offer CME?
No. ORSIF (Occupational Radiation Safety in Interventional Fluoroscopy) does not hold CME accreditation and does not certify anyone. The 2025 Symposium on Interventional Radiation Protection (SIRP), which HMP Global presented in collaboration with ORSIF, carried credit through HMP Global's accredited education company. ORSIF members can watch the SIRP 2025 recordings on orsif.org at no cost, without credit.
More answers are in the radiation safety FAQs.
Sources
Where each fact comes from
Education and Training in Radiological Protection for Diagnostic and Interventional Procedures
A second level of training for interventionalists, knowledge of risks and precautions for nurses who assist, and updates at intervals of no more than 36 months. Free to download.
Guidelines on radiation protection education and training of medical professionals in the European Union
Its annex reproduces ICRP 113's tables of suggested training hours: 20 to 30 for interventionalists, 8 to 12 for nurses who assist.
Occupational Radiological Protection in Interventional Procedures
Calls initial and continuing training in occupational protection a requirement. Free to download.
Occupational Protection in Interventional Radiology: A Joint Guideline
Initial and periodic training for everyone in the room, dosimetry, the eye lens, musculoskeletal injury and pregnancy.
Standards revisions for organizations providing fluoroscopy services, ambulatory health care
The annual fluoroscopy training requirement that took effect January 1, 2019.
Radiation risks of diagnostic imaging and fluoroscopy (revised February 2019)
Suggests annual education, review and competency testing; an alert is advice, not a standard.
NPG 13: Protecting Patients and Providers in Imaging
Hospitals must define and verify qualifications and education requirements for imaging staff.
Condition of participation: Radiologic services
Only personnel designated as qualified by the medical staff may use radiologic equipment.
Interpretive guidelines for 482.26(c)(2)
Training and demonstrated competence before staff are designated as qualified, then periodic training.
Technical Standard for Management of the Use of Radiation in Fluoroscopic Procedures
A policy for granting fluoroscopy privileges, and CME that includes radiation protection.
Ionizing radiation
Paragraph (i)(2): instruction for workers in a radiation area.
Fluoroscopy
The FDA regulates equipment makers; states and other agencies regulate use. It recommends equipment-specific training.
VHA Directive 1105.04, Fluoroscopy Safety
Refresher training every 2 years for operators and supervisors, and safety training every 2 years for everyone in the room.
Council Directive 2013/59/Euratom
Article 15, training for exposed workers; Article 18, continuing education for practitioners.
Requirements for continuing education
Fluoroscopy permit holders: 10 credits every two years, 4 in fluoroscopy radiation safety.
Fluoroscopic X-ray systems
Annual radiation safety training hours for physicians who are not board certified in radiology.
Regulations for the Control of Ionizing Radiation, section F.5(n)
Training before clinical use and 1 hour every 24 months (the state agency's unofficial compiled copy).
General and administrative requirements, fluoroscopy training
Initial hours, interventional hours with hands-on training, and refreshers every 24 months.
Medical fluoroscopic equipment
Two hours of fluoroscopy-specific training, and retraining after a high yearly dose.
Use of radiation machines in the healing arts
The 8-hour CME rule for physicians performing fluoroscopically guided interventional procedures.
Questions and answers on 25 TAC 289.227
Implementation of the radiation safety awareness training is delayed indefinitely.
Eligibility
Companies whose main business is health care products may not provide or control accredited education.
The Physician's Recognition Award and credit system
How providers must state AMA PRA Category 1 Credit™, and why "applied for" is not allowed.
Credit requirements and IPCE credit
Interprofessional credit for activities planned by and for the healthcare team.
Efficacy of a minicourse in radiation-reducing techniques in invasive cardiology
A 90-minute course and a 48.4% lower median dose-area product at 32 centers.
Immersive virtual reality and traditional didactic training on radiation safety: a crossover study
Virtual reality training lowered staff dose more than lectures.
Radiation protection knowledge, attitudes and practice in interventional radiology and cath labs
53% of respondents had received radiation protection training.
National survey on radiation safety among vascular surgery trainees and consultants in Spain
Few had taken an updated radiation protection course.
Increasing awareness and reducing occupational hazards in the cath and electrophysiology labs
Limited knowledge of mitigation linked to musculoskeletal injury; an ergonomics video adopted by 75.9%.
Related from ORSIF
- State Rules Map: training and other rules in every state
- Radiation safety FAQs
- What ALARA means and what is changing in 2026
- What is ALARA+? The 2026 reframing of radiation safety
- International guidelines and dose limits
Acronyms used on this page: continuing medical education (CME); continuing education (CE); American Medical Association (AMA); Accreditation Council for Continuing Medical Education (ACCME); interprofessional continuing education (IPCE); American Registry of Radiologic Technologists (ARRT); American Nurses Credentialing Center (ANCC); physician assistant (PA); nurse practitioner (NP); certified registered nurse anesthetist (CRNA); radiation safety officer (RSO); maintenance of certification (MOC); musculoskeletal (MSK); International Atomic Energy Agency (IAEA); International Commission on Radiological Protection (ICRP).
This guide is education, not legal or licensing advice. Listing a course is not an endorsement, and no provider paid to be listed. Requirements and course details change, so confirm them with the provider, your licensing board and your facility's radiation safety officer. Last updated November 11, 2026.