MQSA Physicist Qualifications Jon Erickson 2016

Integrated Science Support, Inc 2027 North 36

th Street

Saint Joseph, Mo 64506 (816) 390-9011 (800) 306-4477

MQSA Physicist Qualifications

Jon J. Erickson, Ph.D., DABR

Contents

Missouri Mammography Physicist Initial Qualifications Certificate

Iowa Mammography Approval letter

Initial Training for Digital Mammography

Initial Training for Breast Tomo Synthesis

Hologic Dimensions

General Electric SenoClair

Siemens Mammomat Inspiration

Continuing Experience

Continuing Education

Distributed February 2016

Lucas State Office Building, 321 E. 12th Street, Des Moines, IA 50319-0075 515-281-7689 www.idph.state.ia.us

DEAF RELAY (Hearing or Speech Impaired) 711 or 1-800-735-2942

Terry E. Branstad Kim Reynolds Governor Lt. Governor

Gerd W. Clabaugh, MPA Director

March 9, 2016

Jon J. Erickson Certficate #08

Integrated Science Support Inc.

2027 North 36th

Street

St. Joseph, Missouri 64506

Dear Dr. Erickson,

This letter is to verify that you have met the Iowa registration requirements for a medical physicist in:

Mammography: Film/Screen

Mammography: Digital

Tomosynthesis – Hologic, GE and Siemens

Therefore, you are permitted to perform all those procedures required under Iowa Radiation machines

and Radioactive Materials Rules for the above categories. This registration expires April 28, 2017.

Each Iowa facility where you provide medical physics services must have a copy of this Medical

Physics Approval letter.

Thank you for your cooperation. Please call 515-285-0405 for mammography or 515-281-0419 for

radiation therapy if you have any questions.

Sincerely,

Angela Leek MS, Bureau Chief Bureau of Radiological Health Division of ADPER/EH Iowa Department of Public Health 515/281/3478 – Office 515/281/4529 – FAX [email protected]

AL/jak

http://www.idph.state.ia.us/

Logged in as [email protected], CAMPEPID# 9852 | Logout

CAMPEP

Commission on Accreditation of Medical Physics Education Programs, Inc.

Certificate of Medical Physics Continuing Education Credits

----Transcript----

Jon Erickson

2027 North 36th Street

Saint Joseph, MO 64506

US

Participated in the following CAMPEP accredited educational program(s) and is awarded Medical Physics Continuing

Education Credits (MPCECs) as designated

Program Title

Date

Credits

Earned

Category/SubCategory EA Title Credits

2013 AAPM

Online

Continuing

Education

12/09/2013 Nuclear Medicine:None 1622-N Quantitation of SPECT Performance 1

2013 AAPM

Online

Continuing

Education

12/09/2013

Radiation

Protection:Radiation

Protection

1823-N Adult and Pediatric Doses in CT 1

2013 AAPM

Online

Continuing

Education

12/09/2013

Diagnostic

Radiology:Computed

Tomography

1826-N Quality Control in CT, CE - CT 2 1

2014 AAPM

Online

Continuing

Education

12/03/2014 Nuclear Medicine:None1659-N Nuclear Medicine 1 - Scintillation

Camera QC and Accreditation1

2014 AAPM

Online

Continuing

Education

12/03/2014 Nuclear Medicine:None1688-N PET Scanner Performance: Quality

Assurance and Acceptance Testing1

2014 AAPM

Online

Continuing

Education

01/28/2014Diagnostic

Radiology:Ultrasound

1797-N Ultrasound Scanners: Performance

Expectations and Assessments.1

2014 AAPM

Online

Continuing

Education

01/23/2014

Diagnostic

Radiology:Computed

Tomography

2058-N CT: Parameter and Protocol

Optimization1

2014 AAPM

Online

Continuing

Education

01/23/2014

Diagnostic

Radiology:Computed

Tomography

2061-N CT: Dose Estimation and

Measurement1

2014 AAPM

Online

Continuing

Education


Radiology:Ultrasound

2079-N 1 Quality assurance phantom for

gray-scale ultrasound scannersUltrasound 2

Performance testing for any shape

transducer via detectability of anechoic

spheres

1

2014 AAPM

Online

Continuing

Education

01/07/2014 Diagnostic

Radiology:Mammography

2093-N Breast Tomosynthesis: The image

acquisition process

1

2014 AAPM

Online

Continuing

Education



2135-N Anatomical Noise in Contrast

Enhanced Digital Mammography1

2014 AAPM

Online

Continuing

Education



2218-N The Revised ACR MRI Quality

Control Manual: Status Report1

2015 AAPM

Online

Continuing

Education



1632-N Manufacturers Quality Control

Output Templates1

2015 AAPM

Online

Continuing

Education

04/06/2015Nuclear Medicine:Radiation

Protection

2090-N SPECT/PET: Shielding and Radiation

Protection1

2015 AAPM

Online

Continuing

Education

04/15/2015

Radiation

Protection:Diagnostic

Radiology

2123-N CT: Shielding and Radiation

Protection (room, personnel and patient

shielding)

1

2015 AAPM

Online

Continuing

Education

04/15/2015 Nuclear Medicine:None2171-N Characterization of the count rate

performance of modern gamma cameras1

2015 AAPM

Online

Continuing

Education


Radiology:Radiography

2201-N The Art of the Image: The

Identification and Remediation of Image

Artifacts in Projection Radiography

1

2015 AAPM

Online

Continuing

Education



2203-N Comparative performance of

modern digital mammography systems1

2015 AAPM

Online

Continuing

Education



2209-N Accreditation of Stereotactic Breast

Biopsy and Breast Ultrasound Systems1

2015 AAPM

Online

Continuing

Education

04/06/2015Nuclear Medicine:Quality

Management

2212-N Testing of Gamma Camera, SPECT,

and SPECT/CT Systems in a Clinical

Environment

1

2015 AAPM

Online

Continuing

Education

04/24/2015Nuclear Medicine:Quality

Management

2214-N What Medical Physicists Need to

Know about Breast Imaging with Nuclear

Medicine Technology

1

2015 Spring

Clinical Meeting03/08/2015

Diagnostic


Advances in Breast imaging: Digital Breast

Tomosynthesis2

2015 Spring


Diagnostic

Radiology:MammographyClinical Topics in Breast Imaging Pt1 1

2015 Spring


Diagnostic

Radiology:MammographyClinical Topics in Breast Imaging Pt2 1

2015 Spring


General Medical

Physics:ProfessionalDiagnostic Professional Session 2

2015 Spring


Diagnostic

Radiology:RadiographyDigital Radiography QC 2

2015 Spring

Clinical Meeting

03/08/2015 General Medical

Physics:Professional

Medical Physics Practice Guidelines and

Quality Metrics

2

2015 Spring

Clinical Meeting03/09/2015 Diagnostic Radiology:None Radiation Dose Metric Monitoring 2

2015 Spring


Diagnostic


Stereotactic Breast Biopsy Advances in

Breast Imaging2

2015 Spring


Diagnostic

Radiology:Computed

Tomography

TJC Update and CT Protocol Review 2

Image Wisely

Radiation

Safety Case

09/15/2013General Medical

Physics:Patient Safety

CT Dose and Size Specific Dose Estimate

(SSDE)0.5

Total Released Credits: 37.5

Order this Transcript Print Back

KDHE Radiation Control Program Certifies

Jon Erickson has satisfactorily completed the following

sessions of the

Kansas Radiation Control Program Conference 2014

Cat. A CEU Reference No. KSD0094008 Genetic Testing for BRCA: Implications for Medical Imaging (1 Credit)

Cat. A. CEU Reference No. KSD0094009 Lessons Learned in Tomosynthesis (1 Credit)

Cat. A. CEU Reference No. KSD0094010 Mammography Quality Standards Update (1 Credit)

Cat. A. CEU Reference No. KSD0094011 Mammography Outcomes Audit (1 Credit)

Cat. A. CEU Reference No. KSD0094012 Mammographers Making a Difference (1 Credit)

Cat. A. CEU Reference No. KSD0094013 Breasts R Us (1 Credit)

Cat. A. CEU Reference No. KSD0094014 Understanding Your Physicists Report (Mammography) (1 Credit)

Cat. A. CEU Reference No. KSD0094015 What To Expect From Your Inspector (1 Credit)

The above courses with ASRT ID numbers have been approved by the ASRT Department of Education. The number of credits earned are listed next to the event name.

September 9 and 10, 2014

~ r. .. ·:.:·. ·.·. ·. ·. ::· .. · ... :'\ ans as

Depanment of Health and Environment

Signature of

Authorized Representative



sessions of the


Cat. A CEU Reference No. KSD0094019 Pediatric MR Imaging: Tiny Tots and Large Magnets (1 Credit)

Cat. A. CEU Reference No. KSD00940.20 What To Expect From Your Medical Materials Inspector (1 Credit)

Cat. A. CEU Reference No. KSD00940.2.2 What To Expect From Your Medical X-ray Inspector (1 Credit)



Signature of Authorized

Representative

- ---- ---- -------------------------------------------------------------------------------------------------------!



sessions of the


Cat. A. CEU Reference No. KSD0094016 Panel Discussion: Ask the Radiation Control Program, Q&A Session (2 Credits)



Signature of Authorized

Representative

Authorized by: 4/15/2014 Greg Sackett, M.S., CHP Date

Jon Erickson, Ph.D.

Certificate of Completion

Awarded to:

For Attendance of the Mid-America Radiation Safety Roundtable on April 14-15, 2014 CE Credits awarded: Radiation Protection 14 hours Diagnostic Imaging 2 hours

Mid-America Radiation Safety Roundtable Overland Park, KS April 14-15, 2014

THIS CERTIFIES THAT:

Jon Erickson

HAS SUCCESSFULLY COMPLETED THE LIVE WEBINAR ENTITLED:

MODERN ADVANCES IN MRI

Jan 24, 2015

This program has been approved for 8.00 hours of Category A continuing education credit for Radiologic Technologists as required by the ARRT and by various states requiring approval.

ASRT# WIZ0134047 expires 9/1/15

Program Director

20900 Swenson Drive, Ste 650

Waukesha, Wisconsin 53186

(800)765-6864

Jon J. Erickson, Ph.D., DABR.

March 15, 2015

I

CER1.,IFICATE of COMPLETION This is to certifj; that:

Jon Erickson

successfully completed

MAMMO MAT Inspiration Tomosynthesis for Medical Physicists This 3.0 hour web based training on Siemens Tomosynthesis

for Digital 3 ID Mammography Systems. Training includes Siemens unique feature training.

SIEMENS

Course ID: 900 I 0613

Completion Date: I 0/07/2015

Credits Type/Earned: 3 Category A

Approving Organization: AHRA

Reference Number: ENDl 784

Approved Date Range: 08/13/2015 - 08/31/2016

Gregory Setensen MD President & CEO

L

r I

SIEMENS medical

'I

This is to certify on (date): J (/) JI } JS'

J"oN ~J.-l~ L~ ~Il'J ~<;Of\)

has successfully completed a total of 5.0 hours of Siemens hands-on Tomosynthesis training for Medical Physicists in accordance

with MQSA guidelines for Digital 3-D Mammography Systems:

~UJf--Nanci L Wozniak, BS, RT(N), CNMT

Vice President, Education .Services

The following is a true representation of the Continuing Mammography System Evaluation

Experience for the indicated Physicist.

2/12/2016

Continuing Experience Summary for Jon J. Erickson, Ph.D.

Jon J. Erickson, Ph.D

President

Date

Integrated Science Support, Inc.

2027 North 36th Street

St. Joseph, MO 64506

Facility

State

MQSA

Number System ModelDate

Performed

IA 10408338 3000 Nova/Carestream CR 4/16/2014

IA 10427018 Essential 6/7/2014

IA 10381904 Senographe Essential 6/25/2014

IA 10408338 3000 Nova/Carestream CR 4/27/2015

IA 10381904 Senographe Essential 6/2/2015

IA 10427018 Essential 6/2/2015

IA 121624 Inspiration 11/3/2015

KS 120337 Senographe Essential 6/12/2014

KS 233220 Senographe 800T 7/22/2014

KS 234880 Senographe DMR/ZF000DMR 10/29/2014

KS 109652 Sonographe Essential 1/13/2015

KS 101683 DMR/Fuji CR 1/28/2015

KS 109652 Senographe DS 3/24/2015

KS 237359 Selenia 3/30/2015

KS 149336 Selenia 7/15/2015

KS 164244 Lorad Selenia 7/24/2015

KS 234880 Senographe DMR/ZF000DMR 10/28/2015

MO 116079 Senographe Essential 3/3/2014

MO 233441 Instrumentarium/Carestream CR 3/18/2014

MO 237686 DMR/Fuji CR 5/8/2014

MO 119537 Lorad Selenia 6/27/2014

MO 217588 Essential 7/14/2014

Facility

State

MQSA

Number System ModelDate

Performed

MO 235400 Senographe 800T 7/23/2014

MO 234020 Alpha (MGF 110) 7/24/2014

MO 233441 Alpha (MGF 110) 7/25/2014

MO 174330 3000 Nova/Fuji CR 8/26/2014


MO 154526 Lorad M-IV/Fuji CR 10/8/2014

MO 200824 Selenia 10/15/2014


MO 237239 Platinum M-IV- HTC Grid/ Fuji FCR 12/9/2014

MO 238673 Lorad M-IV Platinum 12/18/2014

MO 238396 Planmed Classic 1/14/2015

MO 233441 Instrumentarium/Carestream CR 3/18/2015

MO 174330 Selenia - Dimension 3/25/2015


MO 182758 Aspire 5/21/2015

MO 237686 DMR/Fuji CR 5/28/2015

MO 174330 Selenia - Dimension 8/25/2015

MO 154526 Lorad M-IV/Fuji CR 10/2/2015

MO 200824 Selenia 10/5/2015

IA Facilities: 4 IA Machines: 7

KS Facilities: 8 KS Machines: 10

MO Facilities: 17 MO Machines: 24

MQSA Physicist Qualifications Jon Erickson 2016

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