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
Initial Training for Digital Mammography
Initial Training for Breast Tomo Synthesis
Hologic Dimensions
General Electric SenoClair
Continuing Experience
Continuing Education
Distributed April 2015
Iowa Department of Public Health Promoting and Protecting the Health of Iowans
Gerd W. Clabaugh, MPA Director
April 18, 2014
Jon J. Erickson, Ph.D. Integrated Science Support, Inc. 2027 North 36th Street St. Joseph, Missouri 64506
Dear Dr. Erickson
Terry E. Branstad Governor
Kim Reynolds Lt. Governor
This letter is to verify that you have met the Iowa registration requirements for a medical physicist in:
Mammography: Film/Screen
Mammography: Digital
Tomosynthesis
Therefore, you are permitted to perform all those procedures required under Iowa Radiation machines and Radioactive Materials Rules for the above category. This registration expires April 28, 2015.
Each facility where you provide medical physics services must have a copy of your Medical Physics Approval letter.
Thank you for your cooperation. Please call 515-285-3246 for mammography or 515-281-0403 for radiation therapy if you have any questions.
Sincerely,
Angela Leek, reau Chief Bureau of Radiological Health Division of ADPER/EH (515) 281-3478 - Office Fax (515-281-4529-FAX Angela. [email protected]
AL/jak
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
Jon J. Erickson, Ph.D., DABR.
March 15, 2015
The following is a true representation of the Continuing Mammography System Evaluation
Experience for the indicated Physicist.
1/26/2015
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 4/22/2013
IA 10381904 Senographe Essential 6/11/2013
IA 129296 Mammomat Novation DR 6/13/2013
IA 121624 Mammomat Novation DR 11/14/2013
IA 10408338 3000 Nova/Carestream CR 4/16/2014
IA 10427018 Essential 6/7/2014
IA 10381904 Senographe Essential 6/25/2014
KS 173062 Diamond w/ Fuji CR 3/13/2013
KS 107064 Senographe 2000D 4/11/2013
KS 233220 Senographe 800T 7/16/2013
KS 223065 Senographe Essential 10/7/2013
KS 234880 Senographe DMR/ZF000DMR 10/16/2013
KS 118612 Lorad Selenia 1/15/2014
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
MO 227260 Essential 1/29/2013
MO 233441 Instrumentarium/Carestream CR 3/12/2013
MO 109694 Senographe Essential 3/16/2013
MO 116079 Senographe Essential 3/22/2013
MO 182758 Lorad M-IV Platinum HTC Grid 4/2/2013
Facility
State
MQSA
Number System ModelDate
Performed
MO 209619 Senographe Essential 4/6/2013
MO 140079 Senographe DS 7/9/2013
MO 235400 Senographe 800T 7/17/2013
MO 234020 Alpha (MGF 110) 7/18/2013
MO 233441 Alpha (MGF 110) 7/19/2013
MO 174330 3000 Nova/Fuji CR 8/6/2013
MO 18327 Performa 8/27/2013
MO 200824 Selenia 10/1/2013
MO 237239 Platinum M-IV- HTC Grid/ Fuji FCR 11/1/2013
MO 143149 Selenia Dimensions 11/11/2013
MO 143149 Selenia Dimensions 11/11/2013
MO 143149 Selenia 11/11/2013
MO 238396 Planmed Classic 11/18/2013
MO 187526 Selenia Dimensions 12/6/2013
MO 238673 Lorad M-IV Platinum 12/16/2013
MO 227260 Essential 1/29/2014
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 Essential 7/14/2014
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 109652 Senographe Essential 9/23/2014
MO 154526 Lorad M-IV/Fuji CR 10/8/2014
MO 200824 Selenia 10/15/2014
MO 148205 Senographe Essential 11/20/2014
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
Facility
State
MQSA
Number System ModelDate
Performed
IA Facilities: 0 IA Machines: 7
KS Facilities: 13 KS Machines: 10
MO Facilities: 15 MO Machines: 37
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
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. 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)
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
Signature of Authorized
Representative
- ---- ---- -------------------------------------------------------------------------------------------------------!
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. KSD0094016 Panel Discussion: Ask the Radiation Control Program, Q&A Session (2 Credits)
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
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
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
01/23/2014Diagnostic
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
01/06/2014Diagnostic
Radiology:Mammography
2135-N Anatomical Noise in Contrast
Enhanced Digital Mammography1
2014 AAPM
Online
Continuing
Education
12/03/2014Diagnostic
Radiology:Mammography
2218-N The Revised ACR MRI Quality
Control Manual: Status Report1
2015 AAPM
Online
Continuing
Education
04/06/2015Diagnostic
Radiology:Mammography
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
04/15/2015Diagnostic
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
04/15/2015Diagnostic
Radiology:Mammography
2203-N Comparative performance of
modern digital mammography systems1
2015 AAPM
Online
Continuing
Education
01/26/2015Diagnostic
Radiology:Mammography
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
Radiology:Mammography
Advances in Breast imaging: Digital Breast
Tomosynthesis2
2015 Spring
Clinical Meeting03/08/2015
Diagnostic
Radiology:MammographyClinical Topics in Breast Imaging Pt1 1
2015 Spring
Clinical Meeting03/08/2015
Diagnostic
Radiology:MammographyClinical Topics in Breast Imaging Pt2 1
2015 Spring
Clinical Meeting03/10/2015
General Medical
Physics:ProfessionalDiagnostic Professional Session 2
2015 Spring
Clinical Meeting03/10/2015
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
Clinical Meeting03/08/2015
Diagnostic
Radiology:Mammography
Stereotactic Breast Biopsy Advances in
Breast Imaging2
2015 Spring
Clinical Meeting03/09/2015
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
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