RhMSUS Process

Participation in RhMSUS or the Musculoskeletal (MSUS or MSK) Ultrasound Certification in Rheumatology program is voluntary and open to anyone meeting the eligibility requirements.

ACR has partnered with Castle Worldwide, Inc. to manage the process. You may be directed to/from Castle while applying.

Steps to RhMSUS Certification

Step 1: View the Eligibility Requirements and Select Your Pathway

There are four pathways to eligibility. Each pathway contains career status, medical license possession, and musculoskeletal ultrasound scan experience/education requirements.

Find your eligibility pathway>

Pathway 1 U.S. trained rheumatologist Appendix A (pg. 12)
Pathway 2 Non-U.S. trained rheumatologist Appendix B (pg. 15)
Pathway 3 Rheumatology fellow-in-training Appendix C (pg. 17)
Pathway 4 Physician assistant or nurse practitioner Appendix D (pg. 19)

Membership in the American College of Rheumatology (ACR) or Association for Rheumatology Health Professionals (ARHP) is not required.

Step 2: Prepare your CME and Scan Documentation

Each pathway has requirements for a minimum amount of MSUS ultrasound CME credits and MSUS scans performed.

CME Activities Criteria:

  1. All activities must comply with the ACCME Essential Area and Policies.
  2. The activity must offer a minimum of 14 AMA PRA Category 1 Credits™ and at least 40% of the total CME hours must be dedicated to mentored hands-on scanning practice sessions.
  3. For hands-on scanning practice, there must be no more than five learners per faculty member.
  4. Each activity must have at least one faculty member that is a rheumatologist.
  5. At least 20% of the didactic portion of the course should cover diagnosis of disease pathology.
  6. If commercial support is received, the sponsoring organization must attest to:
    • Complying with the ACCME Standards for Commercial Support: Standards to Ensure Independence in CME Activities.
    • Using ultrasound equipment from more than one commercial entity.

Credits earned outside of the required “at least 14 AMA PRA Category 1 Credits™ from a single course that includes hands-on scanning practice” must be AMA PRA Category 1 Credits™ specifically related to MSUS.

In case of application audit, a copy of the earned CME certificate(s) must be submitted.

For more information see RhMSUS CME Activity Checklist in Appendix E of the Candidate Handbook (pg. 21).

Scan Log Criteria:

Ultrasound scans can be limited or complete, diagnostic or therapeutic. For each unique patient/subject/model, no more than one scan per day can be logged.

In case of application audit, a log with the information included on the Sample Patient/Practice Scan Log or a billing log (both without identifying information in conformity with HIPAA) must be submitted for proof of the number of scans completed.

Step 3: View Application Deadlines and Testing Windows

The RhMSUS exam is offered twice a year. Applications will automatically be scheduled for the upcoming testing window based on the date the application is received.

Spring 2018

  • Application Deadline: March 30
  • Late Application Deadline ($50 late fee): April 13
  • Testing Window: May 15 - June 15

Step 4: Fees

The certification registration fee includes the processing of the application, examination registration, and one testing appointment.

Category Fee
ACR/ARHP Members
Individuals who have been elected to membership and current on their dues.
Non-ACR/ARHP Members
Individuals who are not ACR/ARHP members.
ACR Fellows-in-Training Members
Fellows-in-training who have been elected membership and current on their dues.
Non-Member Fellows-in-Training
Fellows-in-training who have not been elected to membership. These individuals must include a letter from their program director, chief of service or faculty advisor to be eligible for this discounted rate.
Late Applications
Applications are accepted up to 30 days prior to the opening of the testing window.
Candidates who fail the examination receive information on scheduling a second testing appointment.
International Testing Site
Candidates can take the examination at an international testing site for an additional fee collected at the time of scheduling.

Step 5: Apply

Candidates must complete an online application and a multiple-choice, computer-based examination.

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Step 6: Schedule Your Examination

The examination will take place at Castle Internet-Based Testing Sites located throughout the United States. Thirty days prior to the beginning of the testing window, a Castle representative will contact you via email to schedule your examination. Seats are filled on a first-come, first-served basis, based on test center availability.

International Testing Sites Available

Candidates can take the examination at an international testing site for an additional $150 that will be collected at the time of scheduling.

Step 7: Prepare for Your Examination

The examination consists of 100 multiple-choice questions based on the following domains:

Domain I Recognize Indications for the Use of Ultrasound in Rheumatology
Domain II Preparing the Patient and Environment
Domain III Equipment Use and Management
Domain IV Performing the Ultrasound Examination
Domain V Interpretation and Integration
Domain VI Procedural Guidance
Domain VII Documentation

The Candidate Handbook contains the following resources to help you prepare for the examination:

Full Test Content Outline Appendix F (pg. 22)
Sample Questions Appendix G (pg. 32)
Recommended References Appendix H (pg. 33)
Exam Preparation Tips Appendix J (pg. 41)

Step 8: Receive Your Examination Results

Examination results are mailed approximately six weeks after the close of the testing window.

Individuals who pass the examination will receive a personalized certificate and wallet card. In the case of an eligibility audit, certificates will be held until the audit is complete.

Individuals who do not pass the examination may retest in the next testing window. Candidates may not take the examination more than two times in any 12-month period. Candidates who need to retest will receive a Notice to Schedule email 45 days before the next testing window. During the scheduling process, candidates will be prompted to pay the retake fee of $100.

Step 9: Recertify

Recertification is required at 10-year intervals effective as of the date of RhMSUS certification. To complete the recertification process, the candidate must complete the following:

  1. Present documentation verifying the completion of a minimum of 10 AMA PRA Category 1 CreditsTM in musculoskeletal ultrasound within 60 months preceding the recertification process.
  2. Present documentation verifying the completion of a minimum of 100 musculoskeletal ultrasound scans have been completed within 24 months prior to recertification.
  3. Pass a computer-based recertification examination.
  4. Pay a recertification fee.