5-Day Intensive Prep Healthcare Cybersecurity Boot Camp

Transitioning from SOC to Medical Device Security

🚀 Course Overview

A 5-day intensive program designed to help junior SOC analysts transition into medical device and healthcare cybersecurity roles. Gain hands-on experience with healthcare-specific security frameworks, threat modeling, and penetration testing techniques.

🎯 Key Learning Objectives

  • Master healthcare security standards: ISO 81001, FDA guidance, NHS CyberEssentials
  • Develop threat modeling skills: STRIDE analysis for medical devices
  • Execute medical device pentesting: DICOM security testing, FHIR API security
  • Implement secure SDLC: SAST/DAST, SBOM management, vulnerability patching
  • Communicate security risks: Tailor messages for executives, regulators, and developers

🧑‍💻 Who Should Attend?

  • SOC analysts targeting healthcare cybersecurity roles
  • Junior security professionals interested in medical device security
  • Candidates preparing for security interviews in regulated industries

🏆 Program Outcomes

By completing this boot camp, participants will:
✔ Understand healthcare-specific security requirements
✔ Be able to conduct medical device security assessments
✔ Have practical experience with healthcare security tools
✔ Be prepared for junior analyst roles in medical device security

Duration: 5 days Level: Intermediate Format: Hands-on labs, case studies, interview prep

Day 1: Medical Device Security Foundations

Regulatory Standards Comparison

Control Area ISO 81001 Requirements NHS CyberEssentials FDA Guidance Radiotherapy Implementation
Access Control 5.3.1: Role-based access for clinical functions Control 4: User privilege management Section IV.B: Authentication for treatment changes DICOM AE Title whitelisting + Active Directory integration
Cryptography 5.3.2: TLS 1.2+ for network communications Control 2: Secure configuration Section VI.C: Encryption of PHI in transit DICOM TLS with AES-256 and certificate-based authentication
Audit Logging 5.3.4: Log all treatment plan modifications Control 3: Malware protection Section V.D: Detect unauthorized changes Syslog integration with SIEM for treatment plan changes

Implementation Examples for Radiotherapy Systems:

  1. DICOM Security: Configure Orthanc server with TLS 1.3 using DICOM Supplement 142 Basic TLS Profile.
  2. User Access: Implement CyberEssentials Control 4 by integrating Mosaiq with Okta for MFA.
  3. Patch Management: Automated Windows updates for treatment planning workstations per FDA Section VII.

Healthcare Standards & Architecture

DICOM Security (Supplement 142)

Profile Security Requirements TLS Configuration
Basic TLS Mandatory: Server authentication
Optional: Client authentication
TLS 1.2+ with AES-128
Certificate chain validation
Enhanced TLS Mandatory: Mutual authentication
Secure cipher suites
TLS 1.3 preferred
ECDHE key exchange
OCSP stapling

SMART on FHIR Security Framework

Component Requirement Implementation
OAuth 2.0 Authorization Code Flow with PKCE Azure AD or Okta integration
Scopes Least privilege access patient/*.read for viewing only

2020 Elekta Vulnerabilities Case Study

CVE Vulnerability Impact Mitigation
CVE-2020-6975 Hard-coded credentials in MOSAIQ Unauthorized access to patient data Credential rotation + HSM integration
CVE-2020-6977 DICOM service DOS Treatment delays Rate limiting + AE title validation

Threat Modeling Practice

STRIDE Analysis for Radiotherapy System

Component Spoofing Tampering Repudiation Information Disclosure DOS Elevation of Privilege
DICOM Node Fake AE titles Modified treatment plans No logs of changes Unencrypted PHI Flood C-STORE Admin via DIMSE
Web Interface Session hijacking SQL injection - IDOR Brute force login XSS to admin

Mini Security Risk Management Report

Risk Severity Mitigation Standard Reference
Unauthorized treatment plan modification Critical (CVSS 9.1) Digital signatures with HSM ISO 81001 5.3.3
DICOM DOS attack High (CVSS 7.5) Rate limiting + AE title validation NHS CE Control 1
PHI leakage via FHIR Medium (CVSS 5.3) OAuth scopes + audit logging FDA Section IV

Day 2: Secure SDLC & Technical Documentation

Security Documentation Practice

Medical Device Documentation Requirements

Document Standard Template Structure Example Content
Vulnerability Management SOP FDA Postmarket
  1. Scope
  2. Roles
  3. Process
  4. Timelines
  5. Reporting
"Critical CVEs patched within 7 days per NHS CE"
SBOM OWASP CycloneDX
  1. Metadata
  2. Components
  3. Dependencies
  4. Vulnerabilities
"pydicom 2.3.0 (CVE-2022-2534)"
SOUP Management IEC 62304
  1. Identification
  2. Risk Assessment
  3. Monitoring
  4. Updates
"OpenSSL: Critical, used for DICOM TLS"

Security Risk Management Report Template

1. Executive Summary
   - System: Cloud-connected radiotherapy planning  
   - Scope: DICOM, FHIR, and treatment plan storage  
   2. Risk Assessment Methodology
   - Standards: ISO 14971, ISO 81001
   - Tools: Threat Dragon, Microsoft TMT
  1. Identified Risks

    Risk ID Description Severity Mitigation
    R-001 Unauthorized plan modify Critical HSM signatures

     

  2. Residual Risk Evaluation
    • Justification for acceptable risks
  3. Appendices
    • STRIDE diagrams
    • Testing results

Security Testing Tools

SAST/DAST/SCA Command Reference

Tool Command Output Analysis Medical Device Example
SonarQube sonar-scanner -Dsonar.projectKey=RTPlan Check for hardcoded credentials in DICOM config Verify AE titles aren't hardcoded
OWASP ZAP zap-cli quick-scan -s xss,sqli https://rtp-web Review FHIR API injection flaws Test patientId parameter for IDOR
Dependency-Check dependency-check.sh --project RTPlan --scan /src Flag vulnerable DICOM libraries Check pydicom for known CVEs

Medical Device Code Review Findings

Vulnerability Code Example Fix Standard Reference
DICOM injection dcmsnd +P +sd "*.dcm" Validate AE titles DICOM PS3.15
FHIR IDOR /Patient/{id}/TreatmentPlan Add scope checks SMART on FHIR

Day 3: Penetration Testing & Vulnerability Management

Medical Device Testing Frameworks

Medical Device Penetration Testing (MD-PT)

Phase Activities Radiotherapy Focus Tools
Planning Define clinical impact scenarios Treatment plan integrity Threat Dragon
Discovery DICOM service enumeration AE title brute force dcmtk, nmap
Exploitation DICOM file injection Malformed RT Plan objects dcmodify, pydicom

Radiotherapy System Test Cases

  1. DICOM Service DOS:
    echoscu -aet HACKER -aec TARGET -n 1000 target-ip 104
    
  2. Treatment Plan Tampering:
    dcmodify -i "(300a,00b0)=HACKED" plan.dcm
    
  3. FHIR API Abuse:
    curl -H "Authorization: Bearer token" /Patient/*/RTPlan
    

DICOM Security Testing with dcmtk

DICOM Security Test Commands

Test Command Expected Result Security Control
TLS Verification openssl s_client -connect ip:port -showcerts TLS 1.2+ with strong cipher DICOM Suppl. 142
AE Title Validation findscu -aet HACKER -aec TARGET -P -k 0008,0052="PATIENT" Reject unauthorized AE NHS CE Control 4
DICOM File Validation dcmftest malicious.dcm Reject malformed files FDA Section VI

Penetration Test Report Excerpt

Finding Risk Evidence Recommendation
Unencrypted DICOM High (CVSS 7.4) Wireshark capture Implement DICOM TLS per Suppl. 142

Day 4: Automation & Technical Leadership

Security Automation Examples

SBOM CVE Monitor (Python)

import requests
from datetime import datetime, timedelta

# Configuration
SBOM_FILE = "sbom.json"
SEVERITY = "CRITICAL"
NVD_API = "https://services.nvd.nist.gov/rest/json/cves/1.0"

def check_sbom_vulnerabilities():
    # Parse SBOM (CycloneDX format)
    with open(SBOM_FILE) as f:
        sbom = json.load(f)
    
    # Check components against NVD
    for comp in sbom["components"]:
        if "purl" in comp:
            pkg = comp["purl"].split("@")[0]
            res = requests.get(f"{NVD_API}?cpeMatchString={pkg}")
            
            # Process vulnerabilities
            for vuln in res.json().get("result", {}).get("CVE_Items", []):
                if vuln["impact"]["baseMetricV2"]["severity"] == SEVERITY:
                    print(f"[!] Critical CVE found: {vuln['cve']['CVE_data_meta']['ID']}")
                    print(f"    Affects: {comp['name']}@{comp['version']}")
                    print(f"    Score: {vuln['impact']['baseMetricV2']['cvssV2']['baseScore']}")

if __name__ == "__main__":
    check_sbom_vulnerabilities()

GitHub Actions Security Gates

Stage Action Medical Device Example
PR Check - uses: shiftleft/scan-action@v1 Block PR if SAST finds DICOM hardcoding
Build - run: dependency-check --failOnCVSS 8 Fail build if critical CVE in SBOM

Explain TLS requirements to different audiences:

  • Regulatory Team: “Per ISO 81001 5.3.2 and FDA guidance, TLS 1.2+ is required to protect PHI in transit during DICOM transfers. Non-compliance could delay our 510(k) submission.”
  • Executives: “Implementing TLS prevents $2M+ breach penalties under HIPAA while meeting NHS contract requirements, with minimal performance impact.”
  • Developers: “Use OpenSSL 1.1.1+ with AES-256-GCM and certificate pinning in dcmtk configuration - here’s the code sample.”

Behavioral Question: “Describe implementing security in a regulated environment”

  • Situation: “At [Company], our radiotherapy system needed FDA clearance with cybersecurity requirements.”
  • Task: “I led the effort to implement ISO 81001 controls for the DICOM interface.”
  • Action: “Deployed TLS 1.3 with mutual auth, threat modeled using STRIDE, and documented risk mitigations.”
  • Result: “Achieved FDA clearance 3 weeks early with zero cybersecurity findings.”

Final Interview Checklist

Area Key Points Radformation Alignment
Standards ISO 81001 5.3, NHS CE Controls 1/4, FDA Postmarket Global compliance for cancer care products
Technical DICOM TLS, FHIR scopes, Treatment plan integrity Directly relevant to their products
Behavioral STAR method with metrics Show impact on patient safety

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