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Discussion in 'Anesthesiology' started by critd, Jul 3, 2014.
Any one taking the Basic TEE boards? I am using PTE masters.
I am. I didn't pay for PTE masters but have Burch's book "Conquer the PTEeXAM", and I've been going through the free lectures on his website. During my Echo elective, I read most of the Sidebotham book. I think most of this covers the content outline on the ASE website. To me, the exam is a bit of an unknown because I don't know anybody who has taken it in the past. Does anybody have insight into the general themes and level of questions?
I'm debating taking this vs. cardiac fellowship. I wish I knew if most places doing hearts considered it enough or if they really want advanced certs only. I want to do hearts in private practice I think, but i'd rather skip the fellowship if I can.
My attendings also tell me there is talk of discontinuing this exam because theres just no demand for it. I wouldn't want a defunct certifcation.
My group requested I take the test. I believe the exam is only offered every other year because the demand is low. My job was too good to turn down for a fellowship right now, but I kinda wish I had stuck it out the extra year.
I took the Basic exam a few years ago. I used the Sidebotham book along with E-Echocardiography (subscription service). Between those two things, I was overly prepared. The content of the exam is pretty rudimentary stuff. I very much enjoyed E-echo, and it is very helpful to see video clips as opposed to still frames from books. You can also get very cheap echo CME from e-echo, which is nice if you want to get certified without throwing down big bucks for the SCA/ASE course (although I've done that as well).
Regarding the certification, it is probably pretty worthless. If you look at what is "enables" one to do (per the ASE/NBE), it is totally for non-cardiac surgery. It basically "certifies" one to evaluate/monitor cardiac function during procedures on people with sick hearts or during hemodynamic emerencies. No diagnostics. I can count on one hand the number of non-cardiac cases I've used TEE on since residency, and most of those cases were thoraco-abdominal aneurysms. I do TEE regularly for cardiac cases in PP, as do all of my partners, the vast majority of whom do not have any TEE certification. At the end of the day, it's just a feather in your cap. Something on the resume to differentiate you when looking for jobs (or trying to keep your own job when our AMC overlords swoop in to thin the herd). I really did it for personal academic interest. Outside of making me a "go to" guy for TEE questions in my group, it's had no real effect.
Thank you guys for these prompt responses.
I am taking this test to further my interests in basic icu ultrasound.some certification will be better than none
Basic and no fellowship is probably OK for a place that does only bread and butter hearts, though in my fellowship-trained opinion that isn't optimal care.
If the group does any cases with any degree of significant complexity, you owe it to the patients to do it right IMO.
There have been a good number of times where a case billed as a routine CABG or AVR turns into something more based on the TEE findings I obtain, which are sometimes subtle and probably wouldn't have been noted without the training I got in fellowship.
Did plenty of complex hearts in residency. Arterial switch procedres in the little guys, complex aortic arches under DHCA, transplant, bivads, etc.
Lots of echo. Being at a progam that lets you graduate with lots of numbers and allows echo rotations is certainly something to look for if you plan on not doing a fellowhsip.
That being said, I was miles away from my CT trained partner when I started. Had to play catch up and to this day I am greatful to have him around to draw from his experience. You just can't replace a solid fellowship. If I could do it all over again, I would have stayed another year.
As for the basic exam. I think it's great that people are trying to expand their knowledge in echocardiography. I think it will only benefit you and the patient.
Does passing the advance echo board exam and becoming a testamur have any value? I want to expand my echocardiography knowledge and I will never meet the requirements for the advanced certification.
I'm taking the Basic exam this month, and mostly using PTE Masters to review. Working through some of these lectures, I can't help but feel that I am over preparing for this exam (how much diastology, congenital heart, and 3D could really be on the Basic exam?).
We are a fairly low-volume shop (high volume, from the DoD's perspective), with just over a hundred hearts a year, and we have one CT fellowship trained anesthesiologist. I will be the only other one with any form of echo cert, and am mostly taking the exam for personal interest, and for something objective to place on a CV to stand out from the crowd. Ultimately, it'll just serve as a foundation, as I'm planning on CCM fellowship when I leave the Army, and am mostly looking at programs with strong echo exposure.
For some of us who graduated on or before 2009, we will be able to achieve certification via the practice pathway. You need to be doing a minimal of 50 hearts a year and have done a minimal of 150 hearts in 3 years or less. That being said, testamur status is fantastic piece to have on your CV (for both basic and advanced). I have friends in big cities that have the monopoly on most of the cardiac cases. Their groups will not hire you unless you are at least testamur status in advanced echo. 90% of them are cardiac trained. "Value" depends on where you are planning on working.
Academically speaking, I think it raises the bar significantly. The advanced echo baords requires serious study.
Having 400ish echo exams under your belt should make the test much easier, but it's still a gnarly piece of work.
For those in residency: Get to know your cardiac attendings. They carry a wealth of knowledge.
I had a core of 3 awesome attendings that I bonded with. They taught me the basics and some of the more advanced stuff. I also came in early during my general months and was able to get my hand on the probe for 10-20 minutes at a time during my CA-2/3 years. Sometimes I didn't, but I was able to observe an exam being done. As a senior on regional, I'd let the young bucks do all the blocks and head over to the CT rooms. If there were interesting cases that started after I was relieved, I'd stick around for them- as painful as that may sound.
Just be humble, respectful and don't get in the way. Even if you are not the primary on that bad-ass case, you can still learn a lot by keeping your eyes peeled.
It's all attending dependent... but you'll figure out the cool ones from the not-so cool ones pretty fast.
Hey guys so I took the basic exam today. I felt that the intro section to tee series of lectures on e echo cardiography.com was very high yield. Thanks for the tip b-bone. Used perrino for some background but not the crazy physics stuff. Also if you need a refresher on the twenty standard views Toronto general hospital has an amazing tee simulator website that helped tremendously in solidifying the anatomy. Also perrino has a appendix of equations in the back of the book. Lots of applications of the modified Bernoulli equation and the continuity equation. The exam was mostly identifying anatomy/ischemia and simple calculations....like the outline.
Finally, make sure you download the demo software for the exam. Some of the questions on the demo were similar to the exam. Probably did too much work for such a low yield exam but my dept paid for it and it is a feather in your cap for tenure and promotion.
T0ok it on July 14 also. 150 questions so fairly short. Many questions were softballs involving the continuity equation, recognizing gross pathology like wide-open VSD, using simplified Bernoulli, optimizing imaging, and basic coronary and LV regional/segment anatomy. Mostly the media and loops were OK, though many loops were barely a full cardiac cycle and there were a few stills of nonstandard views that were undecipherable.
The best way to prepare is to DO a lot of echos, optimize images, learn the 3d anatomy.
I had online access to 2 echo books (one of them being the companion to Kaplan) which was more than enough.
I think overall it was worth it; I certainly didn't want to study for (and probably couldn't pass) the advanced, and like others have said it's a nice attribute on your CV etc.
Hope you guys all did well, I found out I passed today so I'm stoked! Now just waiting for the ABA written results. It's a bit frustrating that the site is still down.
Passed. Now, to wait for the orals in October, and I am done with tests for a while.