Ultrasound fellowship

[kilroth]

I was wondering if you get a fellowship in ultrasound if you can use it outside of the ED as a side job (i.e. one day a week for a primary care group). Also, does this make you more competitive for community or rural EDs or is it more geared towards academia?

Thanks.

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[docB]

I was wondering if you get a fellowship in ultrasound if you can use it outside of the ED as a side job (i.e. one day a week for a primary care group).

I would say no. The mantra of ED US is focused limited exams while a primary care group or anyone else outside of the ED would require full exams. But that's only my best guess. Peski?

 

[DropkickMurphy]

http://www.ardms.org/physicians/index.htm Vascular sonography
http://www.ardms.org/appresources/prereq.pdf See prereq's 4A1 and 4A2 That should answer your questions.

 

[bartleby]

Aside from the fact that I can't imagine why you'd want to be a ultrasound lackey to an outpatient IM doc, this sort of misses the point of ultrasound in the ED. The idea is not to replace formal ultrasounds. The point is to extend ultrasound to bedside decision making, particularly in times and settings where it would otherwise be unavailable or impractical. In a hypotensive trauma patient, you don't care about the size of the kidneys or the echogenicity of the liver parenchyma, and you certainly can't wait three hours for a "formal reading".

I was wondering if you get a fellowship in ultrasound if you can use it outside of the ED as a side job (i.e. one day a week for a primary care group).

As ultrasound becomes more of an accepted part of EM, there is some interest in integrating ultrasound into community EDs. You don't necessarily need to be fellowship trained to do this, but simply have interest in it. A lot of the skills you cultivate in a fellowship (teaching, research, "pushing the envelope" of u/s) would be wasted in the community setting anyway.

Also, does this make you more competitive for community or rural EDs or is it more geared towards academia?

 

[DropkickMurphy]

I (as a trained echocardiographer) can attest you can make filthy amounts of cash shooting studies for docs, but it pales in comparison to what you would make as a doc.

 

[docB]

I'm gonna bump this so Peski will see it when he cruises by.

 

[peksi]

So,
I'm just back from ACEP and the US management course that we ran. Of note of the 50 folks who attended this course, half were community ED docs and several stated that they are seeking an US Fellowship trained EP for their private group!

So to answer or comment on the questions in this post as i see it or as we are seeing it with EM US and the US Fellowships.

1-Of course you do not NEED to be fellowship trained to perform EM US in the community setting, however the momentum is swinging that community programs are seeking US fellowship trained physicians. Is this every position, of course not, but what represents 10-20 or so places that are activly seeking US fellowship trained folks today will double in the next few years.

From a marketing standpoint my current fellow has jobs flying at him as he stated while we were at ACEP, but this could also be said for residency grads since the market is strong. the demand in community EM specific for EM US fellowship trained doc IS growing. Many fellowships like ours train the fellows for issues specific to those encoutered in these settings. Most residents do not have a detained understanding of the billing, documentation and coding issues for EM US, as well as the understanding in program design and QA.

This is not to say that some well trained residents cannot do this, rather we have had requests (via the ACEP US Section) to help identify EM US fellowship grads for community ED's who feel after 2-3 years of having non-fellowship trained EP's run the program that they believe they need a feellowship trained EP to move things to the next level given their past performance, hurdles etc.

Most EM US fellowships now require ARDMS certification (which has a path for residency trained EP's as well). This is a recognized national certification and has marketablility beyond the ED setting. (This information is not provided as endoursed by ACEP given my position)

Thus in summary, as my own fellowship enters it's 5th year we are seeing more community ED's, large contract groups (like CEP), as well as academic residency programs that are seeking EM US fellowship trained physicians.

It's not for everyone, but the marketability for our graduates remains strong, so we seem to still be on the upslope of the market forces witrh increasing interest by community ED directors.

Feel free to PM me about US at positions you are interested in or fellowships.

Paul

Paul R. Sierzenski, MD, RDMS, FAAEM, FACEP
Chair, ACEP Ultrasound Section
Director, Emergency & Trauma Ultrasound
Director, Emergency Ultrasound
Fellowship
Department of Emergency Medicine
Christiana Care Health System
Newark, Delaware
http://www.christianacare.org