PGY1 Advanced Ultrasound Rotation

The goals of 2 week Advanced Ultrasound rotation are:

  • To become proficient in bedside image acquisition and interpretation in the life-saving US applications, and reliably integrate EUS into clinical practice.

  • To attain certification in the life-saving and core Emergency Ultrasound applications as defined by ACEP: >25 scans per application with grand total >150 scans.

  • To reach the Level 4 Milestone competency in Emergency Ultrasound as defined by CORD-SAEM

  • To develop knowledge and skill in the remaining core EUS applications.

The focus of the Advanced Ultrasound rotation should be to:

  • Ensure that credentialing criteria are met in a subset of the following applications:

    • EFAST

    • AAA

    • Cardiac

    • Thoracic

    • Renal/Urinary Tract

    • Biliary

    • Soft Tissue

    • Vascular access

  • Continue to develop knowledge and skill in the remaining core US applications:

    • First trimester pregnancy

    • DVT

    • Ocular

    • MSK

Clinical experience

  1. Supervised scanning shifts - please refer to Google calendar for dates/times to meet faculty in the ED for bedside scanning and teaching.

  2. Independent scanning shifts - during times when there is no supervised scanning, the intern should be scanning independently in the ED. Patients scanned independently should have a confirmatory study as a gold standard (e.g. CT abdomen, CXR, confirmatory US performed by radiology).

  3. Weekly education/QA meetings - these take place every Thursday at 9am in the 4th floor conference room of the Bayview ED (Room 4100 -- next to the Peds ED). You must attend all Wednesday meetings during your rotation.

Schedule

  • In general, the PGY-2 should be in the ED from Monday-Friday for scanning. At least 5 hours a day should be devoted to bedside US scanning to be able to meet rotation requirements.

  • The resident must attend resident conference every Friday morning.

  • The US rotation is a clinical rotation, and scheduling of other commitments must be approved in advance by the US faculty.

Requirements

1) CLINICAL

  • Perform at least 90 high quality and correctly interpreted ultrasound studies and complete appropriate reports in Qpath.

  • By end of PGY-1 and PGY-2 rotation, you must have >25 scans per application in 6 applications, with grand total >150 scans.

  • Attend all Monday education/QA meetings while on rotation.

2) READING

Review prior reading from basic US rotation, and read the following chapters in Noble's Manual of Emergency and Critical Care Ultrasound.  It's available online on the JHU library website:  https://catalyst.library.jhu.edu/catalog/bib_4300823.

  • Chapter 4: First Trimester Ultrasound

  • Chapter 8: DVT

  • Chapter 10: Ocular

  • Chapter 11: Soft Tissue and Musculoskeletal

  • Chapter 12: Gastrointestinal

  • Chapter 13: Pediatric

  • Chapter 14: Ultrasound in Shock

  • Chapter 16 Procedural guidance

Additional educational material (reading and videos) will be assigned during the rotation.         

3) ASSESSMENT

Complete the following ACEP ultrasound online exams at www.emsono.com/acep  with a minimum score of 70%.  You can take the exam as many times as necessary to achieve this.  Submit your printed score reports at the end of the rotation.  It is wise to keep a copy of your test results for your records, as you will be required to complete all tests by the end of the PGY2 Ultrasound rotation.

  • Lung

  • Ocular

  • Soft Tissue & Musculoskeletal

At the end of the PGY1 Advanced US rotation, please submit a completed Ultrasound Rotation Checklist (together with your ACEP exam reports) to Dr. Fong's mailbox in the ED administrative offices (next to resident mailboxes).

4) PRESENTATION

A 15-20 minute presentation on an advanced ultrasound topic or current ultrasound literature (pre-approved by ultrasound faculty) will be required during one of the Wednesday QA meetings during the rotation

Planned Parenthood

Residents should attend 1 or 2 Planned Parenthood shifts during the 2 week rotation.  Please refer to the Planned Parenthood page for more information.

Contacts

Casey Wilson, MD: cwilso99@jhmi.edu

Randall Rhyne, MD:  rrhyne@jhmi.edu
Tiffany Fong, MD: tfong3@jhmi.edu