Physicians who perform and/or interpret diagnostic ultrasound examinations in the practice of urology should be licensed medical practitioners who have a thorough understanding of the indications and guidelines for genitourinary ultrasound examinations as well as a familiarity with the basic physical principles and limitations of the technology of ultrasound imaging. They should be familiar with alternative and complementary imaging and diagnostic procedures and should be capable of correlating the results of these other procedures with the ultrasound findings. They should have an understanding of ultrasound technology and instrumentation, ultrasound power output, equipment calibration, and safety. Physicians responsible for diagnostic genitourinary ultrasound examinations should be able to demonstrate familiarity with the anatomic, physiologic, and pathophysiologic characteristics of the anatomic areas that are being examined. These physicians should provide evidence of the training and competence needed to perform and/or interpret diagnostic urologic ultrasound examinations successfully. The training should include methods of documentation and reporting of ultrasound studies.
Physicians performing and/or interpreting diagnostic urologic examinations should meet at least 1 of the following criteria:
1. Completion of an accredited urologic residency that includes training in ultrasound since July 1, 2009 (the year reporting of ultrasound examinations was required by the residency review committee), and is board certified by the American Board of Urology or is board eligible. If completion of certification occurred more than 36 months ago, maintenance of competence must be demonstrated, such as 50 diagnostic urologic ultrasound examinations per year and a total of 10 AMA PRA Category 1 Credits™ within the previous 36 months.*
2. Board certification in urology before July 1, 2009, and submission of an attestation of experience including involvement with 100** diagnostic urologic ultrasound examinations and training in urologic ultrasound that includes at least a minimum of 12 AMA PRA Category 1 Credits™; or level 2 course(s) verifying that the individual has satisfactorily met all specified learning objectives for the level 2 classification course(s) including hands-on demonstration of successfully performing and documenting ultrasound studies. Continuing medical education courses must be approved by the American Urological Association Office of Education or AIUM and include both didactic and hands-on ultrasound. If the level 2 course was completed more than 36 months ago, maintenance of competence must be demonstrated, such as 50 diagnostic urologic ultrasound examinations per year and a total of 10 AMA PRA Category 1 Credits™ within the previous 36 months.*
3. Completion of an accredited residency program and/or fellowship or postgraduate training (other than in urology) that includes structured training in diagnostic urologic ultrasound, under the supervision of a qualified physician(s),*** during which the trainee will have evidence of being involved with the performance, evaluation, interpretation, and reporting of at least 100** diagnostic urologic ultrasound examinations.
If completion of a residency and/or fellowship program occurred more than 36 months ago:
a. The supervision and/or performance, interpretation, and reporting of at least 100** diagnostic urologic ultrasound examinations in the previous 36 months must be demonstrated; and
b. Fifteen AMA PRA Category 1 Credits™ dedicated to diagnostic urologic ultrasound must be documented within the previous 36 months.*
4. For completion of an accredited residency program and/or fellowship (other than in urology) in which the physician did not receive the required structured training in diagnostic urologic ultrasound, acceptable clinical experience can be documented by demonstrating:
a. Evidence of being involved with the performance, evaluation, interpretation, and reporting of at least 100** diagnostic urologic ultrasound examinations within the previous 36 months. It is expected that in most circumstances, examinations will be under the supervision of a qualified physician(s);*** and
b. Evidence of 30 AMA PRA Category 1 Credits™ dedicated to diagnostic urologic ultrasound within the previous 36 months.*
*If the physician interprets in multiple specialties, a representative sample of specialties totaling at least 30 AMA PRA Category 1 Credits™ dedicated to ultrasound is acceptable.
**One hundred cases were selected as a minimum number needed to gain experience and proficiency with sonography as a diagnostic modality. This is necessary to develop technical skills, to appreciate the practical applications of basic physics as it affects image quality and artifact formation, and to acquire an experience base for understanding the range of normal and recognizing deviations from normal.
***A qualified physician is one who, at minimum, meets the criteria defined above in this document.
Cases presented as preselected, limited-image sets, such as in lectures, case conferences, and teaching files, are excluded. The ability to analyze a full image set, determining its completeness and the adequacy of image quality, and performing the diagnostic process, distinguishing normal from abnormal, is considered a primary goal of the training experience.
Competence in Urologic Ultrasound
All physicians performing urologic ultrasound examinations should demonstrate evidence of continuing competence in the interpretation and reporting of those examinations. A minimum of 50 diagnostic genitourinary ultrasound examinations per year is recommended to maintain the physician's skills.
Education in Urologic Ultrasound
The physician should complete 10 hours of AMA PRA Category 1 Credits™ specific to Urologic ultrasound every 3 years.
Developed in collaboration with the following organization:
American Urological Association