Training Guidelines for Physicians Who Evaluate and Interpret Diagnostic Breast Ultrasound Examinations

Physicians who evaluate and interpret diagnostic breast ultrasound examinations should be licensed medical practitioners who have a thorough understanding of the indications and guidelines for ultrasound examinations as well as 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 examination findings. They should have an understanding of ultrasound technology and instrumentation, ultrasound power output, equipment calibration, and safety. Physicians responsible for ultrasound examinations should be able to demonstrate familiarity with the anatomy, physiology, and pathophysiology of those organs or anatomic areas that are being examined. These physicians should provide evidence of training and requisite competence needed to successfully perform and interpret diagnostic breast ultrasound examinations. The training should include methods of documentation and reporting of ultrasound studies.

Physicians performing and/or interpreting diagnostic ultrasound examinations should meet at least 1 of the following:

1. Certification in radiology or diagnostic radiology by the American Board of Radiology, the American Osteopathic Board of Radiology, the Royal College of Physicians and Surgeons of Canada, or Le Collège des Médecins du Québec is accepted as proof of sufficient training in breast ultrasound.

If certification was obtained more than 36 months ago:

a. The supervision and/or performance, interpretation, and reporting of at least 100** diagnostic breast ultrasound examinations in the previous 36 months must be demonstrated; and

b. Fifteen AMA PRA Category 1 Credits™ dedicated to diagnostic breast ultrasound must be documented within the previous 36 months.***

2. Completion of an accredited residency program, fellowship, or postgraduate training that includes structured training in diagnostic breast ultrasound, under the supervision of a qualified physician(s),*during which the trainees will have evidence of being involved with the performance, evaluation, interpretation, and reporting of at least 100** diagnostic breast 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 breast ultrasound examinations in the previous 36 months must be demonstrated; and

b. Fifteen AMA PRA Category 1 Credits™ dedicated to diagnostic breast ultrasound must be documented within the previous 36 months.***

3. For completion of an accredited residency and/or fellowship in which the physician did not receive the required structured training in diagnostic breast 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 breast ultrasound examinations within the previous 36 months. It is expected that in most circumstances, examination will be under the supervision of a qualified physician(s)*; and

b. Evidence of 15 AMA PRA Category 1 Credits™ dedicated to diagnostic breast ultrasound within the previous 36 months.

4. Current certification in breast ultrasound by the American Society of Breast Surgeons is accepted as proof of sufficient training in breast ultrasound.

 

Maintenance of Competence in Breast Ultrasound

All physicians performing breast ultrasound examinations should demonstrate evidence of continuing competence in the interpretation and reporting of those examinations. A minimum of 100 diagnostic breast ultrasound examinations and, if applicable, a minimum of 12 ultrasound-guided interventional breast procedures per year are recommended to maintain the physician's skills.

Continuing Medical Education in Breast Ultrasound

The physician should complete 15 hours of AMA PRA Category 1 Credits™ specific to breast ultrasound every 3 years.

 

 

* A qualified physician is one who, at minimum, meets the criteria defined above in this document.

** 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.

*** 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.

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.

 


Approved: 04/10/2013; Reapproved: 10/31/2015

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