Training Guidelines for Physicians Who Evaluate and Interpret Diagnostic Thyroid, Parathyroid, and Neck Ultrasound Examinations

Physicians who evaluate and interpret diagnostic thyroid, parathyroid, and neck 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 thyroid, parathyroid, and neck 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 diagnostic thyroid, parathyroid, and neck ultrasound.

         If certification was obtained more than 36 months ago:

  1. The supervision and/or performance, interpretation, and reporting of at least 100** diagnostic thyroid, parathyroid, and neck ultrasound examinations in the previous 36 months must be demonstrated; and
  2. 15 CME credits dedicated to thyroid, parathyroid, and neck 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 thyroid, parathyroid, and neck 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 thyroid, parathyroid, and neck ultrasound examinations. If completion of a residency and/or fellowship program occurred more than 36 months ago:

  1. The supervision and/or performance, interpretation, and reporting of at least 100** diagnostic thyroid, parathyroid, and neck ultrasound examinations in the previous 36 months must be demonstrated; and
  2. 15 CME credits dedicated to thyroid, parathyroid, and neck 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 thyroid, parathyroid, and neck ultrasound, acceptable clinical experience can be documented by demonstrating:

  1.  Evidence of being involved with the performance, evaluation, interpretation, and reporting of at least 100** diagnostic thyroid, parathyroid, and neck ultrasound examinations within the previous 36 months. It is expected that in most circumstances, examinations will be under the supervision of or support (direct or telemedicine) from qualified physicians who meet this training guideline; and
  2.  Evidence of 15 CME credits dedicated to diagnostic thyroid, parathyroid, and neck ultrasound that includes successful completion of a didactic and hands-on course such as offered by the American College of Surgeons and the American Association of Clinical Endocrinologists (AACE) or equivalent within the previous 36 months.

4. Successful completion of the Endocrine Certification in Neck Ultrasound (ECNU) Program by the AACE is accepted as proof of sufficient training in thyroid/parathyroid ultrasound. If completion was more than 36 months ago, maintenance of competence in thyroid, parathyroid, and neck scanning experience and continuing medical education as listed below must be documented.

Maintenance of Competence in Thyroid, Parathyroid, and Neck Ultrasound

All physicians performing thyroid, parathyroid, and neck ultrasound examinations should demonstrate evidence of continuing competence in the interpretation and reporting of those examinations. A minimum of 100 diagnostic thyroid, parathyroid, and neck ultrasound examinations and, if applicable, a minimum of 10 ultrasound-guided fine-needle aspirations per year are recommended to maintain the physician’s skills.

Continuing Medical Education in Thyroid, Parathyroid, and Neck Ultrasound

The physician should complete 15 CME credits specific to thyroid, parathyroid, and neck ultrasound every 3 years.

 

 

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

**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.

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, 05/20/2019

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