Training Guidelines for Physicians Who Evaluate and Interpret Diagnostic Ultrasound Examinations of the Female Pelvis

Physicians who evaluate and interpret diagnostic ultrasound examinations of the female pelvis 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 ultrasound examinations of the female pelvis. The training should include methods of documentation and reporting of ultrasound studies.
 
Physicians performing and/or interpreting diagnostic ultrasound examinations of the female pelvis should meet 1 of the following:
 
1. Completion of an approved residency program, fellowship, or postgraduate training that includes structured training in gynecologic 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 300** diagnostic ultrasound examinations of the female pelvis.
 
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 300** diagnostic ultrasound examinations of the female pelvis in the previous 36 months must be demonstrated; and
 
b. Thirty AMA PRA Category 1 Credits™ dedicated to diagnostic ultrasound of the female pelvis must be documented within the previous 36 months.***
 
2. For completion of a residency and/or fellowship in which the physician did not receive the required structured training in diagnostic gynecologic ultrasound, acceptable clinical experience can be documented by demonstrating:
 
a. Evidence of 30 AMA PRA Category 1 Credits™ dedicated to diagnostic ultrasound of the female pelvis within the previous 36 months; and
 
b. Evidence of being involved with the performance, evaluation, interpretation, and reporting of at least 300** diagnostic ultrasound examinations of the female pelvis within the previous 36 months. It is expected that in most circumstances, examinations will be under the supervision of a qualified physician(s).*
 
Adjunctive Competence in 3-Dimensional Gynecologic Imaging
Recognition of adjunctive competence in 3-dimensional (3D) imaging requires documentation of 3 AMA PRA Category 1 Credits™ dedicated to 3D gynecologic ultrasound imaging and clinical experience in performing at least 50 gynecologic ultrasound studies with reconstruction of the coronal view of the uterus within the previous 3 years.
 
Maintenance of Competence in Gynecologic Ultrasound
All physicians performing diagnostic gynecologic ultrasound examinations should demonstrate evidence of continuing competence in the interpretation and reporting of those examinations. A minimum of 170 diagnostic gynecologic ultrasound examinations per year is recommended to maintain the physician's skills.
 
If the physician performs both gynecologic and obstetric ultrasound examinations, the physician should demonstrate evidence of continuing competence in the interpretation and reporting of those examinations. A minimum of 170 diagnostic obstetric and gynecologic ultrasound examinations per year, with no fewer than 50 cases per year in either specialty, is recommended to maintain the physician’s skills.
 
Continuing Medical Education in Gynecologic Ultrasound
The physician should complete 30 hours of AMA PRA Category 1 Credits™ specific to gynecologic ultrasound every 3 years. If the physician interprets in multiple specialties, a representative sample should be obtained totaling 30 hours every 3 years.
 
 
 
*A qualified physician is one who, at minimum, meets the criteria defined above in this document.
 
**Three 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.
 
The number of required cases will be greater for physicians using ultrasound for multiple subspecialty applications or anatomic areas (at least 500 cases). It is recognized, however, that the experience gained in the initial 300 cases provides an important foundation of knowledge and skill, which may reduce the number of additional cases needed to master other diagnostic ultrasound uses.
 
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: 04/02/2014; Reapproved: 11/02/2014, 10/31/2015

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