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Training Guidelines for Licensed Medical Providers (PA, NP, CNM/CM, DPT, and DC) Who Perform and/or Interpret Diagnostic Ultrasound Examinations

Mar 10, 2023

In order to meet this training guideline, the individual must be a licensed medical provider such as a Physician Associate (PA), Nurse Practitioner (NP), Certified Nurse-Midwives/Certified Midwife (CNM/CM), Chiropractor (DC), or a Physical Therapist (DPT) and perform and/or interpret ultrasound examinations. They must 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. It is important to have an understanding of ultrasound technology and instrumentation, ultrasound power output, equipment calibration, and patient and operator safety. Performance and interpretation of most ultrasound examinations require advanced skills and knowledge including familiarity with the anatomy, physiology, and pathophysiology of those organs or anatomic areas that are being examined. All qualified providers (PA, NP, CNM/CM, DPT, and DC) must present evidence of training and requisite competence needed to successfully perform and interpret ultrasound examinations in the area(s) they practice. The training should include methods of documentation and reporting of ultrasound studies. A physician who meets the Training Guidelines for Physicians Who Perform and/or Interpret Diagnostic Ultrasound Examinations should be available for supervisory consultation in an appropriate clinical time frame (unless not required by local/regional standard). Only those clinical providers that meet these training requirements can request to be part of an ultrasound practice accreditation application.


Physician Associates (PA), Nurse Practitioners (NP), Certified Nurse-Midwives/Certified Midwife (CNM/CM), Chiropractors (DC), and Physical Therapists (DPT) must show proof of ONE of the following related to their specialty:

  1. Completion of ultrasound training as defined by the American College of Emergency Physicians (ACEP) is proof of training in POCUS. Refer to the ACEP Ultrasound Guidelines

  2. Completion of a midwifery education program accredited by the Accreditation Commission for Midwifery Education (ACME) AND certified by the American Midwifery Certification Board (AMCB).

  3. Certification by the American Registry for Diagnostic Medical Sonography (ARDMS) for OB/GYN Ultrasound (active status) OR Midwife Sonographer (active status) is proof of training in Limited Obstetrical Ultrasound.

  4. Women’s Health Nurse Practitioner (WHNP) degree program AND Board Certified WHNP by the National Certification Corporation (NCC) is proof of training in OB-limited ultrasound.

  5. Credentialed in ultrasound by the Alliance for Physician Certification & Advancement (APCA). 

  6. Completion of an accredited physician assistant (PA) program and certified by the National Commission on Certification of Physician Assistants (NCCPA) with confirmation of ultrasound image acquisition and interpretation skills in their scope of practice confirmed by the chair of the department or section chief (or equivalent) who meets this training guideline, by written attestation.

  7. Doctor of physical therapy (DPT) (or has earned the transitional DPT). 

  8. Diplomate status granted by the American Chiropractic Board of Radiology or the American Chiropractic Board of Sports Physicians.

AND

Must have documented involvement in the performance, interpretation, and reporting of at least 300 ultrasound examinations specific and appropriate to the area of expertise within the previous 36 months. These ultrasound examinations must be reflective of the examinations they perform in their clinical practice and must be under the supervision of a physician or other qualified medical provider who meets these training guidelines.* A physician who meets these training guidelines should be available for supervisory consultation in an appropriate clinical time frame (unless not required by local/regional standard). Thirty (30) AMA PRA Category 1 Credits™ specific to the area of ultrasound they practice and at least 1 ultrasound course that provided didactic and hands-on ultrasound training within the previous 36 months. 

 

If completion of training or certification occurred more than 36 months ago, both of the following must also be demonstrated within the previous 36 months:

  1. 30 AMA PRA Category 1 Credits™ and or American Osteopathic Association (AOA) Category 1-A Credits dedicated to ultrasound examinations they perform in clinical practice; and

  2. Documentation of either:

a. The performance, evaluation, interpretation, and reporting of a minimum of 150 ultrasound examinations. These examinations must be reflective of the examinations they perform in their clinical practice; 

or

b. Confirmation of ultrasound image acquisition and interpretation skills in their scope of practice confirmed by the chair of the department or section chief (or equivalent) who meets this training guideline, by written attestation.


*Methods of supervision when training in ultrasound.

When trainees are learning ultrasound, the supervising interpreting practitioner must review, discuss, and confirm the diagnosis of all examinations performed and/or interpreted. The supervisor does not have to be present at the time of the initial interpretation; however, the examinations must be under the supervision of or with support from (direct or via telemedicine) a practitioner who meets the AIUM training guidelines and the supervisor must review and, if necessary, correct the interpretation of the trainee.


Maintenance of Competence in Ultrasound is required once training is complete.