Training Guidelines for Advanced Clinical Providers in Women's Health Performing and Interpreting Limited Obstetric Ultrasound

Women’s Health Nurse Practitioners (WHNP), Physicians Assistants in Obstetrics and Gynecology (PAOG), and Certified Nurse-Midwives (CNM)/Certified Midwives who perform, evaluate, interpret, and report Limited Obstetric Ultrasound Examinations

Advanced clinical providers (ACPs) in women’s health who perform, evaluate, interpret, and report limited obstetric ultrasound examinations should be licensed medical practitioners who have a thorough understanding of the indication and guidelines for obstetric 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. Advanced clinical providers that are responsible for limited obstetric 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 ACPs should provide evidence of training and requisite competence needed to successfully perform and interpret limited obstetric ultrasound examinations in the area(s) they practice. The training should include methods of documentation and reporting of ultrasound studies.

 A licensed medical provider who, at minimum, meets the Training Guidelines for Physicians Who Evaluate and Interpret Obstetric Ultrasound Examinations must be available for team-based care in an appropriate clinical time frame.  

Advanced clinical providers performing and interpreting ultrasound examinations should meet the following:

1. Women’s Health Nurse Practitioners: Completion of an approved Women’s Health Nurse Practitioner (WHNP) degree program and Board Certified by National Certification Corporation (NCC) and maintain a current state license in the state they practice.

2Physician Assistants in Obstetrics and Gynecology: Graduate from an accredited physician assistant (PA) program, certified by the National Commission on Certification of Physician Assistants (NCCPA), and maintain a current license in the state they practice.

3. Certified Nurse-Midwives/Certified Midwives: Completion of a midwifery education program accredited by the Accreditation Commission for Midwifery Education (ACME), and certified by the American Midwifery Certification Board (AMCB) and maintain a current state license in the state they practice.

Advanced clinical providers in women’s health should be able to provide evidence of their ultrasound training under the supervision of a qualified practitioner*(physician or advanced clinical provider) during which time the trainee will have met the following requirements:

               A. Evidence of 30 AMA PRA Category 1 Credits™ dedicated to obstetric ultrasound, OR certification in OB/GYN Ultrasound (active status) or Midwife Sonographer (active status) by the American Registry for Diagnostic Medical Sonography (ARDMS).

               B. Documentation of being involved with the performance, evaluation, interpretation, and reporting of at least 150** limited obstetric ultrasounds with in the previous 36 months. At least 75 examinations must include biometric measurements of the fetus and at least 30 examinations must include evaluation of the relationship of the placenta to the cervix. These ultrasounds must be representative of the area(s) in which the ACP is practicing.

Maintenance of Competence in Obstetric Ultrasound

All ACP performing limited obstetric ultrasound should demonstrate evidence of continuing competence in the performance, interpretation, and reporting of those examinations. A minimum of 50 ultrasound examinations per year is recommended to maintain the practitioner’s skills. These ultrasounds must be representative of the area(s) in which the ACP is practicing.

Continuing Medical Education in Obstetric Ultrasound

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



* A qualified ACP supervisor is one who, at minimum, meets the criteria defined above in this document. A qualified physician supervisor must meet the Training Guidelines for Physicians Who Evaluate and Interpret Diagnostic Obstetric Ultrasound Examinations.

** One hundred and fifty cases were selected as a minimum number needed to gain experience and proficiency with ultrasound 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 from consideration toward training volume. The ability to analyze a full image set representative of the scope of practice, 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: 03/25/2018;

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