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Subspecialty Certification 2017: ACGME vs DFP vs Alternative
Posted: Tuesday, September 12, 2017
Joined: 4/26/2011
Posts: 2

Ultrasound Community,

Please review the attached update on subspecialty certification. This document was prepared
by leadership across ACEP, SAEM, SCUF and the Clinical Ultrasound Task Force to supplement
previous discussion on this topic and draw attention to some potential advantages and
disadvantages of the different pathways. While this document cannot comprehensively discuss
every aspect of subspecialty certification, it hopes to engender discussion and debate. The
American Board of Emergency Medicine (ABEM) will decide whether to pursue either ACGME
subspecialty certification, the newly created designation of focused practice or neither. Before
moving forward, the ABEM wants to survey the ultrasound community to determine what we
want. This survey will occur after October and may be a critical factor in deciding the future of
clinical ultrasound. It is imperative that everyone voting is as well informed as possible.

In addition to reviewing this document please feel free to post any questions, concerns, thoughts and opinions by posting in this friendly discussion thread.

File Attachment(s):
Subspecialty Certification Communication Sept 2017.doc (46592 bytes)
Posted: Wednesday, September 13, 2017
Joined: 5/23/2011
Posts: 1

Thanks for putting together. My gut is to proceed with full ACGME sub-specialty recognition given the decades of work that has been invested to make EM the leaders in POC US. At our institution, as well as many others I'm sure, our department is the go to for POC US education and oversight. I feel that other pathways will lead to our expertise being watered-down. Am concerned about increased difficulty (initially) establishing the fellowships and recruiting fellows, but feel it will payoff in the long-run. Will look forward to reading others' comments and ideas, and will also be checking with our local DIO for what impact this would have on our available fellowship spots. My best,

Andrew Shedd, MD, FACEP
Ultrasound Director
Assistant Residency Director
Emergency Medicine
John Peter Smith Hospital
Fort Worth, TX

Posted: Wednesday, September 13, 2017
Joined: 8/5/2015
Posts: 1

Yeah, thanks for putting this together, appreciate all the time put in to it.  I am still somewhat fresh out of residency, one that was very US heavy, also recently completed the US fellowship in Fort Worth TX at John Peter Smith, but I am fairly new to this side of the discussion.  I agree with @SonoShedd, my initial thoughts are to proceed with full ACGME sub-specialty recognition.  It may initially make it more difficult to recruit fellows but in the end will only help to legitimize the role of POCUS in EM and even more so show that we are leaders and pioneers in the US community as a whole.  US is not necessary a tool that all EM physicians use or feel comfortable with, even after completing an EM residency, so for those of us who have dedicated time honing those skills and then completing an additional year of training in fellowship, I feel deserve the recognition as "specialists" in this area of EM.

Chad Holmes, DO

Emergency Medicine

John Peter Smith Hospital

Fort Worth, TX
Posted: Thursday, September 14, 2017
Joined: 6/3/2011
Posts: 6

I'll just say that I'm in favor or ACGME subspecialty certification. While there are benefits and drawbacks on both sides, long term, I think subspecialty certification is the best route for the continued growth of our work and gives us the best position to have a larger impact implementing ultrasound into routine health care for the benefits of patients and the health care system as a whole.
Posted: Tuesday, September 19, 2017
Joined: 4/16/2011
Posts: 1

I do not feel a full subspecialty certification is a good idea.  It will put a chilling effect on non-boarded EM docs from using EM US.  It would make more sense to have a focused certification as previously discussed or researched.  Alternatively, I think the unique aspect of the US Fellowship training is the administrative processes, teaching theory, and other unique topics that this additional training brings.  If this is the focus of the subspecialty certification, I might be able to support this.  I do NOT recommend we push ourselves in the direction on mini-EM radiologists.
Posted: Monday, September 25, 2017
Joined: 6/20/2012
Posts: 1

There are enough barriers for Emergency Physicians who desire to perform bedside ultrasound. Adding a subspeciality certification will only make it harder for those physicians to add ultrasound to their clinical practice. What are we teaching our residents for, if not to have them independently perform these exams as attendings?
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