Basic Echocardiography Training and Certification
Basic Critical Care Echocardiography (BCCE) is defined within the intensive care curriculum as desirable for one year trainees and mandatory for those undertaking the full two year programme.
It is anticipated that over the next decade the JFICMI will develop its own centralised training structure for BCCE including didactics, courses and centralised administration and certification. Currently the recommended basic echo accreditation is the FUSIC Heart pathway. Some training sites have their own bespoke accreditation pathways that are recognised by JFICMI but it is clear that FUSIC heart is deliverable on a national scale and therefore is the focus of this guidance.
FUSIC Heart Pathway:
The JFICMI recognises the Focused UltraSound In Intensive Care (FUSIC) programme of the Intensive Care Society (ICS) and British Society of Echocardiography (BSE), and the echo committee of the JFICMI has published a list of Irish FUSIC mentors to assist candidates in identifying local mentors and supervisors.
Information on FUSIC Heart Accreditation (of note the most up to date information will be found on the ICS website and available to those who register for FUSIC with the ICS)
FUSIC Credentialing Pathway recognised by the JFICMI
FUSIC Heart Mentors and Supervisors in Ireland (this list will be updated as required. Please contact JFICMI if you would like your name added or removed)
Of note mentors and supervisors will be limited in the number of trainees they can take on. Some hospitals will have no registered FUSIC Heart mentor, JFICMI acknowledges this and it should be noted that some mentors are willing to travel to facilitate echo training. This is best discussed with the mentor/supervisor directly. It is important to note that mentors need to have an identified supervisor. At present the number of FUSIC registered supervisors in Ireland is small. Any trainees beginning the FUSIC heart process should discuss identifying a supervisor with their mentor before they start. The supervisor is essential to ensure the quality of the training and mentor process. Bringing in a supervisor when half the scans are done is too late. The distinction in the role of the mentor and supervisor is discussed further in the FUSIC Heart documentation
In addition, a digital logbook such as the one available from sonoclipshare.com may be used concurrently. This free service would allow the uploading of anonymised images for review and comment by the candidates mentor or supervisor.
A useful video summary of an Irish trainee’s perspective on completing FUSIC Heart is available below:
Advanced Echocardiography Accreditation
Completion of BCCE as defined above affords the trainee a route for application to higher professional training in echocardiography, such as the ESICM EDEC training programme. Whereas this would be desirable for any specialist embarking upon a career in intensive care medicine, it is not mandatory for completion of JFICMI approved training. However, it is recommended for those seeking to attain a higher level of echocardiography training and accreditation. JFICMI has not endorsed any particular advanced echocardiography accreditation and the information below is intended to help trainees and consultants decide.
Below are a number of video interviews and written summaries of Irish trainees who have completed or in the process of completing some of the advanced or level 2 echocardiography accreditation processes. In addition this video from the BSE provides useful backgound on echo accreditation in the UK.
British Society of Echocardiography Advanced Critical Care Echo (BSE ACCE)
Timescale
- 24 months to complete process
Studies Required
- 250 comprehensive echocardiograms performed and reported
- 5 detailed video cases to be submitted with all images and measurements
Examination
- Two part written exam
- Theory
- Reporting
- In person viva
Approximate Cost
- 250 sterling for process
- 70 sterling for BSE membership
European Association of Cardiovascular Imaging (EACVI)
Timescale
- Logbook completed over a single 12 month period
Studies Required
- 250 comprehensive echocardiograms performed and reported
- 6 detailed video cases to be submitted with all images and measurements
Examination
- Two parts
- Theory
- Reporting
Approximate Cost
- €560 (less for ESC members)
European Diploma of EchoCardiography (EDEC)
Interview with Dr Jennifer Hastings on EDEC (pdf)
Timescale
- 24 months to complete process
Studies Required
- 100 TTE
- 35 TOE
Examination
- Two part written exam
- Theory
- Reporting
- In person viva on mannequins
- Attendance at mandatory ESICM courses
Approximate Cost
- ESICM Member – €700
- Non-ESICM Member – €1150
Other Training Opportunities:
Of note the Intensive Care Society UK (ICM) offers several ultrasound modalities within the FUSIC umbrella including lung and abdominal point of care ultrasound. This is not well established in Ireland as yet but JFICMI is trying to develop this and identify FUSIC mentors for the other modalities. The JFICMI stipulates use of ultrasound for vascular localisation as a required competence, often achieved within the primary specialty programme.
Other excellent training opportunities exist such as Echo Guided Life Support (EGLS) and the JFICMI wishes to support these.
FUSIC is the the current paradigm for basic echo and ultrasound accreditation developed by the UK Intensive Care Society. They have recently developed and published on a more advanced echo and haemodynamics accreditation pathway suitable to intensive care trainees and consultants. This pathway is now potentially available to Irish trainees. Dr Catherine Nix, Consultant Anaesthesiologist and Intensivist was involved in the development process and is happy to be contacted by any interested individuals. Below are some useful resources for those interested. More details about echocardiography training for the JFICMI is available here
- FUSIC HD as published in the Journal of the Intensive Care Society
- Slideset from Dr Nix outlining the essentials of the accreditation.
Other documents