Mission

The Madigan Emergency Ultrasound Fellowship is committed to providing the best training in advanced and military relevant point-of-care ultrasound and to act as a force multiplier training others in the use of point-of-care ultrasound for all practice environments and patient populations.

Vision

The Madigan Emergency Medicine Ultrasound Fellowship will produce experts in the use of point-of-care ultrasound in a military setting with the intention of becoming leaders in the field and moving the military medicine towards an improved quality of care for all military members.

Aims

The Madigan Emergency Ultrasound Fellowship trains military physicians able to deploy anywhere in the world and establish a point-of-care presence to improve medical care in any and all environments. Through strong relationships with the Madigan Emergency Medicine Residency Program, as well as collaboration with multidisciplinary teams, and the Uniformed Services University of Health Sciences (USUHS), the fellowship provides training in all core ultrasound modalities and the experience of teaching and using these modalities in a wide range of environments.

• Quality Assurance (QA): A weekly review of all the ultrasound conducted in the emergency department. This also includes teaching time for resident currently on the ultrasound rotation as well as the fellow.
• Journal Club: Meeting once per month at an off-site location to discuss 2-3 journal articles related to ultrasound.
• Fellow Protected Teaching Time: Time each week set aside and dedicated to the fellow. Fellows can expect a four hours for their discretionary use as well as 2.5-hour block that is protected for lecture, didactics or hands on scanning in the emergency department with ultrasound faculty.
• Exam Preparedness: Curriculum with dedicated reading time and question bank access to ensure graduates are fully prepared for the Advanced Emergency Medicine Ultrasound Focused Practice Designation (or equivalent) exam.

• The Madigan Advanced Emergency Medicine Ultrasound Fellowship (AEMUS) program is 12 months in length and follows the training requirements outlined by the Emergency Ultrasound Fellowship Accreditation Council (EUFAC).
• Fellowship is divided into 10 blocks over the course of the year with dedicated curriculum, reading, and hands-on scanning each block.
• Multidisciplinary rotations: minimum of one day per quarter anesthesia, pediatrics, reproductive endocrinology, or sports medicine.

There are no designated elective rotations at this time but if there is an area of ultrasound you are particularly interested in, we will work with you to create a facilitated learning experience.

• Fellows do not take call
• Hours are generally Monday - Friday, 8 a.m. - 4 p.m.
• Emergency Medicine Fellows work 4-6 nine hour shifts per month as a staff physician in the Emergency Department
• Fellows from Internal Medicine, Pediatrics or Family Medicine work approximately one week per month in their clinic or inpatient team for maintenance of primary specialty clinical skills.

• The use of ultrasound in far-forward facilities is essential to the care provided to service members during deployment; training in the use of ultrasound is expanding within military medicine. Patients presenting with a traumatic injury often benefit from the use of the Extended Focused Assessment in Trauma, where other modalities such as the focused, limited echocardiogram or gastrointestinal ultrasound are essential in the management of medically ill patients.
• The Madigan Advanced Emergency Medicine Ultrasound Fellowship hones skills used in these deployed environments as well as provides training for other military members prior to deployments through simulation training with EM residents as well as other specialties. We also provide didactics training with other ultrasound departments as well as procedural training at cadaver and live-tissue labs when available.

Gulf Coast Ultrasound Echocardiogram Course

Fellows plan and direct ultrasound simulation teaching cases for the residents and medical students quarterly.

A robust curriculum for developing leaders in emergency ultrasound and in the military. Opportunities start from day one and increasing levels of responsibility are nurtured over the 12 months of fellowship. The curriculum includes:

• Faculty development conference participation twice yearly with monthly topics also available.
• Leadership and team building exercises.
• Peer mentorship.
• Progressive leadership responsibilities teaching and providing hands on courses in a variety of settings.

There are robust research opportunities available with publications each year. Completing a scholarly project submission is a requirement for graduation from the fellowship program.

Fellows participate in helping to improve the health care system for our patients.

Funding is provided for fellows to attend at least two professional conferences during training when presenting a scholarly activity. Fellows have given national lectures, research podium presentations, held national leadership board positions, and taught procedural courses at ACEP/EMRA, WAACEP, AAEM, SAEM, GSACEP, SOMA, MHSRS, AMSUS, CORD, AFPARC, and other professional societies. Fellows attend local USUHS leadership and faculty development conference bi-annually.

Madigan Army Medical Center

Our program offers rotations to fourth-year medical students, and third-year medical students on a space available basis. Rotations are typically four weeks (one block) long and may include clinical shifts, didactic opportunities, and simulation experiences. Rotators participate in the weekly QA sessions and perform numerous scans on emergency department patients during the rotation. Students interested in rotating with our program should contact dha.jblm.madigan-amc.list.mamc-adv-em-us@health.mil and follow guidance through Madigan Graduate Medical Education regarding rotation logistics.

If you would like to schedule a rotation with our program, contact dha.jblm.madigan-amc.list.mamc-adv-em-us@health.mil.

Program graduates take the ABEM exam for a Focused Practice Designation in Advanced Emergency Medicine Ultrasonography. This exam is offered bi-annually in even years. To be eligible to take specialty board exams, graduates must complete all pre-requisites required by the ABEM prior to December 31 the year before the exam is offered. Board eligibility is described on the ABEM website. This board is currently only open to board certified Emergency Physicians.

• Medics/Paramedic – EFAST teaching
• AAEM – Ultrasound Course and or podium lectures/abstracts
• JSSEM – Ultrasound Course
• NOAA Dive Course – Ultrasound Course
• WAACEP – Ultrasound Course
• GSACEP– Ultrasound course/lecture

• EM/FM/IM Intern Orientation Ultrasound Course
• MS Ultrasound Courses
• Simulation cases with residents
• EM lectures for resident grand rounds
• Faculty Ultrasound workshops

• Advanced Emergency Ultrasound
• Sports Medicine
• Pediatrics

Mentorship is provided from the faculty. The program has a robust faculty with at least a 1:1 faculty to fellow ratio.

The fellowship program and its curriculum are structured to ensure maximal opportunities for fellow wellness consistently over the course of the 12-month residency. We have worked to consolidate all official activities in such a manner as to maximize off time without reducing the maximal opportunities for training. We schedule a fellowship wellness lunch monthly.