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Advanced EM Ultrasonography


At A Glance

Program Type: Military Medical Center

Location: San Antonio, TX

Accredited: Emergency Ultrasound Fellowship Accreditation Council (EUFAC)

Program Length: 1 year

Required Pre-Requisite Training: Medical School Graduation, Emergency Medicine Residency Completion. All applicants must be active duty members of the U.S. Military.

Categorical Year in Specialty Required: No

Total Approved Complement: 4

Approved per Year (if applicable): 4

Dedicated Research Year Offered: No

Medical Student Rotation Availability: 4th Year elective in emergency ultrasound

Additional Degree Concurrent with Training (e.g. MPH): No

Our Fellows in Action

Program Description

The SAUSHEC Emergency Ultrasound Fellowship is a 1-year advanced point of care ultrasound education program for clinicians interested in becoming experts and leaders in this growing subspecialty. Point of Care Ultrasound has been used extensively by emergency physicians to improve diagnostic accuracy at the bedside, safely guide invasive procedures, rapidly detect life threatening pathology, avoid unnecessary ionizing radiation for the patient, monitor the effects of an ongoing resuscitation, and improve Emergency Department and Intensive Care Unit throughput. It has also seen extensive use on the battlefield to facilitate triage decisions, justify utilization of scarce medical assets such as medical evacuation, and resuscitate critically wounded soldiers.

Fellows receive extensive training in advanced and military relevant ultrasound techniques. Fellows also take a leadership role with resident ultrasound education and teach at the Medical Center of Excellence, providing experience and competency with teaching ultrasound to a wide variety of students. This fellowship is an excellent choice for any physician looking to improve their skill with point of care ultrasound and to focus on improving access across military medicine to this innovative and life-saving imaging modality.

Mission, Vision and Aims

Mission

The SAUSHEC Emergency Ultrasound Fellowship is committed to providing the best training in advanced and military relevant point of care ultrasound and to improving training and use of point of care ultrasound for all military medical professionals.

Vision

The SAUSHEC Emergency Medicine Ultrasound Fellowship will produce experts in the use of point of care ultrasound in a military setting who will become leaders in the field and will move military medicine towards an improved quality of care for all military members.

Aims

The SAUSHEC Emergency Ultrasound Fellowship trains military physicians able to deploy anywhere in the world and establish a point of care ultrasound program to improve medical care in any environment. Through strong relationships with the SAUSHEC Emergency Medicine Residency Program, the Army Medical Center of Excellence and the Uniformed Services University the fellowship provides training in all core ultrasound modalities and the experience of teaching and using these modalities in a wide range of environments.

Curriculum and Schedules

Quality Assurance

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 four to six journal articles related to ultrasound.

Fellow Protected Teaching Time

Time each week set aside and dedicated to the fellow. It is a 4-hour block of undivided attention that may include lecture, didactics or hands on scanning in the emergency department.

Study Time

 Curriculum with dedicated reading time and question bank access to ensure graduates are fully prepared for the Designation of Focused Practice exam

  • The SAUSHEC 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.
  • Cardiology Rotation: minimum of one week with the cardiology department. Includes scanning with ultrasound technicians to learn techniques for better images as well as rotating with the cardiologist reading echocardiograms as they teach their fellows.

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 rotation.

  • Fellows do not take call
  • Hours are generally 8 a.m. – 4 p.m. Monday through Friday.
  • Emergency Medicine Fellows work four 8-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 skills
  • The use of ultrasound in far-forward facilities is essential to the care provided to service members during deployment and 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 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 more than five hands-on grand rounds sessions each year focused on military relevant ultrasound modalities, as well as procedural training at cadaver and live-tissue labs.
  • Transesophageal Echocardiogram Course
  • Fellows plan and direct ultrasound simulation teaching and cases for the residents and medical students.

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:

  • Leadership and team building exercises
  • Peer mentorship
  • Quarterly program leadership and mentoring sessions
  • Progressive leadership responsibilities teaching and providing hands on courses in a variety of settings

Scholarly and Professional Development Opportunities

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

Fellows participate in helping to improve the healthcare system for our patients. Fellows will be educated in quality improvement and patient safety (QIPS) principles through the completion of the SAUSHEC EM QIPS core curriculum.

Funding is provided for fellows to attend at least one professional conference 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 the following educational conferences/events: 

  • American College of Emergency Physicians /Emergency Medicine Resident's Association
  • American Academy of Emergency Medicine
  • Society of Academic Emergency Medicine
  • Government Services Chapter of American College of Emergency Physicians
  • Special Operations Medical Association
  • Military Health Research Symposium
  • Association of Military Osteopathic Physicians and Surgeons
  • Council of Residency Directors in Emergency Medicine
  • American Academy of Nurse Practitioners
  • Air Force Physician Assistant Refresher Course
  • And other additional professional societies

Participating Sites

Brooke Army Medical Center

Applicant Information, Rotation and Interview Opportunities

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.jbsa.brooke-amc.list.saushec-adv-em-us@health.mil and follow guidance through SAUSHEC Graduate Medical Education regarding rotation logistics.

If you would like to schedule an interview with our program, please contact dha.jbsa.brooke-amc.list.saushec-adv-em-us@health.mil.

Program graduates take the American Board of Emergency Medicine (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 open to board certified Emergency Physicians.

Teaching Opportunities

  • Critical Care Flight Paramedic- Extended Focused Assessment with Sonography in Trauma (EFAST) teaching
  • American Academy of Emergency Medicine (AAEM) – Ultrasound Course and or podium lectures/abstracts
  • Special Operations Medical Association (SOMA) – Ultrasound Course
  • Joint Services Symposium on Emergency Medicine (JSSEM) – Ultrasound Course
  • Air Force Physician Assistant Refresher Course (AFPARC) – Ultrasound Course
  • Society of Academic Emergency Medicine (SAEM) – Ultrasound Course
  • Government Services Chapter of American College of Emergency Physicians (GSACEP)- Ultrasound course/lecture
  • Honduras- hands on teaching and lecturing ultrasound at local hospitals
  • EM Intern Orientation Ultrasound Course
  • Simulation cases with residents
  • Emergency Medicine lectures for resident grand rounds

Faculty and Mentorship

All Faculty have subspecialty training in Advanced Emergency Ultrasound.

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

Well-Being

Wellness:

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.

Contact Us

Advanced Emergency Ultrasound Fellowship Program

Location: Brooke Army Medical Center, Emergency Department

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