Pediatric Echocardiography Fourth Year Fellowships

• Understanding of the basic principles of ultrasound physics
• Knowledge of the indications for transthoracic echocardiography in pediatric
• patients
• Knowledge of common congenital heart defects and surgical interventions
• Knowledge of Doppler methods and their application for assessment of blood flow and prediction of intracardiac pressures
• Knowledge of the limitations of echocardiography and Doppler techniques
• Knowledge of alternative diagnostic imaging techniques
• Knowledge of standard acoustic windows and transducer positions
• Knowledge of image display and orientation used in pediatric echocardiography
• Ability to recognize normal and abnormal cardiovascular structures by 2-dimensional imaging and to correlate the cross-sectional images with anatomic structures
• Familiarity with standard echocardiographic methods of ventricular function assessment
• Familiarity with major developments in the field of noninvasive diagnostic imaging

• In-depth knowledge of ultrasound physics
• Ability to recognize and characterize rare and complex congenital and acquired cardiovascular abnormalities in a variety of clinical settings
• In-depth understanding of Doppler methods and their application to the assessment of cardiovascular physiology
• Familiarity with all echocardiographic methods available for assessment of global and regional ventricular function and knowledge of the strengths and weaknesses of these techniques
• Up-to-date knowledge of recent advances in the field of noninvasive cardiac imaging, including ability to review critically published research that pertains to the field
• Knowledge of current training guidelines and regulations relevant to pediatric echocardiography

• Ability to safely, properly, and efficiently use cardiac ultrasound equipment
• Ability to perform a complete transthoracic echocardiographic examination with proper use of M-mode, 2-dimensional, and Doppler techniques in normal pediatric patients and in those with heart disease, with consultation
  as needed

• Ability to perform independently a complete transthoracic echocardiographic examination with proper use of all available ultrasound techniques in patients with all types of congenital heart disease
• Ability to assess cardiovascular physiology and global and regional ventricular function using a variety of ultrasound techniques
• Ability to supervise

• Training should take place in a pediatric echocardiography laboratory that serves a hospital with an accredited pediatric cardiology program, inpatient and outpatient facilities, neonatal and pediatric intensive care departments, a pediatric cardiac catheterization laboratory, and a congenital heart surgery program
• Supervised performance of at least 150 transthoracic echocardiograms (at least 50 in infants age _ 1 y)*
• Review at least 150 transthoracic echocardiograms with a qualified staff pediatric echocardiographer*
• Participate in didactic conferences in which echocardiographic data are reviewed and their clinical applications are discussed
• Reading of textbooks, review articles, and original research on pediatric echocardiography
• Attendance at CME courses that are either dedicated to or include pediatric echocardiography

• Perform at least 200 additional transthoracic echocardiograms (at least 50 in infants age _ 1 y) with subsequent review and critique of the examinations by the responsible staff pediatric echocardiographer*
• Review at least 200 additional transthoracic echocardiograms with a qualified staff pediatric echocardiographer*
• Trainees should gradually attain a high level of independence; the degree and rate at which independence is attained should be determined by the director of the laboratory
• Prepare and present echocardiographic data at clinical and didactic conferences
• Active participation in research that involves echocardiography of pediatric heart disease

CME, Continuing ical education.
*The recommended numbers of examinations outlined here represent minimal and not optimal requirements.