Emergency Ultrasound Fellowship

About

Program Overview

The Carilion Emergency Ultrasound Fellowship is a one-year program designed to develop future leaders, educators, and innovators in emergency ultrasound by immersing fellows in diverse ultrasound experiences in medical education, research, administration, and critical care. Our program was founded in 2017 and accredited by the Emergency Ultrasound Fellowship Accreditation Council in 2021. The emergency ultrasound fellowship thrives with full departmental and institutional support. This has allowed the addition of 6 new ultrasound machines to our fleet in 2021 and integration of cutting-edge POCUS interventions such as resuscitative transesophageal echocardiography and advanced ultrasound-guided regional anesthesia procedures and training. Our cohesive curriculum is tailored to the individual fellow’s interests and future career goals.

Fellow Roberta Pritchard teaching regional anesthesia cadaver lab

Roanoke, VA

Mission, Goals and Strengths

Mission

To develop emergency physician ultrasound leaders who excel in any setting and are dedicated to the advancement of point-of care ultrasound through innovation, inquiry, and education.

Goals

We Aspire to:

Provide innovative training that prepares fellows to be leaders in the field of Emergency Ultrasound
Prepare fellows for all aspects of emergency ultrasound directorship
Master the complexities of emergency department and system-wide point-of-care ultrasound administration and quality assurance
Develop expert physician sonographers with superior advanced image acquisition, interpretation, and ultrasound-guided procedural skills
Teach the fundamentals of research and provide opportunities for quality projects and research tailored to the individual fellow’s interests
Develop excellent physician educators by teaching curriculum development, lecturing, and other advanced teaching skills
Explore innovations in point-of-care ultrasound
Teach and use ultrasound to practice exceptional care for every patient, every time while honoring Carilion Clinic’s mission to improve the health of the communities we serve

Strengths

Collaboration with The Virginia Tech Carilion (VTC) School of Medicine and VTC Emergency Medicine Residency provides fantastic opportunities for educational innovation, curriculum design, and research
Four dedicated emergency ultrasound faculty are deeply committed to fellow education and cumulatively bring over 60 years of point-of-care US experience
Carilion’s unique position as the leading regional healthcare system and referral center furnishes exposure to high patient acuity, high volume, and a wide variety of pathology
There is a strong departmental and institutional commitment to POCUS
Carilion Emergency Ultrasound Fellows have unique access to:
- Carilion's state of the art simulation and training center
- Emergency Department resuscitative trans-esophageal echocardiography
- Advanced ultrasound-guided regional anesthesia training program including soft-cure cadaver workshops
- Robust fellow education/technology fund

Message from Leadership

Thank you for your interest in the Virginia Tech Carilion Emergency Ultrasound Fellowship!
This is a one-year program designed to give graduates of emergency medicine residency programs the skills and knowledge to become ultrasound program directors and leaders in the field of emergency ultrasound. It is designed to provide fellows with the education and tools necessary to succeed in their careers in each discipline important to directing an emergency ultrasound program. The curriculum may be individually focused and tailored to a fellow’s area of interest whether that be academics and medical education, research, or administration.

Please feel free to email us directly for more information, we look forward to introducing you to our program!

Michelle Clinton, MD, FACEP, AEMUS-FPD

Carilion Emergency Ultrasound Fellowship Director

mclinton@carilionclinic.org

Department specs

Carilion Clinic provides an ideal training environment for ultrasound fellowship. We are located in Southwest Virginia where the Carilion Medical Center is the primary tertiary referral hospital for a 6,000 square mile catchment area serving a population of 1.5 million people. This assures high volume, clinical diversity, and acuity in the six Carilion Emergency Departments, including our level 1 trauma center and Pediatric ED located at Carilion Roanoke Memorial Hospital.

Subspecialties

Other emergency department fellowships include: EMS, Wilderness Medicine, Administration

Program Size

1 to 2 Fellows per Year

Academic Affiliation

Virginia Tech Carilion School of Medicine

Curriculum

The Carilion Clinic Emergency Ultrasound Fellowship is accredited by the Emergency Ultrasound Fellowship Accreditation Council and our multi-modal curriculum is in accordance with accreditation council guidelines and highest recommendations. Formal bimonthly didactics with ultrasound faculty are used for discussion of complex, advanced ultrasound, administrative, teaching, and research topics. Fellows both learn and teach through participation in frequent cadaver and sim center ultrasound workshops, ultrasound quality assurance sessions and conferences, bedside scanning and teaching, attending and presenting at national ultrasound and emergency medicine conferences, and leading student and resident ultrasound education sessions.

The Carilion ultrasound fellowship curriculum takes advantage of the diverse opportunities offered by Virginia Tech and Carilion Clinic in order to maximize fellows' learning, teaching, research, and discovery of all aspects of Emergency Ultrasound.

Curriculum Outline:

The topics covered are outlined below. We will have reading and group discussion/lectures on most topics below, some will be independent study. You will receive a yearly schedule of didactic sessions in advance.

A. Ultrasound Physics and Instrumentation

Units and Measurement  
1. Units of Measurement
2. Sound  
3. Pulsed Ultrasound  
4. Intensity  
5. Interaction of Sound and Media  
6. Range Equation  
7. Transducers  
8. Sound Beams  
9. Axial and Lateral Resolution  
10. Display modes  
11. Two-dimensional Imaging  
12. Temporal Resolution  
13. Pulsed Echo Instrumentation  
14. Displays  
15. Image Processing and Dynamic Range  
16. Hemodynamics  
17. Doppler  
18. Image Characteristics and Artifacts  
19. Quality Assurance  
20. Bioeffects

B. Abdominal and General Sonography

Liver  
Biliary Tree  
Pancreas  
Urinary Tract  
Scrotum  
Prostate  
Spleen  
Retroperitoneum  
Abdominal Vasculature  
Gastrointestinal Tract  
Neck  
Superficial Structures

C. Emergency Ultrasonography

1. Standard applications

Abdominal  
Cardiac  
Lungs and thorax  
Abdominal aorta  
Gallbladder  
Pelvic  
Renal  
Vascular access  
DVT

Advanced applications
1. Advanced cardiac  
2. Shock  
3. Musculoskeletal  
4. Soft tissue  
5. Pediatric applications  
6. Regional anesthesia/nerve blocks  
7. Procedural guidance  
8. Ocular  
9. Doppler

Indications  
Limitations  
Literature-based evidence  
Algorithms for incorporation of ultrasound into clinical practice

D. Research Techniques and Statistical Methodology

Overview of the research process  
Planning the research project  
IRB considerations  
Budgets and contracts    
Types of studies  
Reading the medical literature  
Abstract writing   
Submitting to a journal  
Data gathering  
Literature searches

Expectations, Goals and Objectives:

The Fellow will demonstrate comprehensive understanding and proficiency in application of all core and advanced emergency ultrasound exams and techniques listed above including: Indications, limitations, responsibilities of clinician performing the exam, specifications of the individual exam, documentation requirements, equipment specifications, quality control considerations, and accurate interpretation of studies. Emergency Ultrasound Imaging Criteria Compendium and ACEP Core Content of Clinical Ultrasonography Fellowship Training may be reference for details. Available at www.acep.org.
The fellow will analyze and appraise seminal and emerging ultrasound literature in all areas and applications of emergency ultrasound.
Read and analyze material from the relevant chapter in Ma and Mateer Emergency Ultrasound, 4th Edition, prior to didactics meeting and throughout first half of month for each assigned topic of the month.
Read relevant chapters of Designing Clinical Research prior to research discussions
Read Echocardiography assigned reading and complete 123 echocardiography modules or SCCM Advanced echo review course material prior to echo didactic discussions and during echo months
Prepare for advanced critical care echo boards, complete SCCM course, and participate in fellowship discussions of material
Demonstrate accurate clinical application and interpretation of advance critical care echo techniques in critically ill patients.

Supplement your textbook with completion of online didactics from a combination of the following sites and other FOAMED/asynchronous learning resources:

EmSono – advanced module will be incorporated in monthly didactic assignments

Faculty

Emergency Medicinne

Visit Department Page

Michelle E. Clinton, MD

Emergency Medicine

VTC Faculty

Janet S. Young, MD

Emergency Medicine

VTC Faculty

Jonathan Nogueira, M.D.

Emergency Medicine

Current Practice: Roanoke, VA

Medical School: Edward Via Virginia College of Osteopathic Medicine

Hometown: Portsmouth, NH

Graduated Medical School: 2014