• The University of Utah School of Medicine
  
  
• The Department of Anesthesiology
  
  
• Letter from the Program Director
  
  
• Perioperative and Critical Care Echocardiography Executive Medical Fellowship (EMF) Program
  
  
• Educational Methods
  
  
• Advantages of the University of Utah, Department of Anesthesiology Perioperative and Critical Care Echocardiography Executive Medical Fellowship
  
  
• Application Process
  
  
• Certification Requirements
  
  
• Tuition

	Download our application for Executive Medical Fellowship in PDF format (52 Kb).

The University of Utah School of Medicine

The University of Utah, the oldest institution of higher education west of the Mississippi, was founded in 1850. The 25,000 students attending the University represent all 50 states and more than 50 foreign countries.

The campus development program has kept pace with the University’s academic and research expansion. Over half of the 149 permanent buildings on campus have been built in the past decade. The focal point of the campus is the Marriott Library with holdings in excess of a million and a half volumes.

The University of Utah School of Medicine, as well as the College of Pharmacy, College of Nursing, Huntsman Cancer Institute, and Eccles Health Sciences Library are located at the foot of the Wasatch Mountains on the east boundary of the University’s 1500 acre campus immediately adjacent to the golf course and overlooking the Salt Lake Valley.

The Department of Anesthesiology

The Department of Anesthesiology of the University of Utah, School of Medicine has maintained national prominence both clinically and academically for over twenty years. Excellent training is available for candidates interested in an academic career or private practice.

Letter from the Program Director

The faculty and support staff of the University of Utah, Department of Anesthesiology is truly dedicated to creating the best learning environment possible. Because the time you spend away from your practice and your family is precious, every effort will be made to optimize and maximize your learning experience.

The Perioperative and Critical Care Echocardiography Executive Medical Fellowship (EMF) curricula are designed to expose practicing anesthesiologists to a wide variety of cardiovascular pathologies and echo images. Interactive learning experiences are the foundation of the program. With different educational methods, you will learn the principles and practices of echocardiography, be exposed to numerous images and clips, and ultimately be able to diagnose cardiovascular pathologies, as well as formulate an appropriate therapeutic plan. The EMF programs are divided into three categories of educational tools.

1. Lecture Series: The lectures are one or two-hour didactic sessions where a specific topic will be presented by one of the faculty of the program. These lectures are internet-based and can be accessed at any time. The lectures are structured to present a clinical approach to the different concepts in perioperative echocardiography. They are not intended to replace basic knowledge chapters from the textbooks. Instead, you are encouraged to read the basic textbook chapters on your own time.
2. Case Presentations: The case presentations are one-hour periods where the faculty will present a short clinical scenario involving real patients, followed by a few echocardiography images relevant to the case. One or two questions will be asked and the student will be expected to interact and answer the questions. Positive discussions and feedback will be provided by the faculty. The cases are usually short and cover specific topics recently presented during a lecture series.
3. Diagnostic Exercises: The diagnostic exercises are one to two-hour periods where the complete integration of the knowledge acquired is put into action. This is the ultimate experience for your training in echocardiography. Under the direction of an EMF faculty member, a short clinical scenario will be presented. Then, a complete echocardiography examination (either TEE or TTE) will be shown over a 3-4 minute period. No comments will be made at this point. Then, you will be asked to generate a report of your findings. After a few minutes the case will be reviewed with the faculty and an auto-correction of your diagnostic findings will be performed. These diagnostic exercises are challenging but extremely valuable as a teaching tool. There is nothing like expressing your interpretation of the echocardiography images to become a real expert.

As you can see, your time at the University will be productive and entirely oriented toward your own educational needs. It is our mission to help you become an expert in perioperative echocardiography.

Daniel P. Vezina, M.D.
Director, Executive Medical Fellowship Program, Department of Anesthesiology

Perioperative and Critical Care Echocardiography Executive Medical Fellowship (EMF) Program

Many practicing anesthesiologists are not in a position to stop their existing practice or delay entering a practice so they can participate in a traditional fellowship program. However, this does not mean that many of these same physicians are not interested in expanding their skills, especially with emerging technologies that have been shown to improve patient outcomes.

The University of Utah Department of Anesthesiology Perioperative and Critical Care Echocardiography EMF program consists of 5-day, on-site sessions that are customized post-graduate training programs tailored to physicians who want to further their education and career without compromising their existing practice. Specifically, the EMF program offers an alternative to traditional methods for learning perioperative echocardiography. In general, the EMF program covers the following topics.

1. Ultrasound core concepts and principles.
2. Technical skills related to transesophageal echocardiography and transthoracic echocardiography.
3. Perceptual detection skills to identify features in medical imaging, also called visual sensitivity or visual recognition.
4. Image recognition skills to simultaneously perform the necessary technical procedures and identify normal and abnormal structures.
5. Knowledge and skills necessary to accurately and effectively report the medical imaging findings.

A new EMF course format is being introduced starting in December 2007. The new format requires attendance at the first two, 5-day onsite sessions (Weeks 1 and 2), with Week 3 and Week 4 being optional sessions. The two required, 5-day onsite sessions (Weeks 1 and 2) cover the perioperative and critical care echocardiography core curriculum and must be attended at least 30 days apart and both weeks must be completed within one year.

Week 3 and Week 4 sessions are optional, but cannot be attended without first attending both Weeks 1 and 2. You may attend either Week 3 or Week 4, or both; it is not required that you attend both Week 3 and Week 4. The three EMF program options and program requirements are outlined in Table 1 and the curriculum for each program is outlined in Table 2.

Schedule of Available weeks

Table 2. Program curriculum for EMF programs.

Program	Programs	Sessions	Day 1	Day 2	Day 3	Day 4	Day 5
A	Perioperative and Critical Care Core Competencies program	Week 1	TTE examination	TEE examination	Contractile function	Valvular regurgitant lesions	Valvular stenotic lesions
A	Perioperative and Critical Care Core Competencies program	Week 2	Echo-guided fluid management/Diastology	Cardiomyopathy	Hemodynamics	Pericardium/non-surgical aorta	Physics applications
B	Surgical Applications Program	Week 3	Prosthetic valves	Masses/Endocarditis	Valvular repairs	Traumatic injuries/Surgical aorta	Congenital heart disease
C	Perioperative and Critical Care Advanced Competencies program	Week 4	Exercise and pharmacology-based stress testing	Advanced echo reading session 1	Advanced echo reading session 2	Organization of comprehensive perioperative echo service	Advanced echo reading session 3

Perioperative and Critical Care Echocardiography Core Competencies Program (Weeks 1 and 2)

The University of Utah Department of Anesthesiology Perioperative and Critical Care Echocardiography Core Competencies program is designed to meet or exceed the basic clinical competence requirements developed by the American College of Cardiology (ACC) and the American Heart Association (AHA) for perioperative echocardiography (2003).

The program involves attendance at two, 5-day, on-site sessions at the University of Utah for a total of 10 days on-site over the course of the 1 year or less. Between these 5-day, on-site sessions, students review or perform a minimum of 150 perioperative echocardiography studies. Of these 150 studies, at least 50 are personally performed on their own patients and 100 are performed as simulated diagnostic exercises.

Echo studies are submitted to the University of Utah’s EMF faculty using an internet-based, remote supervision software system. After completion of each diagnostic exercise, immediate feedback via the remote supervision system is provided to the student. For studies performed on the student’s own patients, the EMF faculty reviews and quality assesses each study, and then makes it available online for the student to review.

At the completion of the Core Competencies EMF program, physicians should be able to use TEE for indications that lie within the customary practice of anesthesiology. Under appropriate supervision, students will learn to place the TEE probe, operate the ultrasound machine, perform a TEE examination, and convey and document the results of the examination effectively.

The University of Utah Department of Anesthesiology Surgical Applications EMF program is designed to cover all aspects of echocardiography for making diagnoses and decisions in surgical settings.

To attend the surgical applications program, students must have already completed the Core Competencies EMF program outlined above.

The Surgical Applications program involves attendance at one, 5-day, on-site session at the University of Utah. In addition to the 150 cases required for the Core Competencies Program, completion of an additional 50 cases is required; 25 echo cases on their own patients and 25 simulated diagnostic exercises.

Cases are submitted to the University of Utah’s EMF faculty using an internet-based, remote supervision software system. After completion of each diagnostic exercise, immediate feedback via the remote supervision system is provided to the student. For studies performed on the student’s own patients, the EMF faculty reviews and quality assesses each study, and then makes it available online for the student to review.

The University of Utah Department of Anesthesiology Perioperative Stress Testing Program is designed to cover all aspects of echocardiography-based stress testing.

To attend the perioperative stress testing program, students must have already completed the Core Competencies EMF program outlined above.

The Perioperative Stress Testing Program involves attendance at one, 5-day, on-site session at the University of Utah. In addition to the 150 cases required for the Core Competencies Program, completion of an additional 50 cases is required; 25 echo cases on the students’ own patients and 25 simulated diagnostic exercises.

Cases are submitted to the University of Utah’s EMF faculty using an internet-based, remote supervision software system. After completion of each diagnostic exercise, immediate feedback via the remote supervision system is provided to the student. For studies performed on the student’s own patients, the EMF faculty reviews and quality assesses each study, and then makes it available online for the student to review.

Educational Methods

• Students acquire the basic concepts and principles of echocardiography, on their own time, using internet-based electronic modules.
• Students participate in hands-on training sessions where he/she can learn and practice the technical components of transesophageal and transthoracic echocardiography on live models. Students also attend small, on-site group review sessions with experts in the field. The purpose of these sessions is to provide a venue for students to review and discuss a large number of images in a positive and supportive environment.
• Students perform procedures at their own facility utilizing an internet-based remote supervision program. An expert is centrally located at the University of Utah and supervises the work of the students in their own practice. The student’s assessment of each case is evaluated by an expert and feedback is provided.

Advantages of the University of Utah, Department of Anesthesiology Perioperative and Critical Care Echocardiography EMF

The advantages of the Executive Fellowship programs are numerous. In particular, they allow physicians to:

• Acquire skills necessary to improve patient outcomes and standard of care;
• Develop medical imaging skills that can be passed to peers;
• Keep up with the latest technical medical advances without compromising an existing medical practice;
• Interact with peers and experts in a flexible learning environment that provides open and supportive supervision;
• Develop skills necessary to accurately diagnose and identify perioperative cardiac pathologies using medical imaging techniques; and
• Provide an avenue for professional development and greater career opportunities.

Physicians receive 36.75 AMA PRA Category 1 Credit(s)™ for Week 1. The program and syllabus for Weeks 2-4 are in the process of being developed.

Application Process

The Department of Anesthesiology is approved by the American Board of Anesthesiology (ABA) and the Accreditation Council on Continuing Medical Education (ACCME) of the American Medical Association (AMA) for the executive fellowship programs.

Physicians who wish to be considered for an Executive Fellowship position must submit the following information. All applications received are screened by an applications committee, and selected applicants may be invited for a personal interview.

NOTE: Please send all information in one package.
• Must be board certified or a board eligible physician.
• Completed Application Form
• Letter of Intent that describes, in one page or less:
  1. Why you want to be trained in perioperative echocardiography
  2. Your goals of training, and
  3. How you foresee perioperative echocardiography impacting your practice
• Curriculum Vitae with two (2) references including relation, position, organization, phone and address
• Two recent, passport sized photographs
• Copy of valid medical license
• Completed letter of good standing for clinical privileges (The letter must be completed by the chairman or head of department) *The letter must be completed by the chairman or head of department

In addition to the above items, if accepted into the program, students will be required to bring five (5) completed echo cases on their own patients to the EMF faculty upon arrival at their first on-site session.

Certification Requirements

Practicing physicians who complete the certification requirements below for the specific program enrolled receive a certificate of completion of the Perioperative and Critical Care Echocardiography Executive Medical Fellowship issued by the University of Utah, Department of Anesthesiology.

Tuition

Tuition for the EMF programs is outlined in the table below.  Online payment.