UNIVERSITY OF
NIVERSITY OF
V COLLEGE OF MEDICINE
M
ERMONT
ERMONT
COLLEGE OF MEDICINE
ULTRASOUND EDUCATION IN
THE AMERICAN COLLEGE OF
SURGEONS: A HISTORY
Steven R. Shackford, M.D., F.A.C.S.
Steven R. Shackford, M.D., F.A.C.S.
Stanley S. Fieber Professor and Chairman
Stanley S. Fieber Professor and Chairman
Department of Surgery
Department of Surgery

WHY IS THIS IMPORTANT?
! Ultrasound education was unique for ACS
" New initiative for the College
! Create a durable record of events
" Why, where, how?
! New technologies will continue to emerge
" ACS ultrasound educational program can serve as a
template for future teaching

DISCLAIMER
! Recollection
! Sources of data
! Apologies

MAJOR FACTOR: SYNERGISM
! European experience
! ACS perception of its
role in education
! CESTE leadership
! Technological evolution
of ultrasound
! Surgical persona

ROOTS
! Europe
" Germany: Tiling 1976
! First course for surgeons: 1982
! Board requirement (Urology, General Surgery,
Orthopedics: 1987
" Used commonly by surgeons in Scandinavia
! Urology: Torpedersen
! Asia and Indonesia
" Used commonly for trauma and head and neck
surgery

! Confirmed observations in Europe & Asia
" Ultrasound was accurate for
hemoperitoneum
" Surgeons & residents can acquire & interpret
images
! Recommended that surgeons become
proficient
! Proposed a curriculum

! Coined the term “focused” exams
! Called attention to uneven “playing field” of
practice domain
! Called for educational programs
" Similar to Emergency Medicine, Cardiology, OB

NASCENT EDUCATIONAL
PROGRAMS
! No coordinated effort to educate surgeons
! Surgical residents
" Washington Hospital Center
" Rush
" University of Illinois @ Chicago
" University of Vermont
" Emory
! Practicing Surgeons
" EAST
" Rush
" University of Vermont

STATUS OF U/S EDUCATION: 1993
! Ultrasound: not in the practice domain of
surgeons
" Perception that only radiologists were
capable: “took years to learn”
! Liability concerns fueled by practice domain
issue
! Credentialing and “turf war” controversy
! No organized effort at the national level
" Education
" Support for credentialing

EARLY ACS EDUCATION
! Roger Foster # Gerry Strauch
! 21st Spring Meeting: Montreal, 1993
" “New Frontiers in Trauma: New Diagnostic
Modalities”
" Great interest
! Strauch # Jim Carrico, assist by Alex Walt
" CESTE
! 80th Clinical Congress: New Orleans, 1995
" General Session: “The Surgeon and Ultrasound”

First General Session: 1995

ULTRASOUND USERS GROUP
! Surgeons with an “interest” in ultrasound
" 1st meeting 10/24/95; facilitated by Strauch
! Goals and objectives:
" Develop course of instruction for the ACS
" Develop educational format for ultrasound
" Interface with manufacturers
" Interface with the ACS hierarchy
" Interface with ABS and APDS
! Keep the trains running while the airport is built
" Develop first PG Course: Grace Rozycki

1st POSTGRADUATE COURSE
24th Spring Meeting, New York
4/15/96

1st USERS GROUP

USERS GROUP
ACCOMPLISHMENTS 1995-1998
! Developed basic and modular concept
" Standardized the course of instruction-similar to ATLS
! Developed verification program for ultrasound
! Solidified vendor assistance
! Developed liaisons with:
" AIUM
" ABS
" APDS
! Selected an executive committee:
" ACS National Ultrasound Faculty

ACS VERIFICATION PROGRAM
! Course meets standards established by the
College
! Documentation
" Level 1: verification of attendance
" Level 2: verification of satisfactory
completion of course objectives
" Level 3: instructor

INITIAL MODULES AND DIRECTORS
! Basic: Shackford
! Acute Setting: Rozycki
! Breast: Staren
! Vascular: Pilcher
! Abdominal: Machi & Schirmer
! Head and Neck: Harness & Staren

NATIONAL ULTRASOUND FACULTY
(approved by the Regents 1998)
! Chair: Shackford
! VC Education: Knudson
! VC Technology: Rozycki
! VC External Relations:
Wherry
! VC Verification: Staren
! Ultrasound Imaging Group

NUF ACCOMPLISHMENTS 1998-2003
! Instructors Course developed
" Directed by Rozycki
st th
" 1 course: 84 Clinical Congress: Orlando, 1998
! “Exportation” of ACS courses
" Directed by Knudson
" 18 courses to surgical residencies
" 6 courses to professional societies
! Formal membership on CESTE
! Established a mechanism for the Chair, VC, Module
Director & Course Director rotation
! Introduction of new modules as PG courses

Clinical Congress
10
8
6
PG Courses
4
2
0
95 96 97 98 99 00 01 02 03
Year

Spring Meeting
7
6
5
4
PG Courses
3
2
1
0
95 96 97 98 99 00 01 02 03
Year

THE FUTURE
! Basic Course to CD
! Incorporation of Imaging Group into the NUF
! Develop methods to maintain skills
! Develop methods to assess skills
! Develop on-line tools
! Develop “Blue Book”
! Develop new applications of ultrasound
" 1st generation: Sonosite

ACKNOWLEDGEMENTS
! ACS staff
" Gerry Strauch
" Jim Carrico
" Olga Jonasson
" Ajit Sachdeva
! Tom Russell
! Vendors and their staff
! All the 2600 students