The Expeditious Evolution of Emergency Ultrasound Fellowships

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Access to the internet was dial up through AOL, Bill Clinton was President, and ultrasound machines were big, clunky, and new to the emergency department. It was 1999 and I was in Long Island as a resident. As a resident, I saw the ultrasound machine lurking around the emergency department, but very few faculty seemed to know how to use it. A search of fellowships in emergency ultrasound found a single listed fellowship in Chicago, so I organized a rotation to see what ultrasound was all about.

Emergency ultrasound fellowships in the early 2000s were disconnected, isolated, and in many ways under the radar. As the ultrasound interest group president in SAEM (soon to become the Academy of Emergency Ultrasound) I heard firsthand how difficult it was for fellows to find ultrasound fellowships and how difficult it was for fellowship directors to find applicants. Partnered with Pat Hunt, we started as a platform for fellows and programs to meet. Ultrasound became more mainstream as ACEP, SAEM, and CORD fought to have ultrasound integrated into residency training and general emergency medicine.

Eventually evolved into the Society of Clinical Ultrasound Fellowships as a more robust organization focused on advanced training for bedside ultrasound. The first couple of emergency ultrasound fellowships started around 1997. Within 5 years there were 12 fellowships, and within 10 years there were 27. Today there are over 100 emergency ultrasound fellowships graduating more than 70 fellows each year. There are more ultrasound fellows graduating each year than in toxicology and EMS combined.

Emergency ultrasound fellows today join a large vibrant group of specialists across the United States and the world. Physicians use ultrasound to diagnose, monitor, and guide procedures everywhere from the African savannah to the neighborhoods in New York City. The initial meetings in the 1990s involved small groups getting together to discuss cutting-edge research and new applications. Now ultrasound meetings in emergency medicine involve hundreds of people discussing topics such as board certification or ultrasound program management. Research has evolved from single “we can do it too” projects to multi-center collaboratives. The change in ultrasound over the last 20 years is mind blowing.

When I interview medical students now, I ask them why they went into medicine. What do they want to achieve? One of the best answers I hear is that they want to make a difference in medicine and improve care for all patients. I feel that I have been lucky enough to witness the birth of a new subspecialty that will improve how patients are cared for in the future.


What was your initial experience with ultrasound education? Where did you learn your ultrasound skills? Comment below or let us know on Twitter: @AIUM_Ultrasound.

Romolo Gaspari, MSc, MD, PhD, FACEP, is the Executive Vice Chairman of the Department of Emergency Medicine at UMASS Memorial Medical Center. He has also served as the president of a number of Emergency Ultrasound Societies including what is now the Academy of Emergency Ultrasound and the Society of Clinical Ultrasound Fellowships.

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