Bigger and Better in the Big Apple

Last week a near-record 1,500 physicians, sonographers, scientists, students, and educators from across the country and around the world gathered in New York City to network, share, and learn. It was, by all accounts, one of the biggest and best AIUM Conventions yet!

What it made so great? A variety of educational opportunities covering a wide range of topics addressing at least 19 different specialties is just the start. More interaction across disciplines to share techniques, more hands-on learning labs, new product releases, and collaborative learning events added to the excitement and collegiality.

If you were in New York City, we hope you shared your feedback in the follow-up surveys. If you were unable to make it this year, here are a few of the highlights:

New Offerings—As if putting on the AIUM Convention weren’t enough, we decided to make a host of changes. We doubled the number of hands-on learning labs (most sold out), we added the more intimate Meet-the-Professor sessions (again, most sold out), we enhanced networking by adding exhibit hall receptions, we brought back the mobile app to make navigating the event easier, and we invited our corporate partners to host Industry Symposia, which included education, networking, and food. Whew!

New Offerings

SonoSlam—In its third year, a record number of medical schools (21) sent teams to compete for the coveted Peter Arger Cup. This year’s winning team, F.A.S.T. and Furious, is from the University of Connecticut. They competed last year and had so much fun they returned and were triumphant! Save the date for next year—April 6. Big thanks to headline sponsor CoapTech.

SonoSlam 2018

Global Plenary—AIUM President Brian Coley, MD, hosted the Plenary session that featured a lecture on global health from John Lawrence, MD, President of the Board of Directors for Doctors Without Borders-USA. This was followed by Roberto Romero, MD DMedSci, who presented the William J. Fry Memorial Lecture on ultrasound imaging and computational methods to improve the diagnosis and care of pregnant women and their unborn children. The entire Plenary Session is available on the AIUM Facebook Page.

Social Media—This year was the most active social media convention ever for the AIUM. StatsFrom streaming live videos on Facebook to more than 754 individuals participating and sharing on Twitter (a 50% increase over last year), the social media scene was active and engaging.

Fun Activities—Not only was #AIUM18 educational, it was also fun. This year attendees could participate in a morning jog through Central Park; do a scavenger hunt with the AIUM app (Congrats to Offir Ben-David, RDMS, from Stamford, CT, and Jefferson Svengsouk, MD, MBA, RDMS, from Rochester, NY, for winning prizes by completing the scavenger hunt); network during 3 different AIUM receptions and the new Industry Symposia; and win prizes at the AIUM booth (Congrats to Jenna Rothblat who won a free 2019 AIUM Convention registration).

Fun Activities

Sold-out Exhibit Hall—This year’s exhibit hall was the most exciting and active it has ever been. At least 3 companies unveiled new ultrasound machines and several others shared their insights with live video feeds. Combine that with networking receptions and New York street fare at lunch time, and the exhibit hall was always the place to be.

Award Winners—AIUM was proud to recognize the following award winners (look for upcoming blog posts and videos from some of these individuals):

Wesley Lee, MD, FAIUM—Joseph H. Holmes Clinical Pioneer Award

William D. Middleton, MD—Joseph H. Holmes Clinical Pioneer Award

Thomas R. Yellen-Nelson, PhD, FAAPM, FAIUM—Joseph H. Holmes Basic Science Pioneer Award

Tracy Anton, BS, RDMS, RDCS, FAIUM—Distinguished Sonographer Award

Alfred Abuhamad, MD, FAIUM—Peter H. Arger, MD Excellence in Medical Student Education Award

Creagh Boulger—Carmine M. Valente Distinguished Service Award

Rachel Liu—Carmine M. Valente Distinguished Service Award

Lexie Cowger—Carmine M. Valente Distinguished Service Award

Adriana Suely de Oliveira Melo, MD, PhD—AIUM Honorary Fellow

Simcha Yagel, MD, FAIUM—AIUM Honorary Fellow

E-poster winners—Every year, the AIUM supports an e-poster program. This year, a record number of abstracts were submitted and the AIUM recognized the following e-poster winners:

  • First place, Basic Science: Construction and Characterization of an Economical PVDF Membrane Hydrophone for Medical Ultrasound, presented by Yunbo Liu, PhD, from the FDA, Silver Spring, MD.
  • First place, Education: Investigation into the Role of Novel Anthropomorphic Breast Ultrasound Phantoms in Radiology Resident Education, presented by Donald Tradup, RDMS, RT, from Mayo Clinic-Department of Radiology, University of Pittsburgh Medical Center-Department of Radiology, Dublin Institute of Technology, Ireland.
  • First place, Clinical Science: Sonography of Pediatric Superficial Lumps and Bumps: Illustrative Examples from Head to Toe presented by Anmol Bansal, MD, Mount Sinai Hospital, Icahn School of Medicine.
  • Second place, Basic Science: Strain Rate Imaging for Visualization of Mechanical Contraction, presented by Martin V. Andersen, MS, from Duke University.
  • Second place, Education: Tommy HeyneSonography in Internal Medicine, Baseline Assessment (MGH SIMBA Study), presented by Tommy Heyne, MD, MSt, Massachusetts General Hospital-Department of Internal Medicine and Department of Emergency Medicine.
  • Second place, Clinical Science: Serial Cervical Consistency Index Measurements and Prediction of Preterm Birth < 34 Weeks in Twin Pregnancies, presented by Vasilica Stratulat, CRGS, ARDMS, MD, Sunnybrook Health Sciences.

Up and Comers—In addition to our national awards and our eposter winners, the AIUM also recognizes its New Investigators, which this year were sponsored by Canon.

Nonclinical
Winner— Ivan M. Rosado-Mendez, PhD, for “Quantitative Ultrasound Assessment of Neurotoxicity of Anesthetics in the Young Rhesus Macaque Brain.”

Clinical Ultrasound
Winner— Ping Gong, PhD, for “Ultra-Sensitive Microvessel Imaging for Breast Tumors:  Initial Experiences.”

Honorable Mentions
Juvenal Ormachea, MS,
for “Reverberant Shear Wave Elastography: Implementation and Feasibility Studies.”

Kathryn Lupez, MD, for “Goal Directed Echo and Cardiac Biomarker Prediction of 5-Day Clinical Deterioration in Pulmonary Embolism.”

2019

 

 

A Future Career Path for the MSK Sonographer

The sonographic community has the opportunity to take advantage of recent orthopedic surgeons’ interest in diagnostic ultrasound. Although much of the interest was prompted by the usefulness of guided injections, sonographers need to fully appreciate and understand the value of the information derived from an ultrasound study, which will ultimately lead the surgeon to better surgical decisions and better patient outcomes. Once you are a part of the orthopedic diagnostic team, you will be able to function as a specialist Physician Assistant member, adding a new dimension to the orthopedic practice and demonstrating the incredible value of diagnostic soft tissue imaging.

I am a Board-Certified Orthopedic Surgeon, with subspecialty in shoulder orthopedics including arthroscopy and open surgery. I incorporated diagnostic shoulder/MSK ultrasound as part of my office practice 20 years ago especially for evaluation of patients presenting with protracted shoulder pain (in addition to the traditional history and physical exam, and occasional MRI).

I have valued diagnostic shoulder imaging in my practice, and determined that all Orthopedic Surgeons should be using ultrasound imaging as part of their usual diagnostic evaluation of patients (especially patients presenting with protracted painful shoulder problems affecting function). In addition, an ultrasound exam with normal findings may be more important than an ultrasound exam that finds some pathology.

I have concluded that the real-time ultrasound examination with comparison to the contralateral side available to the orthopedic surgeon, in most cases, is more valuable than the information obtained from the MRI (especially regarding soft tissue pathology, present or absent).

For example, compare the MRI detail of the supraspinatus with the ultrasound motion clip of the supraspinatus moving under the acromion (see the still MR image below and, at bottom of page, the 1st video, which is the active ultrasound clip of the supraspinatus). MRI is accomplished with arms immobilized at one’s side, and does not benefit from the study being compared to the contralateral side. However, it produces a nice clear image. The ultrasound image in long axis can be a still image or a motion clip viewing the supraspinatus or infraspinatus moving under the acromion and the reaction causing impingement syndrome, spurs along the anterior lateral border of the acromion, dynamic sub acromial bursitis, or a rotator cuff tear, which may be attritional and similarly present on viewing the asymptomatic shoulder.

figure-1

The Math

The following statistics help to identify the future vital need for the sonographer to become part of the team working with the surgeon in an orthopedic office practice (Orthopaedic Surgeon Quick Facts, www.aaos.org; 10 Interesting Statistics and Facts About Orthopedic Practice, www.beckersspine.com; Am J Orthop 2016;45(2):66-67; 20 Things to Know About Orthopedics, www.beckershospitalreview.com).

There are approximately 28,000 (2012) orthopedic surgeons in the US, 75% of whom are in private practice, and many are in group practices of 2 or more. The general orthopedic surgeon sees an average of 70-90 patients per week, of which an estimated 12% or more have shoulder problems. This equates to 10 orthopedic shoulder evaluations per week for 1 solo general orthopedic practice, and 20 for a 2-man group (in the same office). Ten to 20 patients (minimum) per week would then benefit from ultrasound imaging information, assisting the surgeon in making a surgical decision.

The following image identifies how important the cross axis image is, as well as describes the degree of rotator cuff injury and approximates the relative number of rotator cuff muscle tendon units thathave been rendered dysfunctional.

figure-2-a-to-c

Left, Close to the infraspinatus/supraspinatus interval and insertion site, many fibers are in harm’s way for tendon/fibril tearing. Center, The area for careful X-axis grid examination, looking for possible partial undersurface tearing, fibers losing their connection/attachment to the footplate. Right, Example of an X-axis grid examination of this full thickness tendon tear, which should be accompanied by an x-axis measurement of the width/base of the triangular tear. Real time examination can help to identify the quality of the tissue, which may require repair. Usually, orthopedic surgeons pay more attention to the MRI reading and the coronal views (ultrasound long axis view). (See the 2nd video clip below for real-time imaging of the X-axis rotator cuff tear.) The X-axis view/measurement is the more important image. The wider the tear, the more tendon fibrils are affected and the more dysfunction to the rotator cuff area involved.

This need for diagnostic shoulder ultrasound information could be sufficient and important enough to support an entire career for an MSK sonographer. All the other valuable areas of MSK expertise that come with the MSK sonographer would be an extra bonus to the orthopedic office practice: helping with other ultrasound examinations, diagnosis, and surgical decisions.

Video clip 3 below is an MSK ultrasound examination for CTS identifying median nerve mobility or restriction within the tissue, questioning the presence of scar tissue restricting motion.

 

How have you used ultrasound in orthopedic surgery? What other areas of ultrasound are on the brink of emerging in a new field? Comment below or let us know on Twitter: @AIUM_Ultrasound.

Alan Solomon, MD, is a Board Certified Orthopedic Surgeon and Honorary Staff at the Metro West Medical Center, Natick/Framingham, MA.

 

Ultrasound in Medical Education: How Far We’ve Come

Point of care ultrasound was an obscure elective during my medical school years, a poorly-attended vacation elective to fill the free time between the match and the first day of residency. At the time, the 2 Emergency Medicine attendings directing the course volunteered an expertise, which endured widespread disregard; their craft persisted, unappreciated by the department and hospital. These faculty had a unique passion, a vision of a paradigm shift in medicine that would save more lives, make better decisions, and improve overall care.

I was initially skeptical of that vision. When they expressed excitement over our new, $50,000 Micromaxx (considered a bargain at the time), it sounded to me like the typical exorbitant medical expense with marginal benefit, peddled by savvy sales rmorrow_image1eps. Then we caught our first tamponade in cardiac arrest during a pulse check and I was hooked: POCUS didn’t belong as one of those obscure hobbies limited to the especially nerdy, but was a vital diagnostic and procedural tool, to be learned and disseminated. I went through residency clearly enamored with the technology. To my dismay, early in my internship, we lost our ultrasound director. It was then that I found mentors in podcasts and through the Free and Open Access Medical Education (FOAMed) community.

By my final year of residency, nurses and attendings were calling on me to pause my work in my assigned pod to travel to theirs to help with US-guided procedures. Having identified the need, I started teaching residents and nurses US-guided procedures. The barriers to education were high-quality simulation phantoms, machine access, and educational time. Time we could volunteer, and for machines we begged and borrowed, but for phantoms, we hit a wall. I searched for answers in the young community of FOAMed but found few workable alternatives to the hundred-to-thousand-dollar commercial phantoms. It was at this impasse that I found inspiration from Mythbusters’ use of ballistics gel. I experimented with ballistics gel to create my own phantom and found it morrow_dsf8521to be an effective and practical alternative to the commercial phantoms. I was approached by several companies aiming to turn this into a money-making opportunity, but I felt this information needed to be shared. This skill was too critical to keep it locked up behind a patent. Instead, with the whole-hearted spirit of FOAMed, I published guides and answered questions and gave cooking classes.

I’ve continued to follow the vision of bringing bedside ultrasound to widespread use, from residency to fellowship, and now into my role as Emergency Ultrasound Director and Director of Ultrasound Education at the University of South Carolina School of Medicine Greenville. The future is bright: the FOAMed community is large and growing; US technology is being integrated into earlier stages of medical education; and pocket machines are bringing US in closer reach of the busy clinician. Ultrasound is moving into the hands of clinicians at the bedside and becoming an extension of our physical exam, and there is a growing literature base to support this trend. Someday ultrasound will take its rightful place next to the stethoscope, and my job as an “ultrasound director” will seem as foreign a concept as “director of auscultation.” The complementary forces of FOAMed and formal medical education will bring us to this future of safer procedures and greater diagnostic accuracy, and I am excited to be a part of it.

How have you seen ultrasound medical education change? What are your favorite FOAMed resources? Comment below or let us know on Twitter: @AIUM_Ultrasound.

Dustin Stephen Morrow, MD, RDMS, is Ultrasound Director at Greenville Health System Emergency Medicine, as well as Director of Ultrasound Education at University of South Carolina School of Medicine Greenville. He can be found on Twitter: @pocusmaverick.

Interdisciplinary Education and Training in MSK Ultrasound

In my primary specialty of occupational medicine there is a need for practical education in musculoskeletal ultrasound for both diagnostic evaluation and therapeutic interventional guidance. Incorporation of this into education has begun recently and is continuing in the specialty. A wide variety of specialties are represented in occupational medicine, including many specialists who move into the field after a mid-career transition.

Interestingly, over the last few years clinicians have approached me and asked me to help them learn musculoskeletal ultrasound from many different disciplines outside of occupational medicine. These have included emergency medicine, orthopedics, rheumatology, sports medicine, family medicine, radiology, palliative care, and physical medicine and rehabilitation. When inquiring into why these clinicians are seeking training in this modality it seems that the consistent answer is thdr-sayeedat medical students are graduating and insisting on using ultrasound in their residency training. It would seem that many of our medical students are learning ultrasound at a rate that will outpace attending physician knowledge, exposure, and experience. Indeed, when teaching ultrasound to many of the medical students at West Virginia University as part of their medical education, I was astounded to see how proficient they were at using the machine, the transducer, and correctly identifying both normal and pathologic anatomy. It’s my understanding that many universities have included medical ultrasound into the academic curricula as a bridge to their respective gross anatomy courses and in their general clinical medical education.

Ultrasound is a modality utilized by many medical specialties for various indications. Several specialties outside of radiology, including the ones above, utilize ultrasound. Increasingly, residency programs are integrating ultrasound into their ACGME-accredited curriculum and, importantly, medical students are also learning the benefits of using the modality. It seems clear that despite the number of pitfalls, hurdles, and difficulties using ultrasound, the modality has proven to be an asset in clinical settings and has become a permanent fixture in hospital and clinical settings. The benefits of utilizing ultrasound have been well documented across many academic medical journals. I believe that medicine, as a whole, has done well to embrace the modality, however, there seems to be another vital step to take in the education arena to more fully integrate the modality into our patient’s care.

Currently, most education models for teaching ultrasound, whether it is for residents or medical students, involves grouping like kind together. Emergency residents learn it in the emergency medicine didactics. Physical medicine and rehabilitation (PM&R) residents learn it from demonstrations in their own didactics, and so on. Perhaps approaching the curriculum from a more inclusive perspective, however, would be more beneficial for residents and fellows. I, personally, had experience teaching an integrated musculoskeletal course at West Virginia University. The idea, admittedly, was born out of necessity. Physicians experienced in ultrasound from sports medicine, emergency medicine and occupational medicine created and executed a curriculum to teach musculoskeletal ultrasound and invited residents from other specialties. The interest we were able to garner quite frankly surprised me. Although the curriculum was targeted to occupational medicine residents the interest in using musculoskeletal ultrasound was widespread. Residents from specialties like emergency medicine, radiology, family medicine, internal medicine, and orthopedics attended our sessions.

While the course was a success, introducing an integrated curriculum across medical specialties posed a new set of challenges. My specialty was able to use dedicated didactic time for the education but many other specialties have disparate educational time. Many residents could not make all of the sessions and many more could not make any sessions because of fixed residency schedules. This makes coordination very difficult. As I have pondered this over the last few months I believe that educational leaders should begin to form structured educational collaborative time for activities like education in musculoskeletal ultrasound. Each discipline will be able to contribute to teaching to ensure high quality evidence-based curriculum for residents learning ultrasound. Each discipline has their individual strengths and collaboration ensures coordination and even learning amongst instructors. Integrating medicine has been a goal of thought leaders in medicine at the very highest levels and can be replicated for the instruction and training of our resident physicians.

Another option is to allow residents to attend the American Institute of Ultrasound in Medicine’s annual conference where interdisciplinary education in ultrasound occurs. This conference even has a day for collegial competition among medical students and schools. In fact, the courses are created to encourage engagement in the education and training of clinicians at all levels of training. The overall goal is to advance the education and training in this modality and hope that education leaders begin to encourage collaboration in a much larger scale thus achieving integrated medical care that provides a building block to lead to high quality evidence-based medical care for our patients, families, and communities.

What other areas of ultrasound education have room to grow? How would you recommend making changes? Do you have any stories from your own education to share? Comment below or let us know on Twitter: @AIUM_Ultrasound.

Yusef Sayeed, MD, MPH, MEng, CPH, is a Fellow at Deuk Spine Institute, Melbourne, FL.

Puzzle Solver

During the 2016 AIUM Annual Convention, Michael Kolios, PhD, was awarded the Joseph H. Holmes Basic Science Pioneer Award. We asked him a few questions about the award,November 11, 2015 what interests him, and the future of medical ultrasound research. This is what he had to say.

  1. What does being named the Joseph H. Holmes Basic Science Pioneer Award winner mean to you?
    It means a lot to me to be recognized by my peers in this manner. It motivates me to work even harder to contribute more to the community.  I have been associated with the AIUM for a long time and have thoroughly enjoyed interacting with all the members over the years. When I peruse the list of the previous Joseph H. Holmes Basic Science Pioneer Awardees and look at their accomplishments, I feel quite humbled by being the recipient of this award, and hope one day to match their contributions to the field.
  1. What gets you excited the most when it comes to research?
    I get excited when I generate/discuss new ideas, participate in the battle of new and old ideas, and the immensely complex detective work that is required to prove or disprove these new ideas. I thoroughly enjoy the interactions with all my colleagues and trainees that join me in this indefatigable and never-ending detective work, as solving one puzzle almost always creates many new ones. This is what I’ve encountered in the last 2 decades while probing basic questions on the propagation of ultrasound waves in tissue, and how different tissue structures scatter the sound. Finally, I get very excited when I try to think about how to use the basic science knowledge generated from this research to inform clinical practice, and envisioning the day this will potentially make a difference in the lives of people.
  1. How can we encourage more ultrasound research?
    We need to provide the resources to people in order to do the research in ultrasound. Most funding agencies are stretched to the limit and success rates are sometimes in the single digits. This makes it very challenging to do research in general, including ultrasound research. Therefore, pooling resources and providing environments where ultrasonic research can excel will partially help—creating/promoting/maintaining centers for ultrasound research. This can also be promoted through networking and professional societies, such as the AIUM.Another thing to do to encourage more ultrasound research is by demonstrating the clinical impact of ultrasound and how it could be used to save the lives of patients. Only through the close collaboration of basic scientists/engineers with clinicians/clinician-scientists/sonographers can this be achieved. Developments in therapeutic ultrasound for example are very exciting, and have recently attracted the attention of both public and private funding agencies with many success stories. Moreover, providing seed money through opportunities such as the ERR (Endowment for Education and Research) is a step in the right direction—to give people the opportunity to pursue their ideas in the field of ultrasound research.
  1. What new or upcoming research has you most intrigued?
    While I spent a lot of time trying to understand ultrasound scattering, and how changes in tissue morphology influence this scattering, I’m currently dedicating most of my time to the new field called photoacoustic imaging. It is known that conventional clinical ultrasound has relatively poor soft tissue contrast, but in photoacoustic imaging light is used to generate ultrasound. These ultrasound waves, created when light is absorbed by tissue, provides exciting results that allow not only probing tissue anatomy, but also function in ways that not many other modalities can. After the light is absorbed and the waves initiated, everything we know about ultrasound applies—and in fact we can use the same ultrasound instrumentation to create images. I expect this imaging modality to have clinical impact in the near future.
  1. You are well accomplished within the medical ultrasound research community, but when you were young what did you want to be when you grew up?
    When I was young I wanted to be firstly an astronaut, then a philosopher, pondering basic questions and fundamental problems in nature. I ended up studying physics and its applications in medicine. It has been a highly rewarding choice!
  1. If you were presenting this award at the 2017 AIUM Annual Convention, who would you like to see receive it and why?
    I’d like to see someone that has contributed to ultrasound, with work spanning from the basic science/engineering to clinical application! It would also be encouraging to see the next recipient being a woman or minority, reflecting the true diversity from which new ideas come, and representing a constituency for which society has relatively recently given the opportunity to contribute to science in a meaningful and sustained manner.

Who would you like to see win an AIUM award? What ideas do you have to increase the interest in and funding for research? Comment below or let us know on Twitter: @AIUM_Ultrasound.

Michael Kolios, PhD, is Professor in the Department of Physics, and Associate Dean of Science, Research and Graduate Studies at Ryerson University.

Why I Love Credentials

My name is Mike. I am many things, including a veteran, a business man, a coach, and a sonographer. And while the “things” I am change over time, one thing has remained the same: I am a student! This is thompsonmost evidenced by the 8 professional credentials I currently hold.

I have found that after being in the field of ultrasound for more than 2 decades, credentialing and continuing education can distinguish the enthusiastic sonographer from the merely competent one. With the introduction of more focused credentials such as musculoskeletal, breast, pediatric, phlebology, and advanced cardiac subspecialties, sonographers can now stand out from the crowd in terms of awareness and competency while at the same time being on the cutting-edge of the latest techniques and literature.

Acquiring a new credential, or even just studying for the registry examination, requires you to learn valuable new knowledge that may impact the way you treat and diagnose patients. For example, while I was preparing for the RPhS registry, multiple sources recommended a pneumatic compression device to augment venous flow while a patient is standing as an alternative to the patient performing the Valsalva maneuver in order to induce and record venous reflux. For me, this method has helped me better evaluate for this condition with less strain on the patient while eliminating communication barriers that may exist. If I hadn’t been preparing for that exam, I probably would never have learned this technique.

While some credentials are necessary for certain jobs, multiple credentials prove to existing and future employers that you take your profession seriously and you don’t settle for the minimum standard. I am not saying you need to get multiple credentials. If your professional interest does not reach beyond one credential, that is fine, but few ultrasound labs today only perform only one specialty. Echocardiography labs and vascular labs are growing together as cardiovascular labs, and many departments are requiring a more comprehensive knowledge in ultrasound. Credentialing yourself to the highest degree may get you the new job you pursue or secure the one you have. While increased pay is always a motive, sometimes the satisfaction of being able to set yourself apart from others in the field can be just as rewarding.

Some sonographers have the position that if the credential doesn’t come with a pay raise, it’s not worth it. With reimbursement cuts and higher credentialing standards being proposed by private and government payors, my opinion is that keeping your job is a pay raise.

Why do you hold the credentials you have? What are your go-to resources? What book would you like to see written? Share your thoughts and ideas here and on Twitter: @AIUM_Ultrasound.

Mike Thompson, MPH, RDMS, RDCS, RVT, RPhS, RVS, RCS, RCCS, is Owner of Diagnostic Resources in Perry, Georgia.

 

Obsessed With Ultrasound

1. Tell us how and why you became interested in ultrasound?
During my Emergency Medicine at Mayo Clinic, I gained exposure to point-of-care ultrasound (POCUS) for procedural guidance. I was immediately drawn to the hands-on and technical aspects of using ultrasound, and began advancing my use for diagnostic shihpurposes. After a few cases of diagnosing acute pathology at the bedside (AAA, free fluid, and DVT to name a few), I was hooked! Following residency, I decided to expand my ultrasound training and pursued an Emergency Ultrasound Fellowship at Yale, while also working toward obtaining my Registered Diagnostic Medical Sonographer (RDMS) certification. Ever since I’ve adopted a liberal use of POCUS in my clinical practice, I can say without a doubt that it’s made me a better Emergency Physician, and I can’t imagine practicing without it!

2. Talk about your role as Program Director of the Emergency Ultrasound Fellowship Program at The Scarborough Hospital in Toronto.
I’m thrilled to be able to bring the skills that I’ve learned during my own EUS Fellowship training to the Emergency Medicine community in Toronto! Our team built the Fellowship Program from the ground up, and our Department went all in with the purchase of 4 additional new ultrasound machines and QPath software for archiving. I’m truly proud of what we’ve accomplished. It certainly helps that I have an extremely supportive Department Chair and 2 amazing fellows this year!

3. What prompted the writing of your book Ultrasound for the Win!?
When trying to learn more about ultrasound myself during residency, I found that there was a void in high-yield POCUS books geared toward Emergency Physicians. I found that the few textbooks that were available, while informative, could be quite dense and intimidating to read. So I decided to develop a book that I, myself, and I believe most Emergency Physicians, would appreciate — a case-based interactive and easy-to-read format that’s clinically relevant to our daily practice. It’s a book that a medical student or resident interested in POCUS can easily read and reference during an Emergency Medicine rotation.

4. What’s one thing you learned about yourself through the writing/editing process?
It’s made me realize just how obsessed I am with ultrasound! Writing and putting together the book was hard work, but also enjoyable and extremely satisfying! Seeing these real cases compiled one after another really highlights the potentially life-saving role of POCUS in medicine, and the profound difference it can make in improving patient care and outcomes.

5. What advice would you offer medical students when it comes to ultrasound?
Scan many and scan often—it’s simple; the more you practice POCUS, the better you will be at it! Also, don’t be afraid to take initiative in your own education—while some attendings may not be comfortable enough with POCUS to teach it to you, don’t let that be a deterrent to your own learning. There’s a plethora of resources available online, including Matt & Mike’s Ultrasound Podcast and Academic Life in Emergency Medicine that you can reference!

How did you become interested in ultrasound? What are your go-to resources? What book would you like to see written? Share your thoughts and ideas here and on Twitter: @AIUM_Ultrasound.

Jeffrey Shih, MD, RDMS, is an Emergency Physician and author of the book Ultrasound for the Win! Emergency Medicine Cases. He is Program Director of the Emergency Ultrasound Fellowship Program at The Scarborough Hospital in Toronto, Canada, and Lecturer in the Faculty of Medicine at the University of Toronto. He can be reached at jeffrey.shih@utoronto.ca and on Twitter: @jshihmd