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Obstetrical US

GENERAL OBJECTIVES:

 On completion of the Perinatal Ultrasound training program the resident will be competent to function as a consultant in the discipline of maternal fetal imaging. The resident will be able to supervise, perform, interpret and advise on ultrasound examinations to such a level of competence as to function as a consultant to referring physicians.  The skills will be developed to a level appropriate for Royal College certification.
 

SPECIFIC OBJECTIVES

At the completion of this rotation, the resident will have acquired the following competencies and will function effectively as:
 

Medical expert/clinical decision-maker

 
Specific Requirements:
·         Apply a systematic style of reporting for all obstetrical US cases
·         Demonstrate knowledge of obstetric anatomy as well as maternal abdominal and pelvic anatomy and its changes through pregnancy
·         Demonstrate knowledge of clinical radiology and pathology as it pertains to assessment of
disease processes imaged with US relevant to maternal-fetal medicine
·         Understand the technical parameters used to obtain US images. Develop adequate manual scanning technique and the ability to adjust technical parameters to optimize image quality for each patient; using most commonly utilized US machines. Understand the source of different US artifacts, and how to compensate for these artifacts.
·         Demonstrate knowledge of the safety and biologic effects of ultrasound particularly with regards to the fetus.
·         Understand the clinical presentations of various pathology including fetal anomalies and pregnancy related complications
·         Develop a systematic approach to US interpretation.
·         Be able to detect abnormal findings, normal anatomy and variants for each case.
·         Be able to check sonographers’ findings to ensure adequate images are obtained to answer the clinical question.
·         Be systematic, but flexible, in the conduct of ultrasound examinations, understanding that diagnostic US is a dynamic modality that frequently demands tailoring of studies based on specific clinical situations and observations made during the course of examinations.
·         Be able to offer an appropriate differential for all abnormal findings.
·         Be able to summarize overall findings and differentials, and offer appropriate recommendations for each case.
·         Understand clinical and treatment implications of various findings and disease processes.
·         Understand the indications and contraindications for the various interventional procedures performed

 

Communicator

 
Specific Requirements:
·         Apply a systematic style of reporting for all obstetrical US cases.
·         Have the ability to assemble a report that succinctly and accurately describes the US findings, give the most likely differential diagnoses, and recommend further testing and/or management when indicated, including referral to the perinatology clinic when warranted.
·         Dictate and verify reports in a timely fashion.
·         Understand the importance of communication with referring clinicians, particularly in a situation when the results of an investigation or procedure should be urgently communicated.
·         Be able to effectively communicate results with patients in a compassionate way
 

 

 

 

Collaborator

 
Specific Requirements:
·         Consult effectively with other physicians and health care professionals, especially perinatologists.
·         Have the ability to function as a member of a multidisciplinary health care team. The resident should be able to supervise and work together with nursing staff and sonographers.
·         Be able to suggest alternative imaging modalities when US may not be appropriate in a given clinical situation, for both diagnostic and interventional studies.
 
 

Manager

 
Specific Requirements:
·         Understand quality assurance issues related to US, including, but not limited to, misdiagnoses, vendor specific hardware limitations, and technical parameter optimization.
·         Be able to manage the daily workflow through the US department.
·         Interpreting and/or performing an adequate volume of cases, appropriate to their level of training.
 
 

Health Advocate

 
Specific Requirements:
·         Describe and explain the benefits and risk of US investigations including population screening.
·         Educate and advise on the use and misuse of US imaging and intervention.
 
 

Scholar

 
Specific Requirements:
·         Demonstrate competence in evaluation of the medical literature.
·         Demonstrate ability to be an effective teacher to medical students, fellow residents, technologists, and clinical colleagues.

Professional

 
Specific Requirements:
·         Punctuality, attendance, reliability and respect in the workplace.
·         Be able to accurately assess one’s own performance, strengths, and weaknesses.
·         Be aware of one’s own limitations.