A new advanced training statement from the ACC, American Heart Association and American Society of Echocardiography defines the training requirements for performing Level III echocardiographic procedures. The 2019 ACC/AHA/ASE Advanced Training Statement on Echocardiography was published Feb. 19 in the Journal of the American College of Cardiology, and is the first time that Level III training for echocardiography has been formally defined.

The advanced training statement complements the ACC 2015 Core Cardiovascular Training Statement (COCATS 4), which defines the training requirements for all clinical cardiologists. The new document outlines the length of training, the types of disorders that should be reviewed, the number of various procedures typically required for competence and the knowledge base and skill required to be an advanced echocardiographer. It acknowledges that the number of procedures needed to achieve competency may vary from one individual to another, and the education and training of advanced echocardiographers should occur in a structured clinical learning environment, usually within a formal cardiology fellowship program. The training statement also outlines the resources that are typically required in these training programs and includes requirements for echocardiographic lab accreditation and teaching faculty guidelines.

"All cardiologists should have a basic understanding of echocardiographic techniques – their strengths, limitations and appropriate use," said Susan E. Wiegers, MD, FACC, chair of the writing committee. "Although it is expected that most, if not all, fellows will achieve Level II competency in echocardiography during their three years of general cardiology training, this document describes the more focused, in-depth experience required for Level III competency."

The writing committee recognizes that the indications, technology and capabilities of cardiac ultrasound are continually advancing. The competencies defined in this document equip the advanced echocardiographer with the knowledge needed to acquire new skills as they emerge.

"The use of cardiovascular ultrasound is a key component in the care of many patients in the hospital and outpatient office as well as guiding interventional cardiac procedures in the catheterization lab and the operating room," Wiegers said. "It is important to define what is required to become a Level III echocardiographer."

The document was developed in collaboration with the American Thoracic Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Anesthesiologists and Society of Critical Care Medicine.

Clinical Topics: Noninvasive Imaging, Echocardiography/Ultrasound

Keywords: Clinical Competence, Echocardiography, Cardiac Imaging Techniques, Echocardiography, Stress, Education, Medical, Teaching, Echocardiography, Transesophageal

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