Transthoracic Echocardiography (TTE) Training

The goals of the cardiology fellows are to perform and interpret at least the minimum number of transthoracic echocardiograms (table 1). Tools such as M-mode, second harmonic imaging, contrast echocardiography and power Doppler will be used on routine clinical examinations to enhance the diagnostic information obtained from the test.

Year 1

The first-year fellow will spend 2 months in echocardiography and will be expected to perform transthoracic echocardiograms on call with the assistance and backup of a senior fellow and cardiology attending. Research participation is encouraged. The objective of the first year is to become adept at the utilization of echocardiography in clinical practice as a diagnostic tool.

Year 2

The second-year fellow will continue with regularly scheduled didactic sessions reviewing the basic principles of echocardiography. The fellow will continue to advance manual skills in the independent performance of transthoracic echocardiograms. The fellow will also be asked to regularly interpret complete transthoracic echocardiograms with a focus on providing a clinical diagnosis and a thorough interrogation of associated cardiac abnormalities.

The objective of the second year in echocardiography is to become adept at the independent performance and interpretation of complete transthoracic echocardiographic studies. Learning stress echocardiography (SE) and transesophageal echo (TEE) is introduced during the second year.

Year 3

The objective of the third-year noninvasive echocardiography program is to add procedural skills. The fellow will be further trained in the performance and interpretation of transesophageal and stress echocardiography (exercise treadmill and Dobutamine stress). The fellow will continue active involvement in the didactic sessions and clinical performance and interpretation of transthoracic echocardiograms. The fellow who chooses the noninvasive path will spend an additional 3-6 months in echocardiography.

Table 1: COCATS Training Requirements for Transthoracic Echocardiography