Things to consider before setting your sights on a fellowship…
There are a number of places in Australia that offer dedicated echo fellowships. Not all echo fellowships are the same and it is important to determine the goals and expectations before applying for these positions. Other echo related considerations include – the ability of the programme to be able to support the fellow through a formal qualification such as the DDU, which not only involves transthoracic echoes, but also transoesophageal and non cardiac scans (lung, abdominal, vascular US). The case mix of the patients are also important. This determines the complexity of the the patients being scanned (eg congenital heart disease, mechanical assist devices etc).
The number of scans required for the DDU include 300 TTEs, 150 TTE reported, 50 TOEs, 50 Rapid Abdominal Scans, 50 lung ultrasounds, 50 vascular, 50 line insertions and 25 procedures. Other echo related qualifications are discussed elsewhere on Echopraxis. As you can see, it is no small feat to enrol in the DDU. Therefore, it is important to ensure that the ability to do some, if not most of these scans, is achievable during the fellowship year. A good primary supervisor is will ensure these goals are met. The number of DDU qualified clinicians in the programme, who are able to support you throughout the year, is also an important factor to consider. It is also reasonable to enquire, the relationship with other departments which may aid in acquiring echo or sonography skills such as cardiology or vascular sonography team. One of the fellowship programmes, holds regular video conferencing meetings with other units to discuss echo related topics.
Most echo fellowships I am aware of, also consist of a clinical component. The clinical component usually consists of working as a senior registrar on the roster. This may just be filling gaps for holidays or it may be more than just ‘cover’ shifts. Some argue that it is useful to have some clinical duties in order to keep the skills up but it is also important to have a balance due to the steep learning curve required to pursue echocardiography to an advance level. A programme that has an onerous clinical roster, takes away opportunities for learning echo ( eg theatre time for TOEs, reporting sessions). There are currently no fellowships at present that allow fellows to perform clinical duties as a junior consultant.
The units which currently offer echo fellowship programmes in Australia are, with the primary supervisors in brackets:
NSW – Napean Hospital (Anthony Maclean). St George/ St Vincents Hospital (Stan Yastrebov)
Victoria – Alfred Hospital (Deirdre Murphy)
Upcoming – Austin Hospital (Andrew Hilton)
For more information, it is also useful to contact current or past echo fellows to discuss the intricacies of the programme including benefits and pitfalls.