Training

ULTRASOUND CLINICAL ASSESSEMENT – WHAT ARE YOU WAITING FOR?

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Dr Chris Tomlinson was one of the first candidates to complete the Faculty’s Ultrasound Clinical Assessment for Sport and Exercise Medicine (SEM) doctors and found out that the process was more straight forward than he had initially thought.

I attended the first FSEM DOPs Ultrasound Clinical Assessment day on the 2 September at the ISEH in London, but I have a confession to make. A week before the assessment I nearly pulled out of doing it. There were a couple of reasons. Firstly, returning from holiday with two weeks to prepare, work suddenly exploded, leaving me with little time to practice, other than my normal clinical workload.

 

The second, and most relevant to me in writing this, is that I didn’t like being unsure of what I would be facing. Sure, three upper limb cases in the morning and three lower limb in the afternoon, observed by an experienced SEM physician and a radiologist, but that encompasses a multitude of sins, some of which would not fall within my clinical use or competencies. ‘Scan this hip please sir.’ Errr….

It took a reassuring phone call. Firstly, no hips, but also an explanation that the aim was not to catch you out, but to reassure that you knew how to use a scanner, and approach tissue in a sensible manner.

Which is pretty much what happened. Meeting at the clinic, my cohort were all experienced SEM physicians, and all a little nervous about the smooth running of the FSEM’s very first assessment, with the same reservations as I.

The day proceeded as described above. Patients were drawn from the clinic list, meaning that real pathology was present, but perhaps not necessarily always the pathologies they wanted.

In the morning, there were two shoulders, and then, somewhat disconcertingly, a finger – not something I ever scan, but applying general principles was what they wanted, plus an ESSR (European Society of Musculoskeletal Radiology) tour around the dorsum of the wrist.

In the afternoon, we were faced with a complex knee – again, showing an understanding of the anatomy and working within your competencies was what was required, and then an assessment of Ultrasound practice on two feet! This actually worked in my favour, as I do a fair bit of this in my NHS MSK clinic and it was good to see that the assessment is relevant to NHS practice. A good going Achilles or Patella tendon would have be more relevant to Sports Medicine practice.

Was it worth it? Absolutely!

a) I passed.

b) I can return to my workplaces satisfied that I am competent, and reassure them that I am.

and

c) It was a good learning and networking opportunity. Did I mention I passed?

Clearly, being the first DOPs assessment day, there are issues that will be refined. I think the expectations of the day should be more clearly defined and there should be more time to make it relevant to our clinical practice – a long case where you can take a proper history and perform a thorough examination before scanning would make sense, and perhaps some parameters, such as an expectation that you can follow the BSSR guidelines for shoulders, elbows, wrists, knees and ankles. Some practice time with fellow candidates before kicking off would also have been useful.

That said, the day was well run by the ever helpful college staff, the examiners were friendly and fair (the presence of SEM Doctors is definitely a ‘good thing’) and the aim of the day, to show competence, ultimately incredibly satisfying. What are you waiting for?

For more information and to book a place on the FSEM’s Ultrasound (DOPs) Clinical Assessment visit the Faculty’s Ultrasound page.

Written by Dr Chris Tomlinson at 17:00