This document discusses the history of ultrasound education within the American College of Surgeons (ACS). It describes how early European experience with surgical ultrasound helped establish its value. In the 1990s, the ACS began developing an ultrasound educational program through initiatives like workshops at clinical meetings. This led to the formation of an Ultrasound Users Group and National Ultrasound Faculty to standardize ultrasound education for surgeons. Over years, the ACS program expanded to include multiple modules and courses, establishing ultrasound firmly within the surgical domain through education.

1. UNIVERSITY OF
NIVERSITY OF
V COLLEGE OF MEDICINE
M
ERMONT
ERMONT
COLLEGE OF MEDICINE
ULTRASOUND EDUCATION IN
THE AMERICAN COLLEGE OF
SURGEONS: A HISTORY
Steven R. Shackford, M.D., F.A.C.S.
Steven R. Shackford, M.D., F.A.C.S.
Stanley S. Fieber Professor and Chairman
Stanley S. Fieber Professor and Chairman
Department of Surgery
Department of Surgery

2. WHY IS THIS IMPORTANT?
! Ultrasound education was unique for ACS
" New initiative for the College
! Create a durable record of events
" Why, where, how?
! New technologies will continue to emerge
" ACS ultrasound educational program can serve as a
template for future teaching

3. DISCLAIMER
! Recollection
! Sources of data
! Apologies

4. MAJOR FACTOR: SYNERGISM
! European experience
! ACS perception of its
role in education
! CESTE leadership
! Technological evolution
of ultrasound
! Surgical persona

5. ROOTS
! Europe
" Germany: Tiling 1976
! First course for surgeons: 1982
! Board requirement (Urology, General Surgery,
Orthopedics: 1987
" Used commonly by surgeons in Scandinavia
! Urology: Torpedersen
! Asia and Indonesia
" Used commonly for trauma and head and neck
surgery

6. ! Confirmed observations in Europe & Asia
" Ultrasound was accurate for
hemoperitoneum
" Surgeons & residents can acquire & interpret
images
! Recommended that surgeons become
proficient
! Proposed a curriculum

7. ! Coined the term “focused” exams
! Called attention to uneven “playing field” of
practice domain
! Called for educational programs
" Similar to Emergency Medicine, Cardiology, OB

8. NASCENT EDUCATIONAL
PROGRAMS
! No coordinated effort to educate surgeons
! Surgical residents
" Washington Hospital Center
" Rush
" University of Illinois @ Chicago
" University of Vermont
" Emory
! Practicing Surgeons
" EAST
" Rush
" University of Vermont

9. STATUS OF U/S EDUCATION: 1993
! Ultrasound: not in the practice domain of
surgeons
" Perception that only radiologists were
capable: “took years to learn”
! Liability concerns fueled by practice domain
issue
! Credentialing and “turf war” controversy
! No organized effort at the national level
" Education
" Support for credentialing

10. EARLY ACS EDUCATION
! Roger Foster # Gerry Strauch
! 21st Spring Meeting: Montreal, 1993
" “New Frontiers in Trauma: New Diagnostic
Modalities”
" Great interest
! Strauch # Jim Carrico, assist by Alex Walt
" CESTE
! 80th Clinical Congress: New Orleans, 1995
" General Session: “The Surgeon and Ultrasound”

11. First General Session: 1995

12. ULTRASOUND USERS GROUP
! Surgeons with an “interest” in ultrasound
" 1st meeting 10/24/95; facilitated by Strauch
! Goals and objectives:
" Develop course of instruction for the ACS
" Develop educational format for ultrasound
" Interface with manufacturers
" Interface with the ACS hierarchy
" Interface with ABS and APDS
! Keep the trains running while the airport is built
" Develop first PG Course: Grace Rozycki

13. 1st POSTGRADUATE COURSE
24th Spring Meeting, New York
4/15/96

14. 1st USERS GROUP

15. USERS GROUP
ACCOMPLISHMENTS 1995-1998
! Developed basic and modular concept
" Standardized the course of instruction-similar to ATLS
! Developed verification program for ultrasound
! Solidified vendor assistance
! Developed liaisons with:
" AIUM
" ABS
" APDS
! Selected an executive committee:
" ACS National Ultrasound Faculty

17. ACS VERIFICATION PROGRAM
! Course meets standards established by the
College
! Documentation
" Level 1: verification of attendance
" Level 2: verification of satisfactory
completion of course objectives
" Level 3: instructor

20. INITIAL MODULES AND DIRECTORS
! Basic: Shackford
! Acute Setting: Rozycki
! Breast: Staren
! Vascular: Pilcher
! Abdominal: Machi & Schirmer
! Head and Neck: Harness & Staren

22. NATIONAL ULTRASOUND FACULTY
(approved by the Regents 1998)
! Chair: Shackford
! VC Education: Knudson
! VC Technology: Rozycki
! VC External Relations:
Wherry
! VC Verification: Staren
! Ultrasound Imaging Group

23. NUF ACCOMPLISHMENTS 1998-2003
! Instructors Course developed
" Directed by Rozycki
st th
" 1 course: 84 Clinical Congress: Orlando, 1998
! “Exportation” of ACS courses
" Directed by Knudson
" 18 courses to surgical residencies
" 6 courses to professional societies
! Formal membership on CESTE
! Established a mechanism for the Chair, VC, Module
Director & Course Director rotation
! Introduction of new modules as PG courses

24. Clinical Congress
10
8
6
PG Courses
4
2
0
95 96 97 98 99 00 01 02 03
Year

25. Spring Meeting
7
6
5
4
PG Courses
3
2
1
0
95 96 97 98 99 00 01 02 03
Year

26. THE FUTURE
! Basic Course to CD
! Incorporation of Imaging Group into the NUF
! Develop methods to maintain skills
! Develop methods to assess skills
! Develop on-line tools
! Develop “Blue Book”
! Develop new applications of ultrasound
" 1st generation: Sonosite

27. ACKNOWLEDGEMENTS
! ACS staff
" Gerry Strauch
" Jim Carrico
" Olga Jonasson
" Ajit Sachdeva
! Tom Russell
! Vendors and their staff
! All the 2600 students