Artificial Intelligence in Ultrasound

Physicians who perform and/or interpret diagnostic ultrasound examinations must be licensed medical providers who have a thorough understanding of the indications and guidelines for ultrasound examinations as well as familiarity with the basic physical principles and limitations of the technology of ultrasound imaging. They should be familiar with alternative and complementary imaging and diagnostic procedures and should be capable of correlating the results of these other procedures with the ultrasound examination findings. They should have an understanding of ultrasound technology and instrumentation, ultrasound power output, equipment calibration, and patient and operator safety. Physicians responsible for ultrasound examinations should be able to demonstrate familiarity with the anatomy, physiology, and pathophysiology of those organs or anatomic areas that are being examined. Performance and interpretation of most ultrasound examinations require advanced skills and knowledge. The training should include methods of documentation and reporting of ultrasound studies. Only those that meet these training requirements can request to be part of an ultrasound practice accreditation application.

The ability to analyze a full image set, determining its completeness and the adequacy of the image quality, and performing the diagnostic process, distinguishing normal from abnormal, is considered a primary goal of the training experience.

Physicians performing and/or interpreting diagnostic ultrasound examinations should meet at least 1 of the following (1–4):

1. Specialty Board Certification 

a. Certification in interventional radiology or diagnostic radiology by the American Board of Radiology, the American Osteopathic Board of Radiology, the Royal College of Physicians and Surgeons of Canada, or Le Collège des Médecins du Québec is accepted as proof of sufficient training in diagnostic ultrasound; 

b. Certification in breast ultrasound by the American Society of Breast Surgeons is accepted as proof of sufficient training in breast ultrasound.

c. Current Board certification by the American Board of Urology is accepted as proof of sufficient training in urologic ultrasound. 

d. Board certification by the American Board of Anesthesiology is accepted as proof of sufficient training in ultrasound guidance in regional anesthesia. 

e. Board certification by the American Board of OB and GYN (ABOG) or by the American Osteopathic Board of Obstetrics and Gynecology (AOBOG) is accepted as proof of sufficient training in standard OB and GYN ultrasound.

f. Board certification by the American Board of Emergency Medicine (ABEM) is accepted as proof of sufficient training in emergency ultrasound.

If certification was completed more than 36 months ago, both AMA PRA Category 1 Credits™ or AOA Category 1-A Credit and case volume are required. If the physician interprets in multiple specialty areas, a representative sample of CME credits is appropriate and is not required to exceed 30. A representative sample is a sample that is selected in such a way as to be representative of the specialty areas. For example, if interpreting in 3 specialties then a representative sample would be 10 CME from each specialty.

2. Subspecialty Board certification in the following:

a. Maternal Fetal Medicine (MFM) is accepted as proof of training in detailed fetal anatomic ultrasound.

b. Urogynecology/Female Pelvic Medicine and Reconstructive Surgery is accepted as proof of sufficient training in gynecologic ultrasound.  

c. Subspecialty board certification in Sports Medicine by the ABEM, American Board of Family Medicine (ABFM), American Board of Internal Medicine (ABIM), American Board of Physical Medicine and Rehab (ABPMR), and/or American Board of Pediatrics (ABP) is accepted as proof of sufficient training in musculoskeletal ultrasound.

d. Focused Practice Designation in Advanced Emergency Medicine Ultrasonography by the ABEM or Area of Focused Competence Designation for Acute Care Point of Care Ultrasound by the Royal College of Physicians and Surgeons of Canada is acceptable for demonstrating training in point-of-care ultrasound.

It is expected that subspecialty certification in pathway 2 included case volume during training as defined by the AIUM’s case volume requirements in the relevant specialty; AND

If subspecialty Board certification was obtained more than 36 months ago, both AMA PRA Category 1 Credits™ or AOA Category 1-A Credits AND case volume within the previous 36 months is required. If the physician interprets in multiple specialty areas, a representative sample of CME credits is appropriate and is not required to exceed 30.  A representative sample is a sample that is selected in such a way as to be representative of the specialty areas. For example, if interpreting in 3 specialties then a representative sample would be 10 CME from each specialty.

3. Completion of an Accreditation Council for Graduate Medical Education (ACGME)-approved residency and/or Graduate Medical Education (GME)-approved fellowship program (or international equivalent) not listed above that included specialty-specific diagnostic ultrasound examinations as part of the specialty training requirements under the supervision of a physician(s) who meets this training guideline. The trainees will have demonstrated competency in the performance, evaluation, interpretation, and reporting of diagnostic ultrasound examinations. 

a. If completion of specialty-specific training occurred more than 36 months ago, the following must be completed:

i. Performance, interpretation, and reporting of ultrasound examinations within the previous 36 months is required and must follow the AIUM’s case volume requirements AND 

ii. A required number of AMA PRA Category 1 Credits™ or AOA Category 1-A Credits defined by the AIUM’s CME requirements list within the previous 36 months. Credits must be ultrasound-specific and appropriate to the area of expertise.

If the physician interprets in multiple specialty areas, a representative sample of CME credits is appropriate and is not required to exceed 30. A representative sample is a sample that is selected in such a way as to be representative of the specialty areas. For example, if interpreting in 3 specialties then a representative sample would be 10 CME from each specialty.

4. Case-by-case: in some cases, completion of an ACGME-approved residency and/or fellowship not listed above during which the physician did not receive specialty-specific ultrasound training in the performance, interpretation, and reporting of diagnostic ultrasound will be considered. Documentation of clinical experience* could be acceptable providing the following are demonstrated:

a. The required number of AMA PRA Category 1 Credits™ or AOA Category 1-A Credits defined by the AIUM’s CME requirements list within the previous 36 months. Credits must be ultrasound-specific and appropriate to the area of expertise. We encourage completion of didactic courses and hands-on courses as part of the total AMA PRA Category 1 Credits™.

b. Proof of the performance, interpretation, and reporting of ultrasound examinations within the previous 36 months as defined by the AIUM’s case volume requirement in your specific specialty. The required case volume should be under the supervision and support of a physician(s) that meets one of the requirements above (direct or telemedicine). 

*If training and experience are substantive, the physician may document such in a letter to the AIUM Office of Accreditation for review. An accreditation application must be initiated to be reviewed.

Maintenance of Competence in Ultrasound is required once training is complete.