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The Massachusetts General Hospital Emergency Department Division of Emergency Ultrasound was founded in 2003. The program initially pioneered the development and initiation of a mandatory training rotation for residents in the Harvard Affiliated Emergency Medicine Residency program and introduced the concept of point-of-care ultrasound diagnostics to the care and treatment of patients in the emergency department at MGH. The program has grown to now include a one year emergency ultrasound fellowship program for graduates of emergency medicine residency programs, a visiting fellows program for international physicians interested in learning point of care ultrasound, a robust research program in new applications for point of care ultrasound and outcome research studies looking at the impact of point of care ultrasound on patient care, and a medical student elective for fourth year students to learn point of care ultrasound. In addition, the division offers several continuing medical education courses a year for physicians in many specialties in point of care ultrasound image acquisition and interpretation. Finally, the division is represented in numerous national and international organizations promoting the integration of point of care ultrasound into the management of the critically ill patient. Division faculty participate actively in bringing ultrasound technology to resource poor settings to provide imaging diagnostics where there was none previously – both domestically and internationally – by teaching and providing quality assurance image review.
Vicki E Noble, MD, FACEP is a graduate of the Harvard Affiliated Emergency Medicine Residency program in Boston MA and completed a one-year fellowship in emergency ultrasound at St. Luke's-Roosevelt Hospital in New York, NY. She founded the program at MGH in 2003 and continues to serve as its director.
Andrew Liteplo, MD, FACEP is a graduate of King's County Emergency Residency program in Brooklyn NY and also completed a one-year fellowship in emergency ultrasound at St. Luke's-Roosevelt Hospital in New York, NY. He started the fellowship program in 2007 and serves as the fellowship director.
Dana Sajed, MD, FAAEM is a graduate of King’s County Emergency Residency program in Brooklyn NY and completed a one-year fellowship in emergency ultrasound at Massachusetts General Hospital in 2009-2010. He has since worked as an ultrasound faculty member at NYU Medical Center in NYC and at the University of Washington Medical Center in Seattle. Dr. Sajed returns to MGH as the Director of Ultrasound Education at Massachusetts General Hospital.
The Emergency Ultrasound Fellowship Program at Massachusetts General Hospital began in 2007. The fellowship is designed to provide graduates of emergency medicine residency programs here in the United States with advanced training in ultrasound image acquisition and interpretation, training in how to build and develop an emergency ultrasound program, and opportunities for research in emergency ultrasound applications. In addition, each fellow will have the opportunity to lecture to regional and national continuing medical education conferences and develop their own didactic teaching material in emergency ultrasound.
The international fellows program began in 2007 and since its inauguration we have had fellows from Spain, Scotland, England and Colombia come to Boston to learn emergency ultrasound. Applicants must be physicians but as the program is educational and not clinical, medical licenses for practice in the United States are not required. International Fellows may come for a period of time between one month and one year depending on space availability. All fellows participate in educational conferences, teaching sessions and the Division's didactic program. In addition they attend the weekly Division meeting and have access to all of the educational resources of the Division. There is a tuition associated with the program and international fellows are required to find their own housing and provide their own transport costs. However all international fellows leave the program with a report documenting the number and quality of scans performed, and a certificate documenting the completion of the program. Interested parties can contact Vicki Noble at email@example.com for more information.
The Division has a robust research program and currently has numerous studies ongoing. In the past six years, faculty and fellows have produced research and published on topics such as optic nerve sheath ultrasound and its correlation with intracranial pressure monitoring as well as optimal techniques for optic nerve sheath scanning, learning curves for performing chest ultrasound, a comparison of teaching techniques in emergency ultrasound for both residents and prehospital personnel, correlation of thoracic ultrasound findings of pulmonary congestion and natiuretic peptide point of care test results, financial implications of emergency ultrasound programs, the correlation of ultrasound findings with signs and symptoms of high altitude illness and analgesia's impact on the sonographic Murphy's sign and biliary ultrasound test accuracy.
The Ultrasound Division is also a site for an AHRQ grant looking at outcomes for different diagnostic evaluation protocols for patients presenting with renal colic. In addition, the division participates in the REASON network - a multi-center ultrasound outcomes research network.
In addition, the MGH program has been fortunate enough to participate extensively in the introduction of point of care ultrasound in several international settings. Currently, there are ongoing studies in Rwanda, Malawi and Zambia on the impact of point of care ultrasound on patient care and outcomes in these settings as well as on resource utilization. For interested applicants there are many opportunities to become involved in teaching and research in these settings.
Division faculty participate in many of the national and international organizations that seek to promote emergency ultrasound. Faculty have been involved in the ultrasound interest groups of the American College of Emergency Physicians and the Society for Academic Emergency Medicine for almost a decade. Faculty are also involved in the American Institute for Ultrasound in Medicine and the World Interactive Network Focused on Critical Ultrasound. The division believes strongly in efforts to diffuse point of care ultrasound technology throughout medicine and work vigorously with thought leaders on behalf of those organizations that share this enthusiasm.
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