Fellowship Program in Emergency Ultrasound

Our Mission

The Massachusetts General Hospital Emergency Ultrasound Fellowship program began in 2007 and is recognized nationally for its excellent clinical and research training. The program recently was presented the inaugural national “Stellar Clinical Ultrasound Fellowship” award from the Society for Clinical Ultrasound Fellowships in 2020, a reflection of the dedication of the program to training well-rounded, clinically guided leaders in the field of emergency ultrasound.

The program’s mission is multifaceted but is centered in training fellows equipped to lead ultrasound departments and divisions, advancing the field of clinical and emergency ultrasound across the world. The fellowship additionally is focused on ensuring graduates are fully equipped educators, leaders and researchers with robust faculty and fellowship time dedicated to each of these areas.

Our Program

The Mass General Emergency Ultrasound Fellowship Program, which began in 2007, is a one-year program designed to give graduates of emergency medicine residency programs the skills and knowledge to become ultrasound program directors and leaders in the field of emergency ultrasound. Additionally, the fellowship program frequently collaborates with the Division of General Internal Medicine at Mass General, with the goal of increasing multidisciplinary collaborative efforts using point-of-care ultrasound to care for patients. There are four components to the fellowship program:

• Developing skills in image acquisition, image interpretation and integration into clinical care for both basic and advanced emergency and point-of-care ultrasound applications
• Understanding the administrative aspects required to run an emergency ultrasound program, including technological innovations and learning how to best utilize them for image archiving and quality assurance
• Understanding the state of emergency ultrasound research by participating in weekly ultrasound journal club activities and developing an independent research project from its inception to publication
• Developing lecturing and teaching skills by developing an emergency ultrasound lecture portfolio and contributing to the program’s educational mission

Our program is particularly focused on preparing leaders within the field. Our goal is to equip you with the tools you would need to become an ultrasound director of any emergency department, with all the skill sets, teaching and leadership experiences, and image acquisition skills necessary to do this job with great success. Because of this, the educational component of the Ultrasound Fellowship involves a large amount of both learning and teaching ultrasound within the Harvard Affiliated Emergency Medicine Residency. 

Curriculum

The educational component of the Ultrasound Fellowship involves both a large amount of learning and teaching ultrasound.

Learning Highlights

• Weekly sessions with directors
• Lecture series covering a longitudinal curriculum on core ultrasound applications
• In-depth analysis of standard applications and advanced applications, with a focus on the evidence behind what we do
• Journal club - review of recent literature
• Research updates during dedicated weekly research meetings
• Image and video processing
• Scan review
• Scanning shifts with directors
• Independent reading
• Opportunities with sonographers hospital-wide to learn regional anesthesia, musculoskeletal ultrasound, first trimester obstetrics, echocardiography and obstetric scanning with Planned Parenthood
• Independent scanning
• Completion and review of a minimum of 1,000 scans

Teaching Highlights

• Assist with teaching resident rotation: four-week rotation as PGY-1 and for HMS students
• Develop and give core lecture series to HAEMR residents (Ultrasound 101)
• Teaching to other services (surgery, ICU, PAs)
• Outside courses to community hospitals
• Harvard CME courses
• Faculty credentialing process
• International courses
• Other teaching initiatives
• Rotation for visiting residents
• Medical student elective
• Opportunities for international rotations though Mass General Center for Global Health & Disaster Response, PURE, or many other international contacts
• Simulation opportunities through Institute for Medical Simulation at Mass General, STRATUS with access to SonoSim, Medaphor, Vimedix simulators (with TEE)

Clinical Experience

The Massachusetts General Hospital Emergency Department is a busy, high-acuity Level 1 Trauma Center, Burn Center and Pediatric Trauma Center with an annual census of more than 117,000 patients. The fellowship is designed as a part-time attending position in the Mass General Emergency Department, working approximately 16 hours a week, supervising EM (PGY1-4), pediatric, internal medicine and advanced practice providers. In addition, fellows are expected to devote approximately 30 hours a week to ultrasound related activities. Responsibilities include but are not limited to image acquisition (independently, with residents, and with directors), scan review, lecturing, participation and development of outside courses, attendance at administrative and financial meetings, and research (development of an independent project and participation in ongoing studies).

Research Experience

There are numerous research opportunities within the department as well as with faculty throughout Mass General and the Harvard Medical School. The Department of Emergency Medicine supports each fellow with a research stipend to help advance scholarly projects. In the past ten years, faculty and fellows have produced research and published more than 100 articles on point-of-care ultrasound. These are frequently awarded for the best articles of the year by the SAEM Academy of Emergency Ultrasound. The most recent projects have focused on lung ultrasound for pulmonary edema, learning curves for performing chest ultrasound, integration of ultrasound in clinical practice, carotid flow time in sepsis, development of artificial intelligence in pneumothorax, national radiation safety attributed to ultrasound, developing nomograms on small bowel obstruction and a series of projects on procedural safety including innovative transgluteal sciatic nerve block and impact of difficult IV access on ED throughput. We have also been on the forefront of COVID-19 lung ultrasound research and have developed several projects in this realm.

In addition, Massachusetts General Hospital Emergency Ultrasound Fellows have taught extensively in many resource-limited international settings such as Rwanda, Malawi, Zambia, Uganda, Tanzania and Kenya. We believe in the valuable impact that point-of-care ultrasound can make in these settings on patient care and outcomes as well as on resource utilization. For interested applicants there are many opportunities to become involved in teaching and researching the potential in these settings.

Inter-departmental Collaboration

We collaborate closely with Mass General clinician sonographers hospital-wide to learn regional anesthesia (Anesthesia), musculoskeletal ultrasound (Rheumatology), first trimester obstetrics (Planned Parenthood), transesophageal echocardiography (Cardiac Critical Care), the Echo lab and Radiology departments. We also have a supportive collaboration with our Trauma Surgery service and the Department of Medicine where ultrasound is utilized on a daily basis. We have trained several faculty within the Department of Medicine and collaborate on interdepartmental research projects as a result.  

State-of-the-art Equipment

There are ten ultrasound machines in the Emergency Department from a variety of manufacturers for a diverse scanning experience. We currently have two Sonosite X-Portes, two GE Venues, two Mindray TE7s, two Mindray M9s and two Phillips machines housed in the five different areas of Emergency Department.

We also have two Sonosite M-turbo ultrasound systems which are mainly used for procedural applications. Four Butterfly units are also available for clinical use.

In the CURE Training Center, five additional ultrasounds including two Terason uSmart 3200T, two Sonosite and one Zonare ultrasound machines, and portable Butterfly devices can be used during training sessions and for educational purposes. The Training Center is dedicated to ultrasound training and equipped with SonoSim simulation on cardiac ultrasound as well as Medaphor endocavitary and gynecology ultrasound simulation. We have access to the to SonoSim, Medaphor, Vimedix simulators (with TEE) through the Institute for Medical Simulation at Mass General and STRATUS.

Our People

Our division takes great pride in our faculty, fellows and collaborators within the fields of Critical Care, General Internal Medicine and General Surgery among others. The diverse leadership of our internal team and strong relationships across departments within Mass General ensure that fellows can hone their training to their areas of specific ultrasound. Meet our leadership team below!

Our Faculty

Emergency Ultrasound Fellowship Director

Hamid Shokoohi, MD, MPH serves as the Emergency Ultrasound Fellowship director. Known for his dedication to fellow education, training and clinical experience, Dr. Shokoohi is a beloved member of the team. He trained at the George Washington University for his EM residency and as the inaugural clinical ultrasound fellow. This training then led to Dr. Shokoohi’s appointments as associate professor at Harvard Medical School. He joined the Mass General faculty in 2018 as the director of the fellowship program, and he continues to uphold his reputation as a leader in ultrasound research. View his most recent publications at PubMed. He enjoys spending time with his family and can often be found out to dinner in the best restaurants in Boston—often with the fellows in tow!

Chief of Emergency Ultrasound

Andrew Liteplo, MD is the chief of the Division of Emergency Ultrasound. He founded the fellowship in 2007 and served as the fellowship director until 2018. He is a past president of the AEUS of SAEM, and an elected board member of SCUF. He enjoys innovation and created SonoGames, the SCUF Annual Conference and the AEUS Research Awards (SAEMMYs). He has lectured extensively nationally and internationally. His primary research interests include lung ultrasound, critical care ultrasound, ultrasound education and artificial intelligence. View his most recent publications at PubMed. He is a native New Yorker but loves living in Boston!

Director of Ultrasound Education

Calvin Huang, MD, MPH is a faculty member of the Emergency Ultrasound Division. Dr. Huang is a Harvard Affiliated Emergency Medicine Residency (HAEMR) grad who completed his ultrasound fellowship with the department in 2012, with simultaneous completion of his MPH at the Harvard T. H. Chan School of Public Health, focusing on clinical effectiveness. He is the director of ultrasound education for the HAEMR residents and the advanced practice providers in the emergency department. He is also the HMS course director for the MGH/BWH Emergency Ultrasound Elective. He is interested in medical education as well as ultrasound procedural guidance. View his most recent publications at PubMed. His favorite things are pre-COVID travel and food as well as animal care.

Director of Global Ultrasound

Onyinyechi Eke, MD is a faculty and director of global ultrasound in the Department of Emergency Medicine at Massachusetts General Hospital. Dr. Eke completed her residency at Cook County Hospital in Chicago, IL and her Clinical Ultrasound Fellowship at Massachusetts General Hospital in 2020. Dr. Eke’s global ultrasound program has an inspirational mission on increasing the healing capacity of health care providers in resource-limited areas by providing training and mentorship. Her research interests include the development of point-of-care ultrasound education and training in resource-limited settings, particularly in Sub-Saharan Africa, and the efficient utilization of point-of-care ultrasound to facilitate patient care in the emergency department.

Director of Pediatric Ultrasound

Sigmund Kharasch, MD is a 2018 graduate of the Mass General Ultrasound Fellowship and is currently the director of pediatric emergency ultrasound in the Pediatric Emergency Department at Mass General. Dr. Kharasch is greatly admired for his inspirational work and teaching around the world. He devotes his time, experiences and imagination to help others globally. He is entitled to the most inspirational and of course the oldest ultrasound fellow in our program. Teaching generations of students and residents, student is the last title Sig is giving up on. Sig’s research interest is in lung and diaphragm ultrasound in children with asthma, chronic lung disease and children requiring long-term mechanical ventilation. Sig is an avid student of classical piano in Boston.

Our Fellows

Lauren Selame, MD joined the Center for Ultrasound Research and Education at Mass General as an Emergency Ultrasound Fellow in July, 2020. She completed her residency training in Emergency Medicine at Thomas Jefferson University in Philadelphia, PA. Her clinical and research interests include integration of effective diagnostic POCUS and procedural ultrasound. Outside of the Emergency Department you are most likely to find Lauren on a yoga mat. As for her favorite things about Boston, there's a big tie between the accents, the cannolis, the pizzas, The Charles and the lobsters. 

Kathleen McFadden, MD is a 2020-2021 emergency ultrasound fellow joining from the Mass General Department of Medicine where she recently completed a residency in internal medicine. She is interested in integrating ultrasound into medical education as well as novel applications of cardiac/thoracic imaging. Following in the footsteps of prior internal medicine ultrasound fellows Drs. Thomas Heyne, Irene Ma, and Kay Negishi, Dr. McFadden is invested in carrying the torch of ultrasound education to internal medicine in the COVID-19 era. Her most notable area of (self-proclaimed) expertise is coffee, as she has detailed notes on almost every coffee shop in the entire city of Boston.

Ahad Al Saud, MBBS is a 2019-2021 emergency ultrasound senior fellow joining from the King Saud University in Riadh, Saudi Arabia. Dr. Al Saud earned her MBBS degree at King Saud University in Riadh in 2008 where she fell in love with emergency medicine. She has dedicated over seven years to training and teaching medical students and residents around the world, presenting and teaching in the USA, UK, Australia, Italy, Colombia, Turkey, the UAE and KSA. She serves as the Editor in Chief of the ultrasound/radiology section of the Saudi Journal of Emergency Medicine and the head of Emergency Medicine Females in the Saudi Society of Emergency Medicine. Outside the world of ultrasound, Dr. Al Saud serves as the chief medical director of the Saudi Automobile and Motorcycle Federation (SAF) and the FiA (Federation Internationale de l’Automobile) Deputy Medical Director for Formula E, Formula 1 and WEC races. Ahad enjoys her two hairless cats, Yoda and Cesar, as well as drawing, piercings and baking.

Our Projects

Our division continues to publish regularly, with fellows integrated at the beginning of their training to many of our diverse research projects. Please see list below for our recent publications!

1. Duggan NM, Shokoohi H, Liteplo AS, Huang C, Goldsmith AJ. Best Practice Recommendations for Point-of-Care Lung Ultrasound in Patients with Suspected COVID-19. J Emerg Med. 2020;S0736-4679(20)30582-5
2. Kharasch SJ, Dumas H, O'Brien J, Shokoohi H, Al Saud AA, Liteplo A, Schleifer J, Kharasch V. Detecting Ventilator-Induced Diaphragmatic Dysfunction Using Point-of-Care Ultrasound in Children With Long-term Mechanical Ventilation. J Ultrasound Med. 2020;10.1002/jum.15465.
3. Goldsmith AJ, Liteplo A, Hayes BD, Duggan N, Huang C, Shokoohi H. Ultrasound-guided transgluteal sciatic nerve analgesia for refractory back pain in the ED: A case series. Am J Emerg Med. 2020;38(9):1792-1795.
4. Goldsmith AJ, Eke OF, Alhassan Al Saud A, Al Mulhim A, Kharasch S, Huang C, Liteplo AS, Shokoohi H. Remodeling Point-of-care Ultrasound Education in the Era of COVID-19. AEM Educ Train. 2020 Jun 7;4(3):321-324.
5. Shokoohi H, Duggan NM, Garcia-de-Casasola Sanchez G, Torres-Arrese M, Tung-Chen Y. Lung ultrasound monitoring in patients with COVID-19 on home isolation. Am J Emerg Med. 2020;S0735-6757(20)30440-X.
6. Haney RM, Graglia S, Schleifer J, et al. Interdisciplinary approach to enhance trauma residents education of Extended-Focused Assessment for Sonography in Trauma in the emergency department. ANZ J Surg. 2020;10.1111/ans.16000.
7. Shokoohi H, Nasser S, Pyle M, Earls JP, Liteplo A, Boniface K. Utility of point-of-care ultrasound in patients with suspected diverticulitis in the emergency department. J Clin Ultrasound. 2020;48(6):337-342.
8. Haney RM, Halperin M, Diamond E, et al. Clinical Integration of Point-of-care Ultrasound by Emergency Medicine Residents: A Single-center Mixed-methods Study. AEM Educ Train. 2020;4(3):212-222.
9. Eke OF, Morone CC, Liteplo AS, Shokoohi H. Non-Covid-19 clinical research in the era of pandemic. Am J Emerg Med. 2020;S0735-6757(20)30351-X.
10. Shokoohi H, Boniface KS, Loesche MA, Duggan NM, King JB. Development of a nomogram to predict small bowel obstruction using point-of-care ultrasound in the emergency department. Am J Emerg Med. 2019;S0735-6757(19)30806-X.

Eligibility

Applicants must be graduates of an ACGME-accredited emergency medicine residency program and have completed the program in good standing. Board-eligible or board-certified emergency medicine physician from 3 or 4-year ACGME-accredited emergency medicine residency programs are eligible.

Our Emergency Ultrasound Research Fellowship is a parallel program designed for foreign emergency physicians to learn about point-of-care ultrasound. Interested applicants should contact Dr. Shokoohi as shown below.

To Apply

CV, cover letter and 2-3 letters of recommendation are required to complete an application. Interviews and final decisions are made based on SCEF and Match instructions and deadlines.

For IMGs, a letter of interest, three letters of recommendation, including a letter from the residency program director, and a current curriculum vitae should be submitted to Dr. Hamid Shokoohi, Fellowship Director hshokoohi@mgh.harvard.edu. Interviews are conducted in the fall, and decisions are usually made in November.

Contact Us

Hamid Shokoohi, MD
Director, Emergency Ultrasound Fellowship
Director, Emergency Ultrasound Research
Email: hshokoohi@mgh.harvard.edu

Andrew Liteplo, MD
Chief, Division of Emergency Ultrasound
Email: aliteplo@partners.org

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