Post Graduate Certificate in Ultrasound for Family Medicine
Over 3 semesters, the program covers the Fundamentals of Ultrasound scanning and 6 essential modalities encountered in Family Medicine (according to a 2021 survey carried out amongst Specialists in Family Medicine in Malta) including:
- Deep Vein Thrombosis (DVT)
- Abdominal Aortic Aneurysm (AAA)
- Hepatobiliary
- Renal
- Core ECHO
- Musculo-skeletal (MSK) basics and soft tissue
Generic Information
• Limited to 10 candidates per course for effective mentorship
• Blend of online lectures/webinars and in-person practice
• Segmented online lectures aid self-paced learning
• Online portal for resources, mentor interaction, and submissions
• Each candidate is assigned an experienced mentor for year-long guidance
• Facilitation of access to practice machines
• 6-8 in-person intensive practice days per course
• Mandatory practice logbook with scans and pathologies
• Final exam with practical and theoretical elements for course completion.
Learning Outcomes
At the end of the course the candidate should be able to:
• Appreciate the fundamental physics principles relating to ultrasound including the piezoelectric effect, the factors that influence imaging as well as the recognition and differentiation of various artefacts
• Recognise the importance of frequency and the way it impacts probe selection and machine settings
• Understand and utilise the proper terms to annotate images and report scans
• Utilise the various functions on US machines to optimise the scan
• Hold and manipulate the probe effectively being mindful of ergonomics
• Define the lower limb venous anatomy
• Differentiate veins from arteries
• Recognise thrombus within the deep veins of the lower limb and differentiate it from other pathologies with a similar clinical presentation
• Understand how to integrate US scanning in the clinical algorithm for DVT, the limitations of US scanning for DVT and when to refer to radiology
• Perform an ultrasound scan of the lower limb to identify deep venous thrombosis in the proximal deep veins
• Recognise alternative pathologies presenting with LL pain including superficial thrombophlebitis, Baker’s cyst and muscular hematomas
• Issue a report
• Pathophysiology, epidemiology and anatomy of the abdominal aorta and its branches
• Identify the abdominal aorta, IVC and vertebral body
• Identify the upper abdominal peri-aortic anatomy including the liver, pancreas, portal vein
• Understand the strengths and limitations of Ultrasound in scanning for AAA
• Integrate ultrasound into the management pathway for AAA
• Evaluate the abdominal aorta in both transverse (TS) and longitudinal planes (LS)
• Identify the main branches
• Measure the abdominal aorta correctly in both TS and LS
• How to scan the difficult patient
• Issue a report
• Recognise the sonoanatomy of the hepatobiliary system including the liver, gallbladder, biliary ducts and pancreas. Understand how different approaches and patient positions may optimise the views
• Use a structured approach to interrogate the various hepatobiliary structures including the liver, gallbladder, common duct and pancreas
• Understand and identify the pathologies that affect these structures
• Recognise the limitations of the scan and know when to refer for further imaging
• Evaluate the liver for pathology
• Diagnose hepatic pathology including lesions, cysts and cirrhosis
• Recognise dilated intra and extra hepatic bile ducts
• Identify and measure the Common Bile Duct
• Recognise gallbladder pathology including calculi, acute and chronic cholecystitis and gallbladder polyps
• Identify and measure the pancreatic duct
• Diagnose pancreatic lesions
• Issue a report
• Appreciate the anatomy and normal sonoanatomy of the renal system including the kidneys, ureters and bladder
• Appreciate and Identify normal anatomical variants
• Use a structured approach to diagnose the more common pathology
• Recognise the limitations of the scan and know when to refer for further imaging
• Diagnose perinephric collections, renal and bladder lesions, cysts and calculi
• Diagnose and grade hydronephrosis
• Measure bladder wall thickness, bladder and prostate volume
• Issue a report
• Recognise the value of the various cardiac views in evaluating different cardiac structures
• Define the sonoanatomy and recognise the cardiac structures in all cardiac views
• Understand the changes in the cardiac chambers and valves during the cardiac cycle
• Define the normal upper limits for diameters and ratio of the cardiac structures
• Define the normal parameters for LV contractility
• Acquire parasternal long and short axis, as well as subcostal views of the heart
• Utilise a structured approach to optimise the various cardiac views and recognise the impact of specific movements on the cardiac appearance
• Adopt the DEFG structured diagnostic approach to the evaluation of cardiac dimensions and function
• Diagnose dilated aorta in dissection, dilated LA and dilated cardiomyopathy
• Evaluate the systolic function/contractility to diagnose heart failure with reduced ejection fraction
• Identify pericardial effusions and recognise tamponade physiology
• Appreciate the sonoanatomy of normal muscle, tendon, joints and soft tissues
• Recognise the appearance of pathologies including fractures, contusions and hematomas
• Evaluate lymph nodes and differentiate between normal and abnormal nodes
• Differentiate cellulitis vs abscess
• Identify lipomas
• Diagnose paediatric hip effusions in the limping child