Â鶹AV

Emergency Medicine Ultrasound Fellowship

Dr. Turner teaching ultrasound skills

Fellowship Information

Number of Positions 2
Length 12 months
Academic Affiliation Â鶹AV
Fellowship Director joel.turner [at] mcgill.ca (Dr. Joel Turner)
Hospitals Involved

Jewish General Hospital

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Goals and Objectives - Program Highlights:

  • The Â鶹AV emergency ultrasound fellowship is an intensive 1-year program, dedicated to teaching core and advanced point of care ultrasound applications. The goal is to develop future national and international leaders in both clinical and academic point ofĚýcare ultrasound. Using POCUS findings in clinical decision making, recognizing critical findings that affect management as well as the limitations of POCUS is a paramount objective in the education of every fellow.

  • Based at the Jewish General hospital, the busiest adult ED in the province, the fellow will have access to his/her own ultrasound unit (Philips Sparq or Butterfly IQ) for both clinical as wellĚýas teaching responsibilities. in 2019, almost 20,000 POCUS exams were performed in the ED. Along with a very high acuity and varied pathology, the fellow will have a significantĚýexposure to POCUS.

  • The fellow will be responsible for one-on-one teaching of both basic and advanced ultrasound techniques to residents and medical students rotating at the JGH ED. He/She will be act asĚýinstructor for the annual ePOCUS course given to EM, Family Medicine, and Intensive Care residents. The fellow will also be responsible for presenting cutting edge material both during academic half day as well as journal club.

  • With a dedicated and active research department in the ED, there is a strong emphasis on performing, presenting and publishing POCUS-based research.Ěý

  • Please note that all fellowship applications are done directly through the Â鶹AV Postgraduate department.ĚýAll information regarding eligibility criteria and application material can be found on their web site at:

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Current Research:

1. Effects of POCUS in the ED on time to admission for acute cholecystitis

2. The Use of Point-of-Care Ultrasound in the Diagnosis of Acute Infectious Mononucleosis in the emergency Department

3. Use of POCUS in patients presenting to the Emergency Department with symptoms suggestive of COVID-19

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Publications:

Lewis D, Rang L, Kim D, Robichaud L, et al. Recommendations for the use of point-of-care ultrasound (POCUS) by emergency physicians in Canada.ĚýCJEM. 2019. 21(6) 721-726

Kirkpatrick J,... Turner J, et al.ĚýRecommendations for Echocardiography Laboratories Participating in Cardiac Point of Care Cardiac Ultrasound (POCUS) and Critical Care Echocardiography Training: Report from the American Society of Echocardiography.ĚýJournal of the American Society of Echocardiography 2020 February 28

Brault C, Turner J. “Peer-led female pelvic point-of-care ultrasound: impact of teaching and simulation workshop on undergraduate medical students’ learning and confidence level. Poster presentation at 2018 World Congress of ultrasound in medical education. Salem, NC

Bandegi P, Alghazawi N, Turner J. “Ocular Point of Care Ultrasound: Efficacy and Knowledge Retention of a New Teaching Workshop for Medical Students” Poster presentation at 2018 World Congress of ultrasound in medical education. Salem, NC

Alqaydi K, Turner J, Robichaud L, Hamad H, Xue X, Afilalo M. “Age-Adjusted D-Dimer and Two-Site Compression Point of Care Ultrasonography to Rule Out Acute Deep Vein Thrombosis - A pilot study. Poster Presentation at 2018 Canadian Association of Emergency Medicine Annual meeting, Calgary, Alberta

Turner J. DVT EDE, in The EDE Book - Point of care ultrasound for Emergency Physicians, 2012

Turner J. Ocular EDE, in The EDE Book - Point of care ultrasound for Emergency Physicians, 2012

Turner J, Dankoff J. Thoracic Ultrasound. Emerg Med Clin North Am. 2012 May:30(2):451-73

Teaching Faculty:

Joel Turner. FRCP, CSPQ, specialist in Emergency Medicine. Attending physician at the JGH ED since 2002. CPoCUS Master Instructor. EDE-2, cofounding instructor and author. EDE-3 lecturer. Director of ED ultrasound program for FRCP EM residents. Graduate of Ultrasound Leadership Academy.

Dr. Laurie Robichaud, FRCP, CSPQ, specialist in Emergency Medicine. Attending Physician at the JGH ED since 2016. CPoCUS Master Instructor. Graduate of Ultrasound Leadership Academy. Special focus on cardiac POCUS, ED TEE.

Dr. Jerrald Dankoff, CSPQ, specialist in Emergency Medicine. Attending Physician at the JGH ED since 1981. CPoCUS Master Instructor. Special focus on thoracic and cardiac POCUS.

Dr.ĚýPaul Brisebois, CCFP-em. Attending Physician at the JGH ED since 2016, CPoCUS Master Instructor.

Dr. Gregory Marton, FRCP. specialist in Emergency Medicine. Completed POCUS Fellowship Curriculum at the Jewish General Hospital, CPOCUS Master Instructor

Dr. Jerome Stasiak, CSPQ, specialist in Emergency Medicine. Attending Physician at the JGH ED since 1983, CPoCUS Master Instructor. Special Focus on Musculoskeletal ultrasound.

• 100% of emergency Department staff at the Jewish General Hospital are CPoCUS certified in the core applications of POCUS.

Academic and Clinical Facilities:

• Emergency department, Jewish General Hospital (JGH)

• Dedicated Emergency Medicine ultrasound simulation/training centre in new Pavilion K emergency dept (under construction) with various ultrasound phantoms and hi fidelity simulation mannequin.

• Research Department, JGH, ED

• Â鶹AV Simulation Centre

• Sainte Justine Emergency Dept (pediatric POCUS)

Fellow Duties, Responsibilities, and Curriculum:

The curriculum is based on 13 four-week rotations:

• 11 rotations in the JGH ED. Approximately 8 clinical shifts per rotation. The fellow will act as a senior supervisor to residents rotating in the ED. The fellow will be scheduled to work alongside teaching faculty who are CPoCUS Independent Practitioners (formerly CEUS).

• Fellows will be required to log all scans and will be expected to have performed at least 800 scans.

• It is expected that the fellow obtain level one proficiency as defined by the Canadian Society of Echocardiography.

• 1 elective (Pediatric, TEE, research, Admin).

Example Curriculum:

Period 1: Core POCUS, basic physics and knobology, Quality assurance
Period 2: Cardiac-1 (Gross LV function), lung-1 (Pneumothorax, Pleural effusion, Interstitial Syndrome), ePOCUS course
Period 3: Biliary, Renal, Cardiac-2 (pericardial effusion, tamponade)
Period 4: Advanced knobology, Procedures (central, peripheral lines), DVT, Lung-2 (pneumonia, Blue Protocol)
Period 5: Cardiac-3 (Diastology), Procedures-2 (Thoracentesis, Paracentesis, LP), MSK-I (Joints)
Period 6: Cardiac-4 (Right Ventricle), MSK-2 (Fractures, tears), Abdomen-1 (SBO)
Period 7: Cardiac-5 (Valvulopathy), Soft Tissue, RUSH
Period 8: Cardiac-6 (Wall Motion), Nerve Blocks-1 (Basics), Airway
Period 9: Regional Nerve Block-2, Ocular, MSK-3 (Shoulder)
Period 10: Abdomen-2 (Appendicitis, Diverticulitis), Fluid responsiveness, Testicular
Period 11: Pediatrics (Sainte Justine Hospital)
Period 12: Elective, Cardiac-7 (Review), Quality Assurance review, Research completion
Period 13: Admin, Wrap-up, Evaluation

Academic/scholarly responsibilities:

• Attain CPoCUS Core IP status in the first month (if not already obtained).

• Monthly review of the ultrasound literature with the Fellowship Director. The fellow will present a landmark article at one of the monthly EM journal clubs.

• Weekly Quality Assurance review of ultrasound images generated in the ED by staff and residents. Review M+M cases dealing with POCUS use.

• Help coordinate annual resident Â鶹AV ePOCUS course emergency medicine, family medicine, and critical care residents.

• Help coordinate certification training for FRCP EM residents during ED/ultrasound rotation. This is done with the Fellowship Director in coordination with the Canadian Point of Care ultrasound society (CPoCUS).

• Research project: Develop and conduct at least one research project suitable for publication; Present at least one research project either at Â鶹AV RRD and/ or at national or international meeting.

• Coordinate 1 morning of Academic half-day in the residency program. This may include Simulation sessions, Grand Rounds presentations, Literature Review, etc...

Intended Case Load:

• The emergency department at the Jewish General Hospital is the busiest adult emergency department in Quebec, with over 95,000 visits annually. Furthermore, there is a massive variety of pathology seen in the ED, with particular focus on oncology, cardiology, sepsis, and geriatric cases; all of which lend themselves to bedside assessment with POCUS. In 2019, almost 20,000 POCUS exams were performed in the ED, indicating a significant case load for fellows.

• Regular reading materials. The fellow will be expected to keep up with the latest literature in peer review journals (eg: AEM, Annals of EM, CJEM, J of US in Med), all of which are accessible online. In addition, the fellow will be provided with a copy of the Essentials of Point of care ultrasound for Emergency Physicians. Finally, there are numerous very high quality online blogs providing cutting edge video and literature reviews that the fellow will be expected to keep up with.

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Dr. Turner and 5 ultrasound machines

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