This fellowship focuses on developing expertise in POCUS knowledge, technical performance, and clinical integration, while simultaneously preparing the fellow to be a leader in POCUS. The curriculum develops a framework for knowledge building through weekly ultrasound conferences focusing on image review, literature review, and both faculty and fellow led didactics. Technical performance expertise is enhanced by regular mentored scanning with POCUS physician faculty and/or an educational sonographer, in a variety of settings including the emergency department, cardiovascular and medical ICUs, medical wards, and various outpatient settings. Fellows additionally work with procedure teams in the hospital and the clinic to obtain POCUS-guided procedural training.

Our team believes that the quality patient care is the driver for learning this technique, and the fellow will have either a valued clinical role in the Internal Medicine Clinic or as a nocturnist at OHSU. In this setting the fellow is encouraged to utilize POCUS skills to guide patient care and practice clinical integration when POCUS is indicated. Fellows receive formative evidence-based feedback of their incorporation of their POCUS into their clinical decision-making.

Finally, our fellowship aims to shape and prepare the trainee for future leadership opportunities. We provide additional training in developing expertise in bedside teaching, developing effective lectures, leadership, and acquiring the know-how to build a POCUS program. Fellows additionally have the opportunity to participate in the OHSU’s novel Education Scholars Program with other educators from around the institution.

Curriculum

Fellows learn a broad set of POCUS applications over the fellowship year. Every fellow will learn a core curriculum, but we also develop an individual-driven curriculum plan tailored to the fellows’ specific interests and career goals.

Core Curriculum

1. Ultrasound Operation and Physics
   1. Spectral Doppler
2. Cardiac
   1. Basic
      1. Left ventricular function
      2. Right ventricular function
      3. Pericardial fluid
      4. Tamponade physiology
   2. Advanced
      1. Cardiac Output
      2. Diastology
      3. Endocarditis
3. Lung
   1. Basic
      1. Pleural Fluid
      2. Pneumothorax
   2. Advanced
      1. Consolidations
      2. Alveolar interstitial syndrome (B-lines)
      3. Pleural disease
      4. Diaphragm function
4. Genitourinary
   1. Basic 
      1. Hydronephrosis
      2. Bladder volume assessment
   2. Advanced
      1. Cysts
      2. Renal Doppler
      3. Renal parenchymal assessment
      4. Stone Assesment
5. Hepatobiliary
   1. Basic
      1. Cholelithiasis
   2. Advanced
      1. Ductal Assessment
      2. Masses
      3. Polyps
      4. Sludge
      5. Wall Assessment
      6. Pericholecystic fluid
      7. Porcelain gallbladder
      8. Liver cysts, abscesses, and masses
      9. Fatty liver
      10. Cirrhosis
      11. Portal vein Doppler
      12. Portal venous thrombosis
6. Abdomen
   1. Basic
      1. Free fluid assessment
      2. Splenic assessment
   2. Advanced
      1. Pancreas
      2. Pneumoperitoneum
7. Intestinal
   1. Basic
      1. Gastric antrum assessment
      2. Small bowel obstruction
   2. Advanced
      1. Diverticulitis
      2. Appendicitis
      3. Inflammatory bowel disease
      4. Ileus
8. Musculoskeletal and Soft Tissue
   1. Basic
      1. Cellulitis
      2. Abscess
      3. Joint Effusion
      4. Baker’s Cyst
   2. Advanced
      1. Tendinopathy
      2. Crystal Arthropathy
      3. Injection
      4. Ligament injury
      5. Carpal tunnel
9. Vascular
   1. Basic
      1. IVC
      2. IJV
      3. DVT (upper and lower extremity)
   2. Advanced
      1. Arterial flow
      2. Pseudoaneurysm
      3. VEXUS evaluation
10. Head and Neck
    1. Basic
       1. Thyroid size
       2. Lymph nodes
    2. Advanced
       1. Thyroid cysts and masses
       2. Thyroiditis
11. Procedures
    1. Basic
       1. Paracentesis
       2. Thoracentesis
       3. Lumbar puncture
       4. I&D
       5. Arthrocentesis (small and large joint)
12. Education Skills
    1. Curriculum Development
    2. Lecture construction
    3. Oral presentation and speaking skills
    4. Bedside instruction
    5. Competency Assessment
13. Research Skills
    1. Critical Analysis of Medical Literature
    2. Project Design
    3. Literature review and assessment
    4. Research methodology, data collection, and manuscript preparation
    5. Institutional Review Board submission
14. Administration Skills
    1. Program management
    2. Quality assurance
    3. Competency, certification, and credentialing
    4. Billing/Coding
    5. Documentation
    6. Return on investment
    7. POCUS managers (image archival)
    8. Local, regional, and national policies
    9. Administrative oversight
    10. Risk management
    11. Peer review
    12. Equipment purchase
    13. Equipment maintenance and cleaning
    14. System networking
    15. National organizations

Oregon Health & Science University is located in the beautiful and vibrant Pacific Northwest right in the heart of Portland. Ultrasound activities primarily occur at the University Hospital, Multnomah Pavilion Simulation Center, and at the state-of-the-art Robertson Life Sciences Building (RLSB). Fellows have access to a fleet of both cart-based and handheld ultrasounds and get exposure to up-and-coming technology during the fellowship year.

Faculty

Renee Dversdal, MD, FACP
Professor of Medicine
Medical Director, OHSU Simulation

Michael Wollenberg, MD
Associate Professor of Anesthesiology and Perioperative Medicine
Director, Perioperative Ultrasound Education

Matt Chan, MD
Assistant Professor of Family Medicine
Director, Family Medicine Point of Care Ultrasound Curriculum

Nilan Schnure, MD
Assistant Professor of Medicine
Director, Outpatient Internal Medicine Ultrasound

Aaron Silver, MD
Assistant Professor of Medicine
Director, MD Continuity Elective

James Anstey, MD
Assistant Professor of Medicine
Director, OHSU Faculty Point of Care Ultrasound Education

Graduates

Our graduates have been remarkably successful post-fellowship and have taken a variety of career paths.

2016
Kevin Piro, MD (OHSU)

2017
Tim Flynn, DO (Abbott Northwestern, ambulatory clinic)

2018
Madiha Ahmad, MD (Rheumatology)

2019
Chad Ficek, MD (Sanford Medical Center, hospitalist)
Michael Northrop, MD (Legacy Health, hospitalist)
Florian Sattelmacher, MD (Queen’s Health System, ambulatory clinic)

2020
James Kornfield, MD (OHSU, Pulmonary and Critical Care Medicine)

2021
Scott Biggerstaff, DO (University of Minnesota, POCUS Director)
Paul Musgrave, MD (Legacy Health, hospitalist)
Aaron Silver, MD (OHSU, hospitalist)

2022

Michael Armstrong, DO (OHSU, Pulmonary and Critical Care Medicine)
Kelvin Ng, MD (OHSU, Family Medicine)