Theory and Practical training in Ultrasonography
(RCOG/RCR Diploma in Obstetric Ultrasound)
The Antenatal Diagnostic Centre (ADC) at National University Hospital (NUH) is one of the few RCOG/RCR approved practical training centers in Obstetric Ultrasound, outside the United Kingdom.
There are three basic parts to the Diploma in Obstetric Ultrasound Course offered by RCOG/RCR:
- Attendance at a one-week theoretical course currently held annually in February at the RCOG, United Kingdom
- Clinical attachment at a recognised training centre for a total of 100 sessions (300 hours) over a minimum period of 6 months (The Standing Joint Committee - SJC -will not grant approval for training over a period of less than 6 months.) and a maximum of 24 months. The number and type of scans to be performed is prescriptive and the trainee has to achieve certain practical skills in the use of ultrasound. The trainee is required to complete a logbook of 500 cases and to prepare a 20 case image portfolio
- Final exit assessment where all candidates will be assessed by the OSCE format to be held at least once a year at the RCOG. This involves interactive stations, clinical questions and review by the examiners of the logbook
All three parts of the course must be successfully completed for the candidate to pass and acquire the Diploma.
To apply and register for training with the RCOG, you need to:
- Have basic scanning skills
- Have guaranteed protected hands-on training time (1 to 4 sessions a week)
- Have secured a place at one of the recognised training centers
- Submit a completed registration form
- Pay registration fee to the RCOG
For clinical attachment, medical practitioners, obstetricians and radiologists can apply to ADC at NUH for practical training.
The aim of this clinical attachment is to equip the trainee with the necessary scanning skills to manage complicated pregnancies more effectively. These skills will enable the trainee to:
- Operate the ultrasound machine and use the main settings to optimize the image
- Scan both abdominally and vaginally
- Use the controls for measurement of distance, circumference, area, volume and Doppler induces (including all biometry, assessment of a trial size using the measurement of the lateral cerebral ventricular atrium)
- Gain expertise in the use of ultrasound to:
- Confirm that the pregnancy is intra-uterine
- Localise the heartbeat of the embryo or fetus to confirm viability
- Localise the placenta, assess its morphology
- Assess amniotic fluid volume, to quantify oligo and polyhydramnios
- Gain expertise in the use of ultrasound to perform fetal anomaly screening at 18-20 weeks to a standard above that performed by the routine screening service. For example, the trainee would be expected to be expert in assessment of the following: the brain in detail – midline structures, supra and infratentorial structures, their normal development and appearance;
- full facial assessment to include eyes, maxilla, mandible, lips, nose and nostrils
- extended cardiac scan including outflow tracts, aortic and ductal arches, heart rate and rhythm
- abdomen to include the gallbladder, liver, diaphragm and vasculature; genitalia
- limbs to include assessment of modeling, ossification, movement, fingers and toes
- Follow diagnosis of a structural abnormality in all organ and skeletal systems
- to have the knowledge and scanning skills to search for associated anomalies e.g. chromosomal disorders and genetics syndromes
- to discuss and arrange appropriate investigations e.g. amniocentesis, infection screen, magnetic resonance imaging
- Be conversant with and understand the role of invasive diagnostic procedures such as Amniocentesis, chorionic villous biopsy, fetal cordocentesis
- Be conversant with and understand the role of invasive therapeutic procedures
- Drainage of liquor and of fluid from boy cavities, shunt insertion, selective reduction and termination
- Witness IN PERSON, not in video, a total of 10 invasive procedures to be entered into the logbook
Logbooks
Each trainee is required to keep a record of each case that they scan in their logbook. The purpose is to document the number and type of scans performed to ensure that the trainee is exposed to a sufficient case-mix to acquire the necessary practical and theoretical skills to complete the course.
The trainee is required to complete 2 logbooks :
- a record of the 500 scans performed during the training
- an image portfolio of twenty cases accompanied by an appropriate number of ultrasound images to illustrate each case.
Every entry in the logbook requires the signature to ensure that the candidate is both trained and supervised. Each scan can only be used for one entry in the logbook. The signed RCOG/RCR certificate should confirm that the Lead Trainer have approved and verified the content of the logbook. It must be enclosed with the logbook when the trainee brings it to the exit examination.
A summary of the categories and numbers is:
- First trimester scans (half to be transvaginal) - 60 cases
- General fetal anomaly scanning (in. biometry)
12-14 weeks - 30 cases
14-18 weeks - 30 cases
Over 18 weeks - 240 cases
- Non-cardiac anomalies (>4 organ systems) - 20 cases
- Invasive procedures witnessed - 10 cases
- Fetal cardiac scans - 30 cases
- Fetal well-being assessment - 80 cases
TOTAL CASES 500
20 Case Image Portfolio
Candidates should acquire 20 annotated ultrasound images, which should demonstrate both normal anatomy across all trimesters, and a range of anomalies during the course of their practical training. The number and type of cases required are as follows:
- 4 cases in the first trimester
- 12 in the second trimester (to include 6 normal and 6 structural anomalies each from different system)
- 4 in the third trimester
Practical training duration: 6 months (excluding Saturdays and Sundays)
Course fee: $10, 000 (excluding 5% GST)
Venue of training: Antenatal Diagnostic Centre (ADC), NUH, Level 1, Main Building
Interested applicants, please email Ms Dawn Chia, or contact her at (65) 6772 5180.
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