Point of Care Ultrasonography

Overview 

The Area of Focused Competence (AFC) in Acute Care Ultrasound Fellowship is a one year training program to train the future leaders of Emergency Medicine ultrasonography. We are proud to be home to an incredible ultrasound fellowship since 2010, and became one of the first ultrasound fellowships in Canada to be officially accredited by the Royal College of Physicians and Surgeons of Canada with an AFC in 2021. Fellows will obtain extensive experience in the use of clinical point-of-care ultrasound, as well as in teaching, administration, and research. Graduates will receive an internationally recognized diploma from the Royal College indicating that they have met the highest standard in POCUS skill and leadership. 

Hospital 

The Ottawa Hospital Department of Emergency Medicine is a regional trauma centre with over 140,000 emergency visits/year. The high acuity and diverse patient population has benefited from the Emergency Medicine Ultrasonography (EMUS) program since 1998. 

Ottawa 

As the National Capital of Canada with a population of 1 million people, Ottawa is a beautiful city with countless festivals, concerts, and cultural attractions to offer. Highlights include a visit to Canada’s Parliament, the Byward Market, the annual Tulip Festival, Winterlude festival, the UNESCO World Heritage site of the Rideau Canal, Lansdowne Park, as well as many musical and food festivals each year.  

Ottawa is also host to many incredible and family friendly museums and galleries including the National War Museum, the National Art Gallery, The Canadian Museum of History, The Canadian Museum of Nature, and more. 

Besides the many museums and cultural attractions, Ottawa is an outdoor lover's paradise. Gatineau Park is just a short 15 minute drive from the downtown core and allows an immediate getaway for hiking, skiing, biking, swimming, camping, and more. The city has extensive green space filled with bike paths, jogging trails, the longest skating rink in the world (the Rideau Canal), and there are world class rapids for kayaking and hundreds of kilometers of cross-country trails nearby.  

• City of Ottawa – Visitors 
• Ottawa Tourism 

Highlights 

• Accredited by the Royal College of Physicians and Surgeons of Canada as an AFC program, granting graduates an internationally recognized diploma in point-of-care ultrasound 
• Weekly sessions with EMUS Faculty 
• Opportunities to teach locally and nationally 
• Pediatric, ECHO, and Critical Care rotations with opportunities for electives 
• Access to world-class researchers and methodologists 
• Option to combine the AFC in Acute Care POCUS with a Masters in Clinical Epidemiology for a two year program for those particularly interested in a career in POCUS Research. Any applicants interested in pursuing this unique program are advised to contact us as early as 12-15 months in advance to discuss availability 

Requirements 

• Applicants must be one of the following: 
  • Emergency Medicine certified physicians who are eligible for independent practice in Ontario (CCFP-EM or FRCPC) 
  • Residents in an FRCPC Canadian emergency medicine program undergoing their year of subspecialisation training 
  • International applicants with emergency medicine certification.
• Demonstrated interest in point of care ultrasound 
  • Strong clinical skills 
  • Letter of interest with 3 references (one of which must be from the program director if applicable) 
  • Eligible for appropriate licensure in Ontario by CPSO 
  • Eligible for appropriate medical liability insurance by CMPA 

The AFC in Acute Care Ultrasound Fellowship believes in the principles of equity, diversion, and inclusion in our selection process and encourages members of groups who are underrepresented in POCUS leadership including women, visible minorities, Aboriginal/Indigenous peoples, people with disabilities, and LGBTQ2+ groups to apply. 

Please note that this is a one year fellowship, or a two year fellowship if combining the AFC Diploma in Acute Care Ultrasound with a Masters in Clinical Epidemiology. The typical start date is July 1st, but we are also able to consider start dates for January 1st depending on availability but recommend you let us know you might be interested as early as 15 months in advance. 

Deadline for applications is September 1st for fellows looking for a July 1st start date and February 1st for fellows interested in a January 1st start date. All applicants invited for an interview will take place within the month after the application is submitted. 

Completed applications and questions about the application process can be submitted to Erika Donnelly. 

Dr. Brandon Ritcey completed his medical degree (2011), ultrasound fellowship (2015), and emergency medicine residency (2016) at the University of Ottawa, which is a testament to the wonderful city, hospital, faculty, and training available here. He served as the Assistant POCUS Fellowship Director for 4 years before taking over as the Director of the newly accredited AFC in Acute Care POCUS in 2021. 

Dr. Ritcey currently works as an emergency physician and is an Assistant Professor at The University of Ottawa. Dr. Ritcey has a deep passion and interest in POCUS education and how we can use POCUS across the medical system to improve patient care.  

Clinical Sonography 

Clinical sonography training will occur primarily within The Ottawa Hospital emergency departments. There will also be opportunities to gain additional exposure in pediatrics at the Children’s Hospital of Eastern Ontario (CHEO), Echocardiography, and Critical Care. It is expected that Fellows will have performed over 800 abdominal exams (including 200 gynecologic/pelvic exams), 300 cardiac exams, and 50 exams for procedural guidance and will be experienced enough with all indications that they would be able to teach them to someone else. Fellows will complete a portfolio to document how a selection of their scans contributed to patient care. 

Education and Teaching 

Education and teaching are essential components to the Fellowship. Fellows will develop and enhance teaching skills with a particular emphasis on new methods and web-based technology. Fellows are expected to take turns leading POCUS rounds, give lectures at local courses and may have opportunities to take part in national courses. In addition, bedside teaching is also required and will take part throughout the year. 

Research 

The Department of Emergency Medicine at the University of Ottawa maintains one of the most active research programs in Canada. With access to world-class researchers and excellent infrastructure it is expected that fellows will complete and submit a research project for presentation and publication.   

As mentioned previously, fellows planning a career path as a POCUS Researcher may want to consider our two year POCUS AFC and Masters of Clinical Epidemiology program which will provide formal direction through coursework and completion of a research project or thesis on a POCUS related topic. The completion of the POCUS AFC requirements will be done longitudinally throughout the two years to balance the requirements of the research component and coursework. 

Administration 

Fellows will learn how to develop, direct, and maintain a Clinical Sonography program. This will include providing physician credentialing and organizing and managing a quality improvement program. The ability to develop and maintain inter-professional relationships is essential. Fellows will understand the process of equipment evaluation and purchasing and provide ongoing equipment maintenance. It is expected that Fellows will take part in leadership activities advocating and promoting POCUS. 

A complete list of the Competency Training Requirements as set out by the Royal College of Physicians and Surgeons of Canada is available on the Royal College’s website here 

The Department of Emergency Medicine has three different types of ultrasound machines in each of the General Campus and Civic Campus emergency departments.

There is are 1-2 Sonosite XPorte ultrasound machines with curvilinear, linear, and phased array transducers at each site. 

There are two Phillips Sparq ultrasound machines with curvilinear, linear, phased array, and transesophageal echocardiography transducers at each site. 

There is one Phillips Lumify handheld ultrasound probe at each campus with phased array and linear transducers, as well as one additional unit reserved for ultrasound fellows to use exclusively for education and practice. 

Through the University of Ottawa Skills and Simulation Centre (uOSSC) fellows have access to advanced ultrasound simulation technology including a VimidexTM and ScanTrainerTM simulator to augment their learning, particularly in transvaginal ultrasound and transesophageal echo. 

All of our ultrasound machines have digital image archiving capacity to QPathE and PACS. All cart based machines have a full selection of advanced cardiac packages, Doppler, and echocardiography calculators.

Current 

• Dr. Hetoum Misirliyan, Attending Physician, Hôpital Montfort and University of Ottawa 

Alumni 2020 

• Dr. Tatiana Jilkina, Attending Physician, Pembroke Regional Hospital and Carelton Place & District Memorial Hospital 
• Dr. Adam Jones-Delcorde, Attending Physician, Winchester District Memorial Hospital 
• Dr. Michael Wong, Attending Physician, Royal Victoria Regional Health Centre 

Alumni 2019 

• Dr. Shuo Peng, Attending Physician, McGill University 
• Dr. Geraldine Leong, Attending Physician, Singapore 
• Dr. Robert Suttie, Attending Physician, Deep River & District Hospital 

Alumni 2018 

• Dr. Talia Burwash-Brennan, Attending Physician, Université de Montréal 
• Dr. Massimiliano Iseppon, Attending Physician, Université de Montréal 
• Dr. Rajiv Thavanathan, Attending Physician, University of Ottawa 

Alumni 2017 

• Dr. Elizabeth Lalande, Emergency Physician, Centre Hospitalier de l'Université Laval (CHUL), CHU de Québec, Laval University 

Alumni 2016 

• Dr. Frank Myslik, Assistant Professor and AFC Program Director of Acute Care POCUS, Western University 
• Dr. Sze Joo Juan, Consultant, Yong Loo Lin School of Medicine, Ng Teng Fong General Hospital, Singapore 
• Dr. Mike Rubin, Attending Physician, University of Ottawa 
• Dr. Badar Alhamrashdi, Head, Department of Emergency Medicine, Assistant Director of Medical and Paramedical affairs, Rustaq Hospital, Oman 
• Dr. Noman Khan, Attending Physician, Saudi Arabia 

Alumni 2015 

• Dr. Brandon Ritcey, Emergency Physician and AFC Program Director of Acute Care POCUS, University of Ottawa 

Alumni 2014 

• Dr. Mark Taylor, Emergency Physician, University of Saskatchewan 

Alumni 2013 

• Dr. Hasan Alzharani, Program Director Emergency Medicine, King Khalid University Medical City - Abha, Saudi Arabia 

Alumni 2012 

• Dr. Faiz Alhrbi, Emergency Physician, Windsor Regional Hospital 
• Alumni 2011 
• Dr. Muhammad Tashkandi, Emergency Medicine, Consultant, King Saud bin Abdulaziz Medical City, Saudi Arabia 

Alumni 2010 

• Dr. Donna Lee, Emergency Physician, Vancouver General Hospital, University of British Columbia 
• Dr. Khaled Al-Rajhi, Deputy Chair, King Saud bin Abdulaziz Medical City, Saudi Arabia 

• Wein T, Lindsay MP, Côté R, Foley N, Berlingieri J, Bhogal S, Bourgoin A, Buck BH, Cox J, Davidson D, Dowlatshahi D, Douketis J, Falconer J, Field T, Gioia L, Gubitz G, Habert J, Jaspers S, Lum C, McNamara Morse D, Pageau P, Rafay M, Rodgerson A, Semchuk B, Sharma M, Shoamanesh A, Tamayo A, Smitko E, Gladstone DJ; Heart and Stroke Foundation Canadian Stroke Best Practice Committees. Canadian stroke best practice recommendations: Secondary prevention of stroke, sixth edition practice guidelines, update 2017. Int J Stroke. 2017 Jan 1:1747493017743062. doi: 10.1177/1747493017743062. [Epub ahead of print]
• Pageau, P., Sinclair, D., Abu-Laban, R., Eisener-Parsche, P., Frank, J., Holroyd, B., . . . Toth, P. (2017). The future of emergency medicine in Canada: Reflections one year after the release of the Collaborative Working Group final report. CJEM, 19(S2), S38-S39. doi:10.1017/cem.2017.366
• Connolly, R., Woo, M., Lampron, J., & Perry, J. (2017). Factors associated with delay in trauma team activation and impact on patient outcomes. CJEM, 1-8. doi:10.1017/cem.2017.389
• Gaspari R, Weekes A, Adhikari S, Noble V, Nomura JT, Theodoro D, Woo M et al. A retrospective study of pulseless electoral activity, bedside ultrasound identifies interventions during resuscitation associated with improved survival to hospital admission. A REASON Study.
• Boet S, Thompson C, Woo M Y, et al. (August 22, 2017) Interactive Online Learning for Attending
• Physicians in Ultrasound-guided Central Venous Catheter Insertion. Cureus 9(8): e1592. DOI 10.7759/cureus.1592 [accessed Jan 13 2018].
• Kadhim-Saleh, A., Worrall, J., Taljaard, M., Gatien, M., & Perry, J. (2017). Self-awareness of computed tomography ordering in the emergency department. CJEM, 1-9. doi:10.1017/cem.2017.45
• Gaspari R, Weekes A, Adhikari S, Noble VE, Nomura JT, Theodoro D, Woo M, et al. Emergency department point-of-care ultrasound in out-of-hospital and in –ED cardiac arrest. Resuscitation. 2016;109:33-39.
• Woo MY, Hecht N, Hurley B, Stitt D, Thiruganasambandamoorthy V. Test Characteristics of Point-of-Care Ultrasonography for the Diagnosis of Acute Posterior Ocular Pathology. Canadian Journal of Ophthalmology. 2016; 51(5):336-341. Doi: 10.1016/j.jcjo.2016.03.020
• Ritcey B, Pageau P, Woo MY, Perry JJ. Regional nerve blocks for hip and femoral neck fractures in the Emergency Department: A systematic review. CJEM. 2016 Jan 18(1):37-47. Doi:10.1017/cem.2015.75.
• Ohle R, McIsaac SM, Woo MY, Perry JJ. Sonography of the optic nerve sheath diameter for detection of raided intracranial pressure compared to computed tomography: a systematic review and meta-analysis. J Ultrasound Med. 2015 Jul;34(7):1285-94. - nominated top 5 SAEM/AEUS best review article research award 2016 – New Orleans
• Taylor M, Woo MY, Pageau P, McInnes MDF, Watterson J, et al. Ultrasonography for the prediction of urological surgical intervention in patients with renal colic. Emerg Med J. 2015: doi:10.1136/emermed-2014-204524 - nominated top 5 SAEM/AEUS best retrospective research award 2016 – New Orleans
• Alzahrani H, Woo MY, Johnson C, Pageau P, Millington S, Thiruganasambandamoorthy V. Can severe aortic stenosis be identified by emergency physicians when interpreting a simplified two-view echocardiogram obtained by trained echocardiographers? Critical Ultrasound Journal. 2015: 7:5. doi:10.1186/s13089-015-0022-8
• Woo MY, Taylor M, Atkinson P, Loubani O, Bowra J. My patient’s got abdominal pain: identifying biliary problems. Ultrasound. 2014: 22(4); 223-228. DOI:10.1177/1742271X14546181
• Woo MY. Psoas abscess. J. Emerg Med. 2014. 2014: 47(5); e129-e130.DOI: 10.1016/j.jemermed.2014.06.035

• C Farrell, S Teed, N Costain, M Austin, A Willmore, A Reed, J Maloney, R Dionne. EMS Boot Camp: A Real-World, Real-Time Educational Experience for Emergency Medicine Residents. CAEP Annual Conference, Whistler, Canada. June 2017.
• N Costain, V Charbonneau, S Mitchell, M Austin, A Willmore, A Reed, R Dionne, J Maloney. EMS Month: Familiarizing Emergency Medicine Residents With Prehospital Care And Disaster Medicine. NAEMSP Annual Conference, New Orleans, USA. January 2017.
• Connolly, R., Woo, M., Lampron, J., & Perry, J. (2017). LO89: Factors associated with delay in trauma team activation and impact on patient outcomes. CJEM, 19(S1), S58-S59. doi:10.1017/cem.2017.151
• Ritcey BW, Woo MY, McInnes MDF, Watterson J, Perry JJ. What ultrsonography characteristics predict surgical intervention for testicular torsion? Canadian Journal of Emergency Medicine, Volume 18, Issue S1, May 2016, pp S35-S35 - doi: 10.1017/cem.2016.51
• Shefrin AE, Ritcey B, Perry JJ, Woo MY. What ultrasonography characteristics predict surgical intervention for children with testicular torsion? Canadian Journal of Emergency Medicine, Volume 18, Issue S1, May 2016, pp S71-S71 - doi: 10.1017/cem.2016.155
• Atkinson, P., Bowra, J., Milne, J., Lambert, M., Jarman, B., Noble, V., . . . Tessaro, M. (2016). LO042: Sonography in Hypotension and Cardiac Arrest (SHoC) - Hypotension: Derivation of an evidence-based consensus algorithm for the integration of point of care ultrasound into resuscitation of hypotensive patients. CJEM, 18(S1), S44-S44. doi:10.1017/cem.2016.79
• Atkinson, P., Bowra, J., Milne, J., Lambert, M., Jarman, B., Noble, V., . . . Tessaro, M. (2016). LO045: Sonography in Hypotension and Cardiac Arrest (SHoC) - Cardiac Arrest: A consensus on the integration of point of care ultrasound into advanced cardiac life support during cardiac arrest. CJEM, 18(S1), S45-S46. doi:10.1017/cem.2016.82
• Gaspari R, Atkinson PR, Woo MY, Rang L, Adhikari S, Noble V, Nomura J, Raio C, Theodoro D, Weeks A, Blehar D, Brown S, Caffery T, et al.
• Sonography in cardiac arrest: Real-time Assessment and Evaluation with Sonography – Outcomes Network (REASON). **Plenary Oral Second Place. Can J Emerg Med. 2015; 17(suppl 2): S4.
• Ritcey B, Pageau P, Woo MY, Perry JJ. Regional nerve blocks for hip and femoral neck fractures in the emergency department: a systematic review. Can J Emerg Med. 2015; 17 (Suppl 2): S78.
• Lee JS, Bhandari T, Emond M, Perry JJ, Woo M, Chenkin J. Ultrasound guided regional anesthesia in older hip fractures patients: uptake of regional anesthesia in randomly selected emergency physicians. Can J Emerg Med. 2015; 17 (Suppl 2): S47.
• Woo MY, Chagnon N, Power B, St. Pierre N. Evaluation of a pilot ultrasonography workshop for second year medical students. Presented at Academy for Innovation in Medical Education (AIME) Day. Ottawa, Canada. April 10, 2015.