A challenges for the next generation of European ICM trainees: EDEC

Proving your proficiency in your chosen field has long been tested by the sitting of postgraduate exams such as the EDIC, but beyond this there are proofs of practical proficiencies combined with the knowledge of how to use them—presenting the European Diploma of EchoCardiography.

EDEC: How do I become ICU-Echocardiography proficient?

Nick Fletcher, London

It all stems from this document. Although we have know for quite a while that it is certainly a good idea and complements, and adds to immediate clinical practice for clinical practice.

We have a different skill set to cardiologists and look at different things, so it make sense to learn in a slightly different way.

There are good examples of intesive care doctors finding things on echo that the cardiologists may have not spotted. Let’s get as many people as possible this skill. But it’s not for everyone as EDEC is pitched at quite an advanced level. Training in the echo required for cardiac anaesthesia isn’t pitched right for critical care echocardiography.

So, what can you expect?

You’re going to need to do some basic echocardiographic training. Take your pick of proficiency. Then the EDEC training begins, with an ESICM-endorsed training programme.

That’s 40 hours of training, of which the ESICM advanced echo course is the only mandatory component. Then there are webinar programmes currently in development. There are going to be an increasing number of locally-delivered EDEC-endorsed courses.

You are going to need a mentor & supervisor to guide you through. Your mentor doesn’t necessarily have the full range of critical care echo skills, but can provide cognitive or technical skills to get you through. They can be an echo tech, an intensivist or cardiac anaesthetist.

A supervisor is suitably qualified to train and fully supervise. They should have a national or international qualification with expertise in TTE or TEE(TOE) (in the UK this might be BSE or ACTACC, formerly ACTA). They can apply to become an EDEC supervisor. They may not be in your centre. They might also be able to help you reach other centres to gain expertise and complete your logbook.

The logbook requires 100 TTE scans and 35 TEE(TOE) scans. No more than 20 / 7 respectively should be normal scans or repeated in the same patient or have significant technical limitations. The EDEC report must be used and uploaded to the online logbook repository.

And then there’s the exam

You need to be eligible for it (work in critical care). You need to have an approved mentor and supervisor (registered with EDEC). You’ll need the advanced course under your belt and 40 hours of training. The logbook doesn’t need to have been completed by then, but you’ll need to be making good progress towards it (60 cases at least uploaded to the logbook).

The exam has 3 parts:

50 MCQs,  without images, asking about physics, quantification and haemo-dynamics

10 case reporting images follow

If these are both passed, then you are invited to have a face to face TEE(TOE) OSCE on a simulation mannequin.

The whole process is envisaged to take 2 years. And you are likely to be at least 1000€ poorer, but if you pass you are more than better off!

If you need any more information, then head over to http://www.esicm.org/education/edec for everything you need to know.

Get going now and you could be the first person to be awarded the EDEC. Race you!