The Year in Detail

The University of Iowa (UI) program is fully funded one-year fellowship training based on the 2011 American Society of Echocardiography guidelines/standards.

Aside from one month of NICU fellow service designed to familiarize non-UI trainees with the operations, population, and protocols unique to the UI program, the year is protected for Neonatal Hemodynamics training.  NICU service may be completed concurrently with phase I.

The duration of each phase will vary by trainee based on acquisition of competencies and individual progress.  Longitudinal exposure to primarily hemodynamics cases and primarily cardiology teaching/cases is encouraged and will be facilitated collaboratively independent of training phase.

Phase I – Image Acquisition  

Ultrasound physics tutorial utilizing online resources with a log-book of modules completed and a quiz, this will be completed concurrently with familiarization with normal and abnormal anatomy using a dedicated echocardiography simulator (EchoCOM, Leipzig Germany) and the TnECHO website/app. After successful demonstration of these skills, hands-on training will be undertaken in the Pediatric Echocardiography lab under the co-supervision Neonatal and Cardiology departments.

Phase II – Neonatal Hemodynamics Integration

Hands-on training in the NICU with graduated supervision of Hemodynamics consults including imaging, measurement, interpretation and therapeutic decision making with regular case reviews. Training at UI will provide a wide range of clinical exposure including asphyxia, ECMO referrals, congenital diaphragmatic hernia, and a high volume of periviable neonates (e.g. 22+0– 23+6 weeks). Training in limited head ultrasound screening and point of care ultrasound will be provided.

Longitudinal Academic Progress

Academic supervision on a minimum of one research project suitable for presentation at a scientific meeting and publication as a first author in a peer reviewed journal. An academic oversight committee will be formed for each trainee.

On call

Limited on call commitments will continue throughout the year in order to maintain competency in intensive care skills and procedures [1-2/month].  Pay, duty hour restrictions, and vacation policy will be standardized in accordance with University of Iowa policy.


Comprehensive evaluation will be performed on the basis of the achievement of competencies. Throughout training, fellows are expected to keep a log book of scans completed including the indication, their role in the consultation (clinical data collection, image acquisition and which plane(s), duration, reporting).  Learners will be expected to complete a practical test of image acquisition covering recognition of red flags for common cardiovascular problems and congenital heart diseases utilizing simulator cases to complete phase I. Thereafter imaging skills will be evaluated using objective scoring tools using Direct Observation of Practical Skills (DOPS) assessments throughout the training.  By the end of training, fellows should be able to adequately capture 90-110 images in ≤30 minutes. Fellows will provide assessment, impression and plan for every scan and will be critiqued on their problem formulation, interpretation and physiological knowledge.  The intent is to document progress in sophistication of analysis and concordance with expert opinion. Upon completion of training, the candidate is expected to function as a competent and independent specialist in neonatal hemodynamics. A successful candidate must acquire a working knowledge of the theoretical and practical aspects of the discipline including its foundations in science and research.