Today’s inane image of the day:

It is no secret that ultrasound is a powerful tool for the anesthesiologist and intensivist. During residency, we achieve competence in using ultrasound for vascular access, regional anesthesia, and basic cardiac examination [both transesophageal and transthoracic]. When I was a resident, there were times when it was really challenging to get an ultrasound, which translated into feeling like my own skill was mediocre. Fellowship in critical care anesthesiology certainly helped me build upon my skill and clinical application of ultrasound has continued to advance my knowledge.

During my critical care fellowship, I opted to take the CCEeXAM^® Examination of Special Competence in Critical Care Echocardiography. Mostly because someone else was paying for the certification and I thought that it could be a useful certification to possess. At the time, the exam had only been administered a few times; there were limited resources to study from and very sparse information on the internet on how to structure my studying or where to focus my attention.

Luckily, if you’re looking to make this ~$1,000+ [probably more like ~$2000-$3000 after you include the study resources below] investment in your clinical practice, I have some advice from my own experience and a recent test-taker’s experience to help guide your study plan.

This entry won’t be as comprehensive as my previous “how to study for X board exam,” because honestly, I wasn’t very structured in my approach to the exam. Additionally, I was literally on my first ever vacation [more on that another time] the week before I was scheduled to take my exam. Luckily, the Park City library is a beautiful place to study in.

Resources

CCEeXAM^® Examination of Special Competence in Critical Care Echocardiography Handbook Free!

Those of you that have used my prior “how to study” entries probably recognize that I believe it’s important to know what you’re being tested on. One way to ensure that you’ve structured your study plan to cover all of the topics that will be tested is to review the content outline for the exam. Page 6 of the handbook linked above is the content outline. Make sure you’ve looked through this [and consider creating a study document around this outline] to ensure that you’ve covered all of the topics listed.

U of U POCUS Course Free

I had no idea this resource existed until I was writing this entry. I certainly wish I knew about this resource to study for my exam. Just previewing one of the views on basic anatomy, it seems like it does a good job with breaking down concepts in a simple way. I’ll probably bookmark this course to try to complete… maybe… someday.

SCCM Comprehensive Critical Care Ultrasound $220-$440

When I took the exam, this SCCM book was pretty much all that was available from a critical care society to use for studying. I went through this book at the recommendation of my department members.

SCCM Critical Care Echocardiography Review [Course] $1870-$2340

I personally did not use this review course, but both the internet [here’s one SDN thread] and a colleague that shared their experience [Leshawn Richards, MD] both utilized the review course. There is both an online version and an in-person version.

Critical Care Echocardiography Review: 1200+ Questions and Answers $175

I wish this book was available to me when I was studying… but I have heard from prior fellows that many people have been utilizing this book as a resource to prepare. Of note, there’s a conflict of interest because I submitted a couple of questions to the book [on gastric ultrasound, I think?]. Either way, I’ve heard that this is an excellent resource for the exam.

Dr. Richards [via IG] noted that this book also had the most realistic style of second order or third order types of questions [instead of, “what is this pathology?” it is more like “how will you manage this?”] that are found on the CCEeXAM.

Clinical Echocardiography Review $200

This was one of the only question books available to me when I was studying for the exam. The questions were definitely geared more toward the level of a cardiologist studying for their board examinations, but it still offered concepts that were important to have exposure to for the CCEeXAM. There are certainly advocates of this book to this day when I review online posts.

Textbook of Clinical Echocardiography $180

One of the SDN posts about how to study for the exam included this textbook. The post reports that they excluded any topics that were not relevant to this exam such as stress echo, 3D, etc. If I had a lot of time to study for this exam, I’d definitely invest in something like this to get a more comprehensive understanding of echocardiography.

How I actually studied for the exam

I took my CCEeXAM on 1/14/2020. Looking back at my study spreadsheet, my plan started with reviewing materials 12/9/2019. So, I guess I gave myself 1 month to study for the exam. Of note, at the time, I was a critical care fellow with some flexibility during elective weeks to do dedicated studying. If you’re in a busy fellowship or are working full-time, how I approached studying for the exam may not apply to you.

Looking back at the resources I actually used – it included the SCCM Comprehensive Critical Care Ultrasound book, Clinical Echocardiography Review book and some random slide deck that someone sent me. I also got advice from a colleague that there was more diastology than they had expected… so I spent time on really getting to know diastology.

If I had to take the exam again today

Looking at all of the resources available now, I think that as a full-time working anesthesiologist/intensivist, I probably would opt for the SCCM Critical Care Echocardiography Review [Course] and the Critical Care Echocardiography Review: 1200+ Questions and Answers book. This also appears to be somewhat of the consensus on this SDN thread on how to study for the exam. At this point in my life, I know that I don’t have the self-motivation to sit down and focus on doing questions; having a course outline would structure my study plan and ensure that I hit all the material I needed to. As I’ve said in all of my posts – the most important thing to do is to ensure that you complete whatever resource you pick to use. Since there are now two resources that are mostly geared toward this material, I’d focus on creating a plan that ensures that you’ve completed these two resources in their entirety.

Let me know your thoughts on this entry/advice and good luck with your exam!