Frequently Asked Questions (FAQ)

1. Which professional Societies are sponsoring and developing the NBE ACCE Certification?

 

A recently updated document by the NBE lists the following partnering organiziations: NBE (National Board of Echocardiography ), CHEST (American College of Chest Physicians), ATS (American Thoracic Society), SCCM (Society of Critical Care Medicine), ASE (American Society of Echocardiography), SCA (Society of Cardiovascular Anesthesiologists), ASA (American Society of Anesthesiologists), ACEP (American College of Emergency Physicians), and WINFOCUS (World Interactive Network Focused on Critical Ultrasound) are all involved with the development of the examination and in defining criteria for Certification in ACCE.

 

CHEST, ATS, and SCCM have published editorials that reflect their support. In the coming months, their Societies’ Journals and Websites will be publicizing the ACCE Certification on a regular basis.

- Mayo PH et al. Advanced Critical Care Echocardiography: The Intensivist as the ACCE of Hearts. CHEST 2017;152(1):4-5.

- Brown SM et al. A New Era in Critical Care Ultrasound: Professionalization. Annals ATS 2017;14(12):1747-1749.

- Diaz-Gomez et al. National Certification in Critical Care Echocardiography: Its Time Has Come. Critical Care Medicine 2017;45(11):1801-1804.

 

2. What information about the Certification is available from the NBE?

The first examination was administered on 1/15/19. Prior to that examination, the NBE released some information, follow this link for the full document and this link for a short advertisement email. The 2020 exam date has  been announced to be Tuesday January 14th, 2020. Early registration fee is $995.00 (ended 9/6/19) and the late registration fee is $1,195.00. The late registration deadline is 11/8/19 at noon. The list of subjects that was initially posted has been updated and in included on page two of the aforementioned document.

The examination is a 200-item computer-based examination administered by Prometric. Only physicians are eligible to sit for the examination and it is only being offered in the United States. Further details are available in the document.

After the a physician passes the examination, they will  be awarded Testamur status with the NBE. The certification process for Diplomate status with the NBE was released on 5/8/19 and is described below.

For the 2019 examination there was a refund/cancellation policy and a policy for deferring the exam to 2020 if needed. It has not be released if this policy will continue for future examinations.

3. You took the 2019 examination, what can you tell me about it!

Results for the 2019 examination were released on 3/18/19. There were 526 candidates that took the examination and this group is now considered the base reference group. Based on my look at the percentile scores of the total group and the set minimum pass score, approximately 14% of candidates did not pass the examination, this calculation may be off and at some point the NBE will publish the exact passing rate.

4. In addition to passing the exam what else is required to obtain certification?

On 5/8/19 the NBE released details describing the pathway to certification. You may view the complete handbook here which describes the process in detail. I also received this letter describing the certification requirements. I will briefly summarize the process.

Certification eligibility criteria:

- Successful completion of the CCEeXAM or ASCeXAM (ASCeXAM only eligible if taken prior to 2020 and those applicants must apply by 2022).

- Must hold a valid unrestricted license to practice medicine at the time of application.

- Must be board certified by a board that holds membership in the American Board of Medical Specialties, the Advisory Board for Osteopathic Specialties, The American Association of Physician Specialists, or Royal College of Physicians and Surgeons of Canada.

- The applicant must complete a minimum of 150 full transthoracic echocardiograms that are logged and mentored. See each training pathway for further details.

- Note: non-North American trained physicians must have had the equivalent of each of the applicable requirements.

After those requirements are fulfilled, there are two potential pathways:

1) Supervised Training Pathway) (i.e. critical care fellowship pathway):

- Applicants must have successfully completed at least one year in a fellowship level training program dedicated to adult critical care prior to applying for certification.

- If training takes place after 12/31/22, it must be in an ACGME accredited or other national equivalent program (i.e. neurology, pulmonology, anesthesiology, surgery, or emergency medicine).

- 150 full transthoracic echocardiograms - all studies must be acquired and interpreted by the applicant, logged, and signed off by the fellowship director, program director, or chair of the critical care program. The letter must be notarized.

2) Practice Experience Pathway (expires 12/31/26):

- Applicants must have at least 750 hours of clinical experience dedicated to critical care medicine delivered to patients over the past 3 years prior to application. This activity  requires the clinical hours billing 99291. A notarized letter from the hospital administrator verifying these hours is required.

- 150 full transthoracic echocardiograms - all studies must be acquired and interpreted by the applicant during the 3 years prior to application. Studies must be reviewed by the supervisor, documented, signed, and notarized. 

-- The supervisor must hold NBE certification station in CCEeXAM, ASCeXAM, or Advanced PTE, or be an individual who has achieved ASCeXAM testamur status within the last 10 years and who is also a recognized expert in the field of critical care echocardiography.

- Must have at least 20 hours of AMA category 1 CME devoted to echocardiography obtained during the 3 years prior to application.

Based on the NBE's Certification Handbook I have created a Microsoft Excel spreadsheet that you may download and use to log to your echocardiograms. Click here to download the spreadsheet.

 

5. What guidance can you give me to prepare Certification in ACCE?

Please follow the following links for recommendations:

- Exam Preparation

- Image Set Requirement

- Reading List

 

Now that the first examination has been administered I will begin to update study recommendations based on my experience and the experience of others.

6. How do I find somebody to supervise and sign off on my echocardiograms for certification purposes?

 

The image set requirement was delineated on 5/8/19 (see FAQ #4 and the image set section for further details). The supervisor must hold NBE certification station in CCEeXAM, ASCeXAM, or Advanced PTE, or be an individual who has achieved ASCeXAM testamur status within the last 10 years and who is also a recognized expert in the field of critical care echocardiography.

Currently there is no repository of experts that are willing and able to take on this role. Ideally applicants will have local experts available to perform this duty. It is obvious that in the beginning such expertise will not be widespread and thus efforts are underway to organize a working group that can provide this service to those in need and I will update this website once that information is available. Once I have achieved certification status I plan to make myself available in this capacity. 

If you plan to start acquiring images for the echocardiogram requirement I recommend that you record all studies in your log book and store the echocardiogram images in a de-identified manner so that you will be able to have them reviewed by an expert without disclosing protected health information.

7. Who are you and why should I listen to anything you have to say?

My name is Yonatan Greenstein, MD, FCCP. I am an Associate Professor of Medicine at Rutgers New Jersey Medical School in the Division of Pulmonary & Critical Care Medicine. I have been fortunate to train with

pre-eminent critical care ultrasonographers and have developed a strong passion for critical care ultrasonography and echocardiography. This has resulted in teaching critical care echocardiography with CHEST since 2012 and authorship of multiple critical care ultrasonography peer-reviewed manuscripts and book chapters. I took and passed the first ACCE examination on 1/15/19.

After discussions with my colleagues it became apparent that there was likely to be a need for a central repository of information related to this examination. My hope is that this website will serve to provide useful information to those considering certification in ACCE.

8. I have useful and important info to share. How do I get it on this website?

If you have information related to the Certification process that I am missing please share it. Furthermore, if you become aware of other review materials and/or review courses geared to ACCE Certification please let me know.

I am also very interested in hearing from candidates that took the 2019 examination. If you have helpful examination preparation tips please share it with me. I will be sure to give you credit.