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Image Set

Certification in ACCE will require passing the examination and completing a required image set of 150 full transthoracic echocardiograms.


For preparation of the image set:

  1. 150 full transthoracic echocardiograms acquired, interpreted, and logged by the applicant.
    - ​​​​Supervised Training Pathway:  reviewed and signed off by the fellowship director, program director, or chair of the critical care program.

       - Practice Experience Pathway (expires 12/31/26): done 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.

  2. The NBE is quite vague when defining a complete critical care transthoracic echocardiogram. In the Certification Handbook they define it as follows:


      "A critical care transthoracic echocardiogram is performed by the clinical provider at the point-of-care in the management of a critically ill patient. For   

       certification, the critical care transthoracic echocardiogram must include all obtainable elements of the transthoracic echocardiography examination.


       NOTE: Serial exams performed on the same patient will be considered for certification if they are repeated in response to a change in the clinical           

       presentation to assess the effect of an intervention and are complete and comprehensive: repeat examinations are limited to 1 per patient. The log of

       cases performed and interpreted must be submitted and signed off by fellowship director and submitted. As there is no clearly defined image set, I have

       prepared an example of what I define for my image collection requirements to be a full image set. Please note that American Society of

       Echocardiography no longer recommends M-mode for chamber size quantification - you may ignore these reference to M-mode in the provided image

       set. ​"

       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.

 3.  Experience has shown that a document listing the required views is not enough to help a clinician get started in  this endeavor. In conjunction with Dr.

      Paul Mayo and CHEST I put together a long form and short form walk through of the complete examination with aforementioned caveat about M-

      mode. I hope you find it useful.

4.  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


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