Society of Cardiovascular Anesthesiologists

1998 – Formation of National Board of Echocardiography (NBE) by SCA and American Society of Echocardiography

Formation of National Board of Echocardiography (NBE) by SCA and American Society of Echocardiography

In the early 1990s, the American Society of Echocardiography (ASE) introduced an examination of special competence in echocardiography (ASEeXAM).  ASE’s goals for this examination were fourfold. First, it wanted to give physicians the ability to test and demonstrate their knowledge of echocardiography based on objective standards. Second, it wanted to provide the medical community with the opportunity to recognize individuals who passed a voluntary examination. Third,  ASE wanted to stimulate continuing education in echocardiography and finally, it wanted to provide training programs with a mechanism to identify strengths and weaknesses in their echocardiography curricula. ASE selected the National Board of Medical Examiners (NBME) to manage the exam and organized a “pilot” exam for 100 participants including 11 anesthesiologists in 1995. The following year, ASE conducted its first examination in conjunction with it’s annual Scientific Meeting. At the same time, ASEeXAM was established as a separate corporate entity.

Although the examination was open to all physicians, several cardiothoracic anesthesiologists perceived ASEeXAM as a potential threat to their practice of perioperative transesophageal echocardiography (TEE). Indeed, the fear was that health care facilities might require passing ASEeXAM as a prerequisite for credentialing in TEE. An additional concern was that the content of the ASEeXAM was not at all focused on perioperative TEE. In response to its members’ apprehensions, the Society of Cardiovascular Anesthesiologists (SCA) decided to develop an examination that focused specifically on the perioperative practice of TEE. SCA established a Task Force for Certification in Perioperative TEE and charged it with the development of an examination process. NBME was retained to manage the examination.

A pilot Perioperative TEE examination was held at the 1997 SCA Annual Meeting in Baltimore then the first formal examination in Perioperative TEE was administered on April 24, 1998, a day before the SCA Annual Meeting in Seattle. Two hundred forty-three physicians took the exam and 185 passed the test. While their respective examination processes were being developed, the leadership of SCA and ASEeXAM began discussions about collaboration and in November 1998 they jointly established the National Board of Echocardiography (NBE). The NBE is a not-for-profit, physician led organization whose mission is “To improve the quality of cardiovascular patient care by developing and administering examinations for physicians leading to certification that recognizes special knowledge and expertise in echocardiography.” The leadership of NBE has equal representation of cardiologists and anesthesiologists and its presidency rotates between the two specialties.

Certification by NBE is a two-step process whereby a candidate must pass the examination and also provide proof of fellowship training that includes substantial experience in echocardiography. The first NBE diplomates in advanced perioperative transesophageal echocardiography were recognized in 2004. Since then, numerous cardiothoracic anesthesiologists have completed the certification process, many of whom have also completed the recertification process that was initiated in 2014.

Dan Thys

Above: Dan Thys MD