Emergency Medicine

Stanford Emergency Medicine Ultrasound Fellowship

Stanford University Medical Center is an adult and pediatric Level 1 Trauma Center and world-renowned quaternary care center. It also has an exceptional children’s hospital (Lucile Packard Children’s Hospital); adjoining the adult Stanford Hospital & Clinics; whose ED is within the main Stanford ED.  Stanford offers exceptional specialty training in many fields, including emergency medicine (EM), critical care, surgery, cardiology, pediatrics, radiology, and multiple other areas. We draw on these tremendous resources to provide outstanding training and opportunities for our Emergency Medicine Ultrasound (US) Fellow. 

Stanford’s Emergency Medicine Ultrasound (EMUS) Fellowship is one year long. It is based on the ACEP Guidelines for Ultrasound Fellowships. It is enhanced by training in both our adult and pediatric Emergency Departments (with Emergency US trained faculty) and also with ultrasound experts outside the ED setting.

Ultrasound 1Within the Emergency Department, we have an exceptional Emergency Medicine Ultrasound faculty. Dr. Sarah Williams and Dr. Laleh Gharahbaghian (info below) are EM residency trained and EM ultrasound fellowship trained.  The EM residents have deep exposure in ultrasound starting at the beginning of residency, and their enthusiasm for ultrasound in ED patient care as well as involvement in US research is deep and vibrant.

In the main hospital, we enjoy an exceptional relationship with our Trauma Surgery service, which uses ultrasound routinely, and our Radiology Department has been exceptionally supportive of our ultrasound program. They also have phenomenal high-end didactic education and have been involved in collaborative research projects with us. Our Cardiology Echo Lab has also been highly supportive of our Fellowships and ultrasound research which includes US scanning shifts with an expert echocardiographer and cardiologist in our ED. We were involved in the coordination and purchase of new US systems throughout the hospital; multiple inpatient units, including the ICU, have similar US systems as in our ED. We have an outstanding relationship with the critical care team for many reasons. We use these and other resources for Fellowship education and research opportunities.

Ultrasound ClassIn the ED, we have several top-of-the-line Sonosite M-Turbo ultrasound systems, which are loaded with multiple transducers, clip storage, multiple software packages, and thermal printers. All are equipped with an additional monitor for teaching purposes. One is stationed in the Trauma Suite of the ED, another is stationed in the central area of the ED for multipurpose use, a third is located in the Pediatric ED, and has dedicated pediatric linear and echo probes, and a 4th is stationed in our ED Holding Unit. A 5th Aloka machine, and 6th Philips Optigo system are available where needed; including teaching the EM residents, faculty, and rotating housestaff, students, and mid-level practioners. Our ED houses the ED for Lucile Packard Children’s Hospital; our dedicated US machine equipped with pediatric transducers allows for rapid imaging of complex pediatric patients and is a great educational experience for the Fellow.

We use the US machines for many applications, including (but not limited to): FAST, extended FAST, renal, bladder, ophthalmologic, biliary, aortic, IVC, limited echo, pediatric, musculoskeletal, soft tissue, ob/gyn, pulmonary, line placement and other US guided procedures.

Ultrasound Research

Teaching is a fundamental component of the Fellowship. US education is a regular part of the Resident Core Curriculum. Dedicated US scanning shifts with US trained faculty also enhance the Fellow’s education. Regular workshops are scheduled to train EM and rotating residents and medical students in emergency ultrasound.  We teach a dedicated intensive two-day ultrasound workshop during new intern orientation. Educationally, as part of this training, we meet with residents to review their scans and provide constructive feedback. We also have an ultrasound elective in the ED.

We also teach other ultrasound courses, at Stanford Medical School, and at local /regional /national conferences. We have also collaborated with our International Emergency Medicine program, assisting with courses given around the world, including Bali, Egypt, India, Guatemala, and Honduras.

Stanford Emergency Medicine also performs cutting edge ultrasound research. There are many original projects underway is the various stages of IRB approval/data collection/analysis/writing/submission. Several other projects are in the planning stage.  Each Fellow will be encouraged to design a project of their own and carry out basic research. The Fellow also coordinates the ultrasound journal club (USJC) article review to all of us up to date US research. The year is very productive!

The Fellow is also in charge of the Quality Assurance reviewing all ultrasound images of the department ensuring compliance and credentialing. This is with EMUS faculty support and supervision and allows for great independence/responsibility with our program. The Fellow is also responsible for doing one administrative project in the year, and again, this is not hard to accomplish and is usually quite enjoyable to the Fellow.

The Fellowship position has the salary and benefits of a half-time Stanford attending faculty appointment, with the potential for extra income from moonlighting (as long as it augments and does not impede the Fellowship experience) and possibly from teaching as well.

In addition to ultrasound learning/teaching/research time both in the ED and with our off-service ultrasound rotations, the Fellow would keep up their general emergency medicine skills by doing eight or nine 8-hour shifts attending in the Stanford ED, which is a Level 1 Trauma Center, has a Pediatric ED, and an extremely high acuity general ED.

For information about the Stanford Emergency Medicine Ultrasound Fellowship, or for questions regarding research opportunities related to emergency department/critical care ultrasound, please contact:

Ultrasound Directors

 

 

 

 

 

 


Laleh Gharahbaghian, MD, FACEP, FAAEM
Assistant Clinical Professor
Director, EM Ultrasound Program and Fellowship
Email: lalehmd@gmail.com
Faculty Profile: Stanford Faculty Profile

Sarah R. Williams, MD, FACEP, FAAEM
Associate Clinical Professor
Co-Director, EM Ultrasound Fellowship
Associate Residency Director
Email: srwilliams@stanford.edu
Faculty Profile: Stanford Faculty Profile


Division of Emergency Medicine
Stanford University Medical Center
300 Pasteur Drive, Alway M121
Stanford , CA 94305
phone (650) 725-9668; fax (650) 723-0121


 

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