Content covered in this comprehensive article includes the Echo Board Exam, Echo boards information, ASCeXAM®, echoboardstudy.com, Echo board certification, echo board review, echo board study, echo board resources, echo board practice questions, and echo board practice tests.
What is the Echo Board Exam?
The echocardiography board exam is also known as echo boards or the echo board exam, and is officially known as the ASCeXAM®. ASCeXAM® stands for Examination of Special Competence in Adult Echocardiography. The NBE, short for the National Board of Echocardiography, administers the test. It is essentially meant to be a certification of proficiency in adult echocardiography.
Sonographers and cardiovascular technicians can also obtain board certification in echocardiography through Cardiovascular Credentialing International (CCI) or American Registry for Diagnostic Medical Sonography (ARDMS).
Echo Board Exam Practice Tests and Example Questions
Below we have listed a number of available resources for echo board questions, also in the section on the echo board syllabus a number of example questions kindly supplied by echoboardstudy.com have been listed. These echo board example questions and echo boards practice tests are listed below. Here is one such example.
This is an example of something that we would rarely look at in clinical practice, but is frequently tested on the echo board exam, M-mode echocardiography.
Do you need the Echo Board Exam?
Currently the echo board exam is not mandatory to read echocardiograms in the United States. Many believe that over the next few years it will become mandatory as healthcare payers will require it for reimbursement. There is no confirmation of this contention, however there are increasing numbers of people now sitting for the exam as a result, particularly those graduating from fellowships.
Most practices in the United States recommend that sonographers gain board certification in echocardiography though CCI or ARDMS.
Who is eligible for the Echo Boards?
For Physicians Trained in North America: To apply for the echocardiography board examination applicants must have a valid license to practice medicine or must be enrolled in a AGCME accredited training program. For those that don’t have a license, a notarized letter is required from a program director.
For Physicians Not Trained in North America: To apply for echo boards you will need an original letter from the Medical Council confirming your license is permanent (if there is no expiry date) or a certificate of good standing within a 12 month period of applying.
For Sonographers and Cardiovascular Technicians: Contact CCI and ARDMS for the application requirements. Typically, students in their last year of training are eligible to sit for the registry exam.
What Is The Difference Between an Echo Board Testamur and a Diplomate?
Both a Testamur and a Diplomate have to sit and pass the echocardiography board examination. Passing the echo board exam alone doesn’t mean that one becomes echo board certified. To become echo board certified certain criteria have to be met. A Diplomate means that someone has passed the exam and fulfilled the criteria to be certified. To be a Diplomate one must have essentially completed a cardiology fellowship training program and as part of that performed at least 150 TTE’s and interpreted at least 300 TTE’s. A Testamur means someone has passed the exam, however they don’t meet criteria to be echo board certified. A Testamur is still recognized as having passed the exam however.
How long is the Echo Board Exam and what is the Format?
There are four blocks in total in the echocardiography board exam. 1 case oriented block and 3 multiple choice blocks. The case oriented block may last up to 1 ½ hours. The multiple choice blocks may last up to an hour each.
What is the Content of the Echo Board Exam?
The following six areas are tested in the Echo Board exam:
- Physical Principles, Instrumentation, Examination Principles
- Valvular Heart Disease
- Chamber Size and Function
- Congenital Heart Disease
- Cardiac Masses, Pericardial Disease, Contrast and New Applications
- Miscellaneous Topics (Role of Echo)
These areas will now be discussed in a little more detail.
Physical Principles, Instrumentation, Examination Principles for the echocardiography board exam:
This tests aspects of a routine Doppler echocardiogram exam including all standard imaging planes. Also will be expected to have a working knowledge of aspects of a TEE exam, Intraoperative TEE and ICE. There is expected to be a good understanding of associated physics principles including Doppler flow and color flow. M-mode echocardiography, hand held echocardiography and and 3D echocardiography will be tested. Requirements for laboratory accreditation will be tested also.
Echo physics is the Achilles heel of most people sitting the exam and the most cause for concern in people who have just taken the test wishing they had done more of it.
My advice is for test takers is to do as many questions as possible – although echo physics can be annoying, there are a finite number of questions that can be asked.
The use of echocardiography in physiologic assessment is extremely important and tested vigorously.
Valvular Heart Disease for the echocardiography board exam:
All 4 valves, aortic, mitral, pulmonic and tricuspid. The aorta and the sub-aorta will be tested. Echocardiographic assessment of prosthetic heart valves will be tested. Infective endocarditis will be tested. There is an expectation to understand regurgitant jet dynamics and also echocardiographic assessment of pulmonary hypertension.
Chamber Size and Function for the echocardiography board exam:
In this section there is an expected working knowledge of stress echocardiography and its applications. Assessement of chamber size and function and also evaluation of cardiomyopathies. Both systolic and diastolic function will be tested. Vena cava, atrial and ventricular septum, coronary sinus and coronary arteries are included here.
Congenital Heart Disease for the echocardiography board exam:
This includes the anatomy and nomenclature of congenital heart disease and the post operative evaluation of these conditions. Coronary artery anomalies and their associations are also tested as well as fetal echocardiography.
Cardiac Masses, Pericardial Disease, Contrast and New Applications for the echocardiography board exam:
This tests pericardial disease, cardiac masses and tumors. The role of contrast in assessment of perfusion. The role of echocardiography in disorders of chamber evaluation, cardiac conduction disease and rhythm disorders. The role of echocardiography in cardiac transplantation.
Miscellaneous Topics: This includes heart failure assessment. Quality in the echocardiography lab. The role of the digital lab. The role of echocardiography in interventional cardiology such as the TAVR procedure and Mitraclip procedure. Cardiac trauma. Identification of ageing, athlete’s heart and pregnancy as it relates to echocardiography.
Comments on Echo Boards
Most people that take the echo boards come out of the exam and feel they have done terribly. Many test takers, particularly cardiologists feel that the exam does not have enough clinical relevance and there is an overemphasis on physics and technical aspects that have little to do with practical echo application. Having said that the rate of passing the echo board examination is around 80%.
Echo Board Resources
Echo Board Study, echoboardstudy.com
This is an online resource and question bank, easily navigable and entirely dedicated to the echocardiography board exam. This is our recommended resource for those taking the exam.
Advantages: Dedicated to exam, cost effective, clearly explained answers, simulates exam experience similar to the format of the board exam, >500 questions
Disadvantages: None significant
Cost: Starts at 100 dollars
CME credits: Pending
Currently registration allows a user to take a free practice quiz online (10 questions); answering all 10 questions correctly provides a free limited access pass to a large portion of the site.
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Clinical Echocardiography Review
Echo review Book, 1000 self assessment questions with answers
Advantages: Reportedly the best when it comes to learning echo physics
Disadvantages: cost, book format
Cost: Around 175 dollars
Reviews: People online seem to rate this the best for echo physics
CME credits: No
ASCeXAM/ReASCE Review Course
This is an echo board review course by the ASE.
Advantages: Dedicated to the echo board exam, comprehensive agenda.
Disadvantages: 4 days, costs around 1000 dollars making it expensive
Cost: Around 1000 dollars
Reviews: Limited
CME credits: Yes, Category A
ASCeXAM/ReASCE Online Practice Exam Simulation.
Online echo board exam simulation by the ASE.
Advantage: Online exam, relevant questions
Disadvantage: Only 300 questions.
Cost: 200-250 dollars for 18 weeks access
Reviews: Limited
CME credits: Not stated
Questions, Tricks, and Tips for the Echocardiography Boards
Study guide for the echo board exam in the form of a book.
Advantage: >500 questions
Disadvantage: Mainly book format
Cost: 100 dollar range
Reviews: Decent reviews online
CME Credits: None
Mayo Clinic Echo Board Review
This is an echo board review course by the Mayo Clinic.
Advantages: Dedicated to the echo board exam, comprehensive agenda.
Disadvantages: 4 days, costs around 1000 dollars making it expensive
Cost: Around 1000 dollars
Reviews: Limited
CME credits: Yes, Category A
Board Vitals Online Review
Echocardiography board review question bank online.
Advantage: Online exam, >400 questions
Disadvantage: Limited testimonial
Cost: 100-350 dollars
Reviews: Limited
CME credits: Possible
Echocardiography Board Review: 400 Multiple Choice Questions
Book based MCQ’s with CD
Advantage: 400 questions
Disadvantage: Book based
Cost: 60 dollars
Reviews: Mixed
CME credits: No
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