About Our Fellowship

In the dynamic field of Emergency Medicine, the quest for newer technology that is faster, less expensive, and less harmful has made emergency ultrasound a necessity to all providers of emergency medicine. The emergency ultrasound (EUS) fellowship at Kaiser Permanente in San Diego brings together this imaging modality to a health system that specializes in providing smart and cost-effective medicine. 

Kaiser Permanente in San Diego, California started an Emergency Ultrasound Fellowship in July 2015. Fellows will have the opportunity to work in San Diego’s highest volume emergency department, with over 130k annual visits including 15k pediatric patients annually. They will also teach the residents of the PGY1-3 EM program as well as rotating students, faculty, and nurses.

EUFAC accredited: Yes (as of 4/26/2021)

Length of Fellowship: 1 year

Salary: $100,000 plus benefits and 4 weeks of paid vacation, $1500 Educational fund for travel to ultrasound conferences and educational expenses related to ultrasound

Number of Clinical Hours: Two, 10-hour clinical shifts per week (all in the ER, none in urgent care or alternative sites)

Other Duties: Teaching EM residents, medical students and faculty through didactics, bedside teaching and ultrasound courses. Later in the fellowship, fellows will also be expected to do scan review of the residents. During the course of the fellowship, the fellow is expected to develop an ultrasound research project.

Number of Sites: 2 (both in central San Diego)

Number of Positions per year: 2

Additional Opportunities: Fellows will have the opportunity to lecture and teach hands-on at local and regional ultrasound courses. Moonlighting opportunities are ample within the department but you can also moonlight externally if you choose.

Educational Experience: Primary ultrasound education is done by the ultrasound faculty. This is done through scanning shifts, scan review, didactics and journal club. Vascular labs and echo lab time is available in the hospital if desired. TEE will be learned in the sim lab before use in the ER and practice can be done with cardiology in the ICU/DOU/outpatient.

Deadline for fellowship application: Rolling

Fellows chosen: NRMP Match Date

Ultrasound Machines: 11 Zonare, 4 Butterfly, 6 Vscans

Ultrasound Probes: TEE, Curvilinear, phased array, endocavitary, linear (standard L10, high frequency L20 and hockey stick L14)

Image Recorder: Qpath

FELLOWSHIP DIRECTOR

Dasia Esener, MD, MS

EM Residency: Tufts University/Baystate Medical Center

Years in Position: 8

Prior National Positions:

Co-chair of ACEP Ultrasound Section Fellow subcommittee

Current Co-Editor for Sonoguide.com

FELLOWSHIP GRAD REQUIREMENTS

1. Is the EUS fellow required to perform >1000 ultrasound examinations during fellowship? YES

2. Is the EUS fellow required to design at least one research project to be submitted to the home site institutional review board, and commence the project and data collection during the course of the fellowship? YES

3. Is the EUS fellow required to submit at least one abstract as first author and presenter to a national meeting such as ACEP, SAEM, or AIUM during fellowship? YES

4. Is the EUS fellow required to be involved with at least one other ultrasound research project during fellowship for which publication is planned with the fellow as an author? YES

5. Is the EUS fellow required to be involved with various administrative and quality assurance duties including but not limited to internal billing audits, interdepartmental meetings, and monitoring of the credentialing process of colleagues? YES

6. Is the EUS fellow required to prepare and deliver lectures to the department (faculty, residents, medical students, other health care providers) on at least four separate basic emergency ultrasound applications? YES

7. Is the EUS fellow required to show at least 20 hours per month of hands-on teaching of residents and or other faculty in bedside emergency ultrasound? (This includes but is not limited to didactic lectures, bedside teaching, research involvement of residents or faculty, and QA education.) YES

8. Is the EUS fellow required to attend one national emergency ultrasound organization meeting during the year? YES

RESIDENT EDUCATION EXPERIENCE

Average Number of US: 750 scans

Is there a dedicated US month? Yes, two 2 week rotations as an intern and scan sessions throughout residency as well as yearly refresher courses and lectures

Is there an US elective? Yes

Number of Residents who went on to become US fellows: None thus far, first class of residents graduated June 2017

Number of hours Hands-on (i.e. scan shifts): Outside of ultrasound rotations, each resident does 2-3 scan sessions with faculty per year (4 hours each). During the ultrasound rotations they do three to five 4-hour sessions with the faculty or fellows per week.

Number of hours Image Review: 4.5 per week on rotation

Number of hours didactics: 2 day intro course as interns and didactics throughout year

Other Information: All residents expected to reach 400 scans by end of residency (some have reached up to 1400). Many have reached that or are close by the end of intern year. Many also select advanced ultrasound for their electives throughout the R2 and R3 years.

ULTRASOUND PROJECTS

Outside Lectures

Many lecturing/teaching opportunities available and vary by year but include the yearly ACEP Scientific Assembly ultrasound workshops, Naval Medical Center Point-of-Care Ultrasound Course, CalACEP ultrasound course, Rady Children's Hospital Pediatric EM course and the annual Kaiser Permanente National Conference. Most fellows also lecture at international ultrasound courses.

Internal Lectures

Weekly residency conference

Ultrasound Courses

-Resident Introductory EUS course

-ACEP Critical Care Ultrasound Workshop
-Yearly faculty ultrasound course
-Advanced faculty ultrasound course
-RN vascular access course
-Internal medicine ultrasound course
-Medical student ultrasound course

Unique experiences

-Sonolympics (regional residency competition)
-SURF Conference (Southwest Regional EUS fellowship management conference)

Memorable Moments