The Yellow Brick Road
Christopher J. Gallagher
(This chapter is included as a kind of time-capsule of how we thought 9 years ago. I make reference to “buying tapes” which is laughably ancient.)
1. Go ye to the “Comprehensive Review of Intraoperative Echocardiography” meeting. It’s held each year in February. For the next 5 years or so it will be held in San Diego. There are other echo meetings, including a quite similar review held in Atlanta in September every year. (The talks and speakers are similar at the meetings.) Both meetings are a little pricey but they are worth it! If you are considering taking the PTEeXAM, it’s worth remembering that the same people who make up the exam give the lectures at the meeting. So figure it out, Sherlock. Need info? Go to the Society of Cardiovascular Anesthesiology website (www.scahq.org).
2. Do as much hands-on echo as you can at your hospital. Go to the echo lab. Ask if you can see some old tapes and go over them with a cardiologist. The more you DO, the more you LEARN. This has not changed in 9 years.
3. Look at the content outline of the PTEeXAM and see if you know the subjects listed. That list is waiting for you at www.echoboards.org/pte/pfoutline.html.
4. Buy the complete set of tapes from the 2002 “Comprehensive Review” meeting. It’s pricey (over a thousand smackers), and lengthy (25 tapes, each about 2 hours long), but it’s all there. Maybe get your department to buy a set of the tapes? Anyway, they are invaluable, full of great lectures, and all the TEE movies are reproduced clearly on the tapes. All in all, a good investment. Order them through CME Unlimited (phone: 800-776-5454 or 760-773-4498; fax: 760-773-9671; website: www.CMEunlimited.org). Note: There are much more current reviews online now. And like so much else, a lot of these reviews are FREE. It is impossible to keep current, so google away and see what is out there.
5. If your pockets aren’t that deep, buy the syllabuses from the meeting. There are two, one from days one through three of the meeting, and one from days four through six of the meeting. You can order them ($35 for one, $60 for the pair) from the Society of Cardiovascular Anesthesiology (phone: 804-282-0084; fax: 804-282-0090; E-mail: sca@societyhq.com; website: www.scahq.org). Tons of material from my studying and for this book came straight from those syllabuses.
6. Get a hold of the book most people use to study for the TEE exam, Textbook of Clinical Echocardiography, by Catherine M. Otto. (W. B. Saunders, 2000; ISBN 0-7216-7669-3). When I talked to a sales representative at the TEE meeting in 2003, he confirmed what others told me—Otto has it all. (Between Otto and those syllabuses, you’ll have all the “book reading” you could possibly need). Since then, a million more books have come out. Look for books by Savage and Perrino, among others.
7. Get the 2-CD set TEE: An Interactive Board Review on CD-ROM, edited by David S. Morse and C. David Collard (Lippincott Williams & Wilkins, 2002; ISBN 0-7817-3375-8). This has a series of TEE movies with attached tests. The tests are multiple choice (like the PTEeXAM). Once you’ve taken the test, you can check your answers. Best of all, each answer comes with a complete explanation along with references.
8. Another good CD is TEE on CD: An Interactive Resource, edited by Steven N. Konstadt and Navin C. Nanda (Lippincott Williams & Wilkins, 2001; ISBN 0-7817-2629-8). This CD does have a lot more text than the Morse and Collard CDs, and it is tough to scroll text for a long time on a computer.
9. More CDs? You bet. Since echo is a moving image, it makes sense to get CDs that show TEE images moving. Look on amazon.com; at last count, there are 30-something books on transesophageal echocardiography, lots with accompanying CDs. Robert Savage himself (a Big Kahuna in echo circles and organizer of the big TEE meeting) will have a big book coming out soon, so snap it up!
10. A great book fresh off the press and specifically made for transesophageal echocardiography is A Practical Approach to Transesophageal Echocardiography, edited by A. C. Perrino and S. T. Reeves (Lippincott Williams & Wilkins, 2003; ISBN 0-7817-3638-2). The second editor of this book is a fellow who talked at the big TEE conference in San Diego, Dr. Scott T. Reeves. Great speaker! Funny stories! Knows how to get his point across crystal clear and that’s just what he and his co-editors did in this book. (If you’re short on dough, buy their book, put mine back on the shelf, and use the money you saved to buy a gyro. Then eat the gyro while you’re reading Perrino and Reeves’ book—but don’t spill the cucumber sauce all over the pictures). And yes, they have updated versions since then.
You have a long path ahead of you. No lions and tigers and bears, but plenty of stuff to learn.
Guess what, (2) is still most important—get as MUCH hands on TEE work as you can.
