EACVI Certification in Adult Transthoracic Echocardiography (TTE)

Exam

Eligibility

The EACVI TTE written examination is open to all healthcare professionals involved in adult transthoracic echocardiography. Sonographers and doctors of all disciplines can apply for certification in TTE.

The EACVI TTE Certification is not a compulsory or regulatory certificate of competence or excellence. Individuals' rights to report and sign clinical studies in individual countries remain to be defined by national laws and regulations.

Exam format

The EACVI TTE examination is a multiple-choice written examination in English.

The examination consists of 125 questions, divided into two parts:

• Part 1 - Reporting: 50 questions on TTE cases with displayed echoes
• Part 2 - Theory: 75 questions

The first part is administered in 1 hour and 30 minutes and the second part is administered in 1 hour 50 minutes, with a 10-minute break in-between. 

Questions are designed to assess the candidate's knowledge:

• Based on a clinical scenario
• Five options with only one single best answer. 
• No negative marking

Questions are drawn from the entire spectrum of transthoracic echocardiography. 

Exam date and delivery

The EACVI TTE examination is usually delivered twice a year, using an online proctoring platform (CYIM/ProctorU^®).

This provides candidates with the safety and convenience of an online platform while retaining the integrity and quality of an on-site supervised exam.

The online format of the EACVI TTE exam is:

• Accessible anywhere in the world.
• Taken on the candidate’s device (computer only) and monitored by a human proctor online through ProctorU^®.

More information is available.  

Exam Preparation

The EACVI TTE exam is designed to test a wide range of transthoracic echocardiography knowledge. 

There is no single source from which all questions are developed, and candidates are encouraged to read widely, including but not limited to:

• A.E. Weyman, Principles and Practice of Echocardiography, 2nd ed. 1994, Lea & Febiger.
• H. Feigenbaum, Echocardiography, 5th ed. 1994, Lea & Febiger.
• C. Otto, The Practice of Clinical Echocardiography, 4th ed. 2012, Elsevier Saunders.

You can also visit the EACVI educational area.

This section includes information about education-related matters such as:

• Cardiovascular Imaging Recommended Reading
• EACVI webinars (live, online seminars)
• Educational and preparatory courses organised by, or in collaboration with, the EACVI
• EACVI core syllabus
• EACVI textbooks and an ESC textbook on imaging 

Exam results

To be successful, a candidate must pass both sections of the written exam (reporting and theory). 

The passing scores for each section of the exam are established using referenced methodologies, that are widely used in certification. The passing score links the score required to pass the exam to the minimum level of knowledge required for transthoracic echocardiography practice.

Following the exam, psychometric analysis of the questions is conducted and items that do not meet psychometric standards are removed from the exam. In addition, any items that have been flagged during the exam administration are reviewed and if these items are deemed to be defective for any reason they are removed from the exam.

Results are subjected to multiple levels of verification before being reported to candidates.

Examination results are communicated to candidates in the eight weeks after the examination.

Candidates will receive an email containing their results letter on the date of the result release. Successful candidates for the exam will also receive a certificate of completion of the written exam.

The candidate’s results are also made available through the candidate’s My ESC account.  

Note:

Borderline candidates (candidates who succeeded in one section and failed the other one by one point) are considered with the greatest attention by the EACVI TTE Certification Committee and the rule is very strict for these candidates. The candidate needs to have more than the average of all candidates in the section he/she passed. In that case, candidates are passed by the decision of the EACVI TTE Certification Committee. 

Appeal

The ESC/EACVI aims to deliver examinations of the highest quality and provide the best level of service for all candidates. To ensure that all candidates are assessed fairly, there is a procedure to allow candidates to appeal against their exam results.

More information is available.

Policies for Online Proctoring Examinations

For more information, please refer to the ESC online proctoring examination terms and conditions. 

Logbook

Once candidates have passed the exam, they can then apply for the logbook part of the programme to prove their practical experience in the TTE field. No late submissions will be accepted and, if the deadline is not respected, the candidate will have to repeat the exam to apply for certification.

Eligibility

The EACVI TTE logbook part of the programme is accessible to all successful candidates for the exam. 

Access to the logbook platform is granted to candidates only after having successfully passed the written exam.

Mutual recognition

EACVI has established a reciprocity agreement with the below societies:

• British Society of Echocardiography
• Austrian Working Group of Echocardiography
• Working group on echocardiography and imaging modalities in cardiology, Croatian Cardiac Society

Individuals with a valid TTE certification with one of these societies have only to pass the corresponding EACVI exam and do not have to submit a logbook to be fully EACVI certified.

How to claim for mutual recognition?

After having passed the TTE exam, the candidate needs to use the Contact Us form to claim for mutual recognition. The candidate has to provide a copy of his/her national individual certification diploma/certificate (the national individual certification needs to be valid when claiming mutual recognition). 

Requirements

Candidates are required to provide evidence of their clinical experience.

Candidates must provide the following documents:

• A signed supervisor letter documenting the training and review of studies undertaken by the candidate. 
• A logbook of 250 cases assessed and signed by the candidate's supervisor.
• 6 TTE cases following requirements defined by the certification committee.

Note:

• The full 6 cases presented in the logbook must have been conducted under the care of the candidate and accompanied by the original clinical reports that the candidate wrote in their place of practice. 
• Several measurements should be included to indicate the workings and outcome of each case. Findings in the report must be supported by relevant measurements and Doppler-derived data.
• A comprehensive conclusion should be included.

Important:
Reports are judged on completeness and accuracy, meaning the reports should match the uploaded images, and there should be no errors of interpretation or omission. 

Logbook regulations

Not complying with the below regulations will result in the logbook being returned to the candidate for modification and as such, delay the grading process.

• The application must be submitted in English or one of the available languages. Any document in the local language must be accompanied by an English translation. 
• The application must be anonymised (the candidate's name should not appear in the application)
• The application must not include any patient data, to comply with GDPR. Nevertheless, it is important to be precise with other details, such as the age and sex of the patient.
• The application must be submitted no later than 1 year after having received the exam results. 
• Cases included in the logbook must have been collected from one year before to one year after the written exam and must cover only 12 consecutive months.
• Each patient may be present only once in the logbook. It is not allowed to add multiple studies of the same patient. 

Candidates are not asked to submit the full reports, although they may be requested by the EACVI TTE graders and EACVI TTE certification committee. Thus, candidates are asked to keep this information available. 

Supervisor

There are no specific requirements to be a supervisor for the EACVI TTE logbook. The supervisor does not need to be EACVI TTE certified, and the candidate doesn’t need to upload any documentation regarding the supervisor’s qualifications. The supervisor should be the person supervising the candidate’s work, possibly the person who taught the candidate how to perform the procedures and should be experienced in the field. The supervisor needs to provide a letter of support and also sign off on the logbook, certifying the accuracy of the application content and that the candidate has done all the procedures listed in the logbook.

Logbook results

As soon as the logbook is compliant with the requirements, the application is sent for grading to members of the EACVI TTE Certification Committee. Graders may require additional information from the candidate to provide their grading. 

Results are sent by email within 3 months of submitting the e-Logbook. Please note that some delays in grading can occur due to the high volume of applications received throughout the year. 

Appealing the logbook

Candidates who fail to do the logbook part may raise an appeal.

More information is available. 

Extension requests

There is a one-year window to complete the logbook part of the programme. In exceptional circumstances, candidates may request an extension to submit their application.

To ensure the process remains fair and robust, extensions will generally only be given in the following circumstances: parental leave, less than full-time work or illness of the candidate.

Extension requests must be accompanied by a signed letter from your supervisor briefly explaining the situation and stating the duration of the extension required. Requests cannot be considered without this letter. The request must be submitted before the deadline.

Please note that extension requests are not guaranteed and are reviewed on a case-by-case basis by the certification committee.    

Use the Contact Us form to submit such requests and further information.

Recertification

Candidates will be granted certification in TTE once they have completed the two parts of the programme (exam and logbook). The certification is valid for 5 years after which the candidate must apply for recertification to keep the certification valid. 

Requirements

For more detailed information, please refer to the recertification requirements webpage.

Recertification fee

• Non-members and EACVI Associates: €200 (excluding VAT)
• EACVI Silver Members: €75 (excluding VAT)

How to apply?

Candidates must apply for recertification from six months before to six months after the current certification expiration date.

During this time, candidates who are eligible for the recertification will receive automatic reminders to apply for recertification. These reminders are sent to their My ESC account email address.

All candidates will be reminded as the deadline approaches, but it is the candidate's responsibility to ensure that the recertification is submitted on time. No late submissions will be accepted and, if the deadline is not respected, the candidate will have to repeat the certification process (exam + logbook) to recertify.

If all requirements of recertification are met, a certificate will be issued which will be valid for a further 5-year period.

Extension requests

There is a one-year window to apply for recertification (from six months before to six months after the current certification expiration date). In exceptional circumstances, candidates may request an extension to submit their application.

To ensure the process remains fair and robust, extensions will generally only be given in the following circumstances: parental leave, less than full-time work or illness of the candidate.

Extension requests must be accompanied by a signed letter from the candidate's supervisor briefly explaining the situation and stating the duration of the extension required. Requests cannot be considered without this letter. The request must be submitted before the deadline.

Please note that extension requests are not guaranteed and are reviewed on a case-by-case basis by the certification committee.    

Use the Contact Us form to submit such requests and further information.

Certification result and list of certified candidates

Candidates will be granted certification in TTE once they have completed the two parts of the programme (exam and logbook). The certification is valid for 5 years after which the candidate must apply for recertification to keep the certification valid. 

The EACVI is pleased to list all their TTE certified candidates.