Fellowship Prerequisites:

  1. You must have prior "basic" Point of Care Ultrasound Training and proficiency. 
    This does not have to be sophisticated training or recent! Common one-day courses such
    as "HOUSE", "EGLS", "EDE1" or "EDE2" are sufficient.  Also, reasonable volumes of informal training & practice during residency will suffice too - contact us to enquire.

    ➤ You must to be familiar with how to hold a probe and operate the machine at a basic level. E.g. if "fan the probe" or "reduce the gain" are mysterious terms, please obtain further introductory training in basic Point of Care Ultrasound prior to applying.  
  2. Have your own personal Ultrasound Hardware.
    See the Recommended PoCUS Hardware section below.  In order to be successful in this program it is crucial you have the opportunity to scan wherever and whenever you are practicing clinically.  Access to hospital-based machines (only) is insufficient for successful completion of the program. Contact us if you have questions.     
  3. A fast and reliable internet connection for virtual meetings.
    We've broken down a lot of traditional barriers in creating a virtual-delivered ultrasound fellowship, however we depend completely on the internet to make this happen.    Large parts of rural Canada still struggle with robust connectivity, but happily satellite-based internet is now available, and so a robust internet connection is possible no matter where you live. 

    Note: Several of our fellows have switched to satellite internet in order to accommodate their studies.
  4. A passion for Point of Care Ultrasound
    and a strong desire to commit to regular [near-daily] scanning throughout the course of the year. 

    ➤ We ask fellows to target a minimum of 20 scans per week.
    Note: this is not 20 different patients.  Rather, multiple windows on the same person such as: RUQ, LUQ, Pelvis & Sx views as part of a trauma assessment, each count as one "scan".     

    ➤ Realistically, plan to spend ~ 10 hours per month on self study, plus a minimum of 1-2 hours per week of scanning, mixed in amongst your usual clinical activities. 

Recommended PoCUS Hardware:

The Rural Ultrasound Fellowship works hard to stay up to date on the latest "personal" ultrasound hardware (sized to fit in your bag).   We can only recommend hardware which is approved by HealthCanada, but for international fellows there could be other great options to consider.

Disclosure: The Rural Ultrasound Fellowship does not receive payment or gifts from any external source.  Our employees or faculty members who concurrently work with industry players or have other identified conflicts of interest, are not permitted to contribute our PoCUS Hardware recommendations below. 

Whatever device you choose, the Rural Ultrasound Fellowship requires you have access to your own device in every clinical location, and at all times.  We do NOT want you to rely on occasional access to a hospital machine (often with limited probe selection or other missing features.) 


Note:  all probes below are listed as having 3 year warranties, which realistically will be the life expectancy of a handheld probe during this era of rapid ultrasound advancement. 

last updated: 10 Sep 2024
Butterfly iQ+

3 probes in 1.
~$4,030 CAD + $290-600/year (conditional)*

☙ 2nd generation probe 

☙ All-in-one probe: no need to carry 3+ separate probes. Butterfly's microchip technology permits one probe to do the scanning of all three most common probes. (i.e. linear, curvilinear, phased)

Proprietary features / modes available only on Butterfly: Bi-Plane®, Needle-Viz® and smart-algorithms to rapidly calculate bladder volume or ejection fraction, etc.

☙ Robust compared to legacy technology: Butterfly is sturdy (its 4-foot drop tested.) That equates to peace-of-mind when moving your equipment between ER & clinic or using it during a busy shift.

☙ Full suite of advanced features (seldom available on hospital-based machines) including Pulsed-Wave Doppler, Needle Enhancement and others.

☙ Secure Butterfly Cloud Storage making it easy to store, share & review scans with your professors and co-fellows. Auto-cataloguing your scans is especially helpful during the fellowship training.

☙ Realtime virtual scanning is possible. i.e. connect virtually, in real time with a fellowship faculty member. We will see your images and can provide live feedback as you scan. 

☙ Corded.  Not sure if this is an asset or liability! (Bluetooth connections can be fickle and often delay startup, but cords can get caught and wound up or break.)    

Our thoughts:  At the price point, you cannot beat the rich feature set and reliability of a Butterfly iQ+. 

The resolution is not as good as the other more expensive models, but iQ+ offers sufficient resolution for intermediate and early advanced scanning.  Anticipate bumping up against the ceiling of B-mode resolution as you progress in the program.  Transition from the iQ+ to a quality, feature rich and well maintained cart-based system would be ideal for the second half of the fellowship, if selecting this personal probe. 

* The Rural Ultrasound Fellowship presently carries an medical education subscription which saves our fellows the annual subscription fee required to access all advanced features. 

Butterfly iQ3

3 probes in 1.
~$5,299 CAD + $290-600/year (conditional)*

☙ Latest (3rd) generation 

☙ All-in-one probe: no need to carry 3+ separate probes. Butterfly's microchip technology permits one probe to do the scanning of all three most common probes. (i.e. linear, curvilinear, phased)

Proprietary features / modes available only on Butterfly.  In addition to iQ+ features of Bi-Plane® and Needle-Vis®: this model also has iQ Slice® technology.   

☙ Same advantages as iQ+ in terms of Robustness / drop testing, Full suite of advanced features, Secure Butterfly Cloud storage and sharing and Realtime virtual scanning.  

☙ Same comments about probe being corded (not wireless), as iQ+

Our thoughts: Butterfly iQ3 offers more detailed resolution (as good as some cart based machines in most applications). 95% of Rural scanning is in B-mode.  Users argue whether Butterfly iQ3, Clarius or GE VScan Air has better resolution. (It typically depends on the application.) All three have improved resolution over Butterfly iQ+, however at the Point of Care level, this may not translate into a clinical advantage very often. 

Like its predecessor, iQ3 offers even more proprietary features than even cart-based machines.   While these bells and whistles are interesting, and in occasional circumstances helpful, they are not of major importance when learning / practicing comprehensive bedside ultrasound. 

The largest drawback is price point.   If you have access to a quality cart-based machine(s) with a full suite of features, which is well-maintained (prioritized) by your facility and available across all of the locations you practice in, contemplate the less expensive iQ+ model for learning and occasional home-visits etc. 

However if you do not have quality cart-based equipment in all of your practice locations, investing in the more expensive iQ3 (or Clarius or VScan-Air)  for superior B-mode resolution is recommended.

* The Rural Ultrasound Fellowship presently carries an medical education subscription which saves our fellows the annual subscription fee required to access all advanced features. 

Clarius

Sold as single probes. (Ideally fellows have all 3.) 
~$3,595 USD per probe + $595/year*

☙ Single probe function only: thus Fellows would need to carry at least  2 separate probes (linear + curvilinear), possibly 3 (+ phase array) to get full cardiac echo functionality   

☙ Full suite of advanced features (seldom available on hospital-based machines) including Pulsed-Wave Doppler & Needle Enhancement

☙ Secure Clarius Cloud Storage making it easy to store, share & review scans with your professors and co-fellows. Auto-cataloguing your scans is especially helpful during the fellowship training.

☙ Realtime remote ultrasound support is possible. i.e. connect virtually, in real time with a fellowship faculty member. We will see your images and can provide live feedback as you scan.  

☙ Cordless. Not sure if this is an asset or liability! (Bluetooth connections can be fickle and often delay startup, but cords can get caught and wound up or break.)


Our thoughts: Clarius offers more detailed B-mode resolution, (as good as some cart based machines in most applications).  95% of Rural scanning is in B-mode.  Users argue whether  Butterfly iQ3, Clarius or GE VScan Air has better resolution.  (It typically depends on the application.)  All three have improved resolution over Butterfly iQ+, however at the Point of Care level, this may not translate into a clinical advantage very often. 

Clarius offers a full feature set including PWD, thus it would be a great tool for full Fellowship learning, especially if you do not have access to a quality / full feature set cart-based machine to practice with. 

The bluetooth connectivity can be irritating for both Clarius & GE VScan Air.  Users of both devices offer conflicting opinions of which brand's connection is more stable: no clear advantage for either. 

The largest drawbacks of Clarius are the price and the need to carry / switch between multiple probes.  (An important consideration for the Rural Ultrasound Fellowship curriculum.) 

*Other pricing options exist, see website for details. 

GE VScan Air CL

3 probes in 1.
~$6,600 CAD
(no mandatory subscription) 

☙ Three-in-one probe: no need to carry 3+ separate probes.  (One end of your probe is Linear, the other is Curvilinear / Phased Array combined.) 

☙ Robust.  Drop tested to Military Standards & Waterproof. That equates to peace-of-mind when cleaning your device or moving your equipment between ER & clinic or using it during a busy shift.

Best in class for B-mode imaging, which represents 95%+ of imaging mode used in most Comprehensive Rural Applications.   Colour-mode available but M-mode & Pulsed Wave Doppler are not available at this time. 

☙ Secure GE Cloud Storage is under development but not available at time of last update. 

☙ Cordless. Not sure if this is an asset or liability! (Bluetooth connections can be fickle and often delay startup), but cords can get caught and wound up or break.)  

Our thoughts:  VScan Air offers more detailed B-mode resolution, (as good as some cart based machines in most applications). 95% of Rural scanning is in B-mode. Users argue whether Butterfly iQ3, Clarius or GE VScan Air has better resolution. (It typically depends on the application.) All three have improved resolution over Butterfly iQ+, however at the Point of Care level, this may not translate into a clinical advantage very often.

VScan Air's drawbacks are in its feature set (does not offer M-mode or Pulsed-Wave Doppler).   Many cart-based hospital systems do not offer PWD either, and thus lack of access to PWD during your fellowship will deprive you from learning a small but signifiant part of the advanced fellowship curriculum.   (PWD can be extremely useful in select Rural applications.)   Cardiac scanning is awkward due to the larger curvilinear footprint of the probe. 

The bluetooth connectivity can be irritating for both Clarius & GE VScan Air. Users of both devices offer conflicting opinions of which brand's connection is more stable: no clear advantage for either.

GE VScan Air is a solid choice for someone who knows they will not need PWD (or has access through another device), and who can afford the extra capital expense. 


Is there another personal ultrasound option that we have missed? 
 Do you disagree with any of our recommendations?   
Let us know!


Learn more about the Rural Ultrasound Fellowship:

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Rural Ultrasound Fellowship is a CPD program operated by Community Health Network Ltd.
This Group Learning program has been certified by the College of Family Physicians of Canada for up to 52 Mainpro+ credits.
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