BEST PRACTICE GUIDELINE – COMPETENCY LEVELS

A. The basic obstetric scan.

Proposal for list of practitioners with sufficient skill and competence to perform a basic obstetric scan:

 All practitioners deemed competent in performing a fetal anatomy survey

 Qualified Obstetrician

 Qualified Radiologist

 MBChB or Radiographer who holds a “Certificate of Competence in the Basic Obstetric scan” of one of the South African Universities or SASUOG accredited courses.

B. The fetal anatomy survey.

Proposal for list of practitioners with sufficient skill and competence to perform a screening fetal anatomic survey:

1. Obstetrician or Radiologist who

 holds the Certificate in Maternal and Fetal Medicine (except when by grandfather clause in maternal medicine) OR

 holds the Certificate of Competence in the 18-23 weeks scan by the Fetal Medicine Foundation, UK OR

 holds the Diploma in Fetal Medicine by the Fetal Medicine Foundation, UK OR

 holds the virtual fetal medicine fellowship, Spain (Barcelona) OR

 has a letter of recommendation from the Head of the obstetric ultrasound unit in one of the academic institutions in SA certifying competence

2. MBChB who performs at least 200 of such scans (on different patients) per year AND regularly attends educational meetings in obstetric ultrasound (at least 5 CPD points in 2 years) AND

 holds the Certificate of Competence in the 18-23 weeks scan by the Fetal Medicine Foundation, UK OR

 holds the Diploma in Fetal Medicine by the Fetal Medicine Foundation, UK OR

 holds the Australian Diploma of Medical Ultrasound OR

 holds the virtual fetal medicine fellowship, Spain (Barcelona) OR

 holds a Diploma or MSc in one of the courses in Obstetric Ultrasound accredited by the Consortium for the Accreditation of Sonographic Education (UK) OR

 has a letter of recommendation from the Head of the obstetric ultrasound unit in one of the academic institutions in SA certifying competence, after having worked the equivalent of at least 2 years full-time in such unit OR

 holds the “Certificate of Competence in the Detailed Fetal Anatomy scan” of one of the South African Universities or SASUOG accredited courses

3. Radiographer, registered with the Health Professional Council of South Africa as a Sonographer, who performs at least 200 of such scans (on different patients) per year AND regularly attends educational meetings in obstetric ultrasound (at least 5 CPD points in 2 years) AND

 holds a BSc or BTec in Ultrasound by one of the SA Universities of Technology OR

 holds a National Diploma in Ultrasound by one of the SA Universities of Technology

C. Specialised assessment of the fetal anatomy and wellbeing in pregnancies at high risk of fetal pathology, including when prior screening results (ultrasound or otherwise) suggest an abnormality.

Minimum requirements for this level of scanning include:

 FMF accreditation in first trimester screening, not limited to NT assessment but including detailed first trimester anatomical assessment, accreditation in NB, TR and DV and skilled in the interpretation of serum screening results

 Predominantly practising obstetric ultrasound and fetal medicine

 Substantial exposure to and extensive knowledge and experience in fetal medicine

 Expertise not only in the ultrasound diagnosis of a wide range of gross and subtle fetal anomalies, but also in the diagnostic workup and management of pregnancies with complications due to anomalies, multiple pregnancies, placental dysfunction, etc.

 Regular and extensive CPD activities in obstetric ultrasound and fetal medicine

Proposal for list of practitioners with sufficient traning, skill and competence in Fetal Medicine and capable of dealing with referrals from colleagues:

 Subspecialist in Fetal Medicine

 Obstetrician or MBChB with the Diploma in Fetal Medicine, Fetal Medicine Foundation, UK or the virtual fetal medicine fellowship, Barcelona

 Obstetrician or MBChB with extensive experience in the field, recognised by peer-review by SASUOG council

 Obstetrician or MBChB with a letter of recommendation from the Head of the obstetric ultrasound unit in one of the academic institutions in SA certifying competence, after having worked the equivalent of at least 2 years full-time in such unit.

Practitioners who work in this fields and believe their training and expertise is equivalent to the criteria described above, are welcome to submit their CV to SASUOG for peer-review and possible recognition.