Page 79 - Journal of Special Operations Medicine - Spring 2016

SOLCUS program curriculum. With the success within USASOC and each of the three Emergency Ultrasound
the 3rd SFG and exposure to the remaining SFGs, in- Fellowships. In essence, the SOLCUS Ultrasound MOA
terest in the battlefield applications of this technology stated that each SFG would pay the TDY costs for the
began to accelerate, and with it came a number of new instructor to teach the SOLCUS curriculum and the Fel-
challenges. How would the program expand beyond lowships agreed to provide enough qualified instructors.
the initial training provided by the ultrasound purchase This MOA is still in effect and follows a regular review
agreement? It was unclear whether the USASFC would cycle to update as needed.
have to contract for additional ultrasound training for
the SFGs, and who would provide that training. In addition to teaching in the SF BNs, the SOLCUS
program was presented to the future medics in train-
Casting a Wide Net ing. The Special Warfare Medical Group (SWMG), as
As the USASFC Surgeon’s office expanded and delin- part of the US Army John F. Kennedy Warfare Center
eated its duties and responsibilities outside of USASOC, and School, was responsible for training future medics.
ultrasound became a major beneficiary. The USASFC COL Robert Lutz, MD, was the medical director at the
Surgeon, LTC Andrew Landers, MD, insisted on devel- time. He was very receptive to the idea of training the
oping and expanding the ultrasound training to include future 18D in the use of ultrasound. COL Lutz, LTC
every active and reserve SFG. I was brought on to lead Landers, and the USASOC Surgeon, COL Peter Benson,
that effort and I turned to the military’s point-of-care ul- facilitated the inclusion of the SOLCUS program within
trasound experts to gain experience and exposure, and the SWMG. The SOLCUS program was split to allow
to find solutions for program expansion. the Special Operations Combat Medic (SOCM) to learn
the FAST examination, and the remainder was included
The US Army has three Emergency Ultrasound Fellow- in the SFMS course. The intent was to promote early
ship programs: Carl R. Darnall Army Medical Center exposure to ultrasound technology and stress it as a tool
at Fort Hood, Texas; Madigan Army Medical Center at they should use early in their medical decision-making
Joint Base Lewis McCord, Washington; and San Anto- process. After a trial period of familiarization, ultra-
nio Uniformed Services Health Education Consortium sound became a testable item the student medics had to
at Joint Base San Antonio, Texas. Each program allowed pass to continue their training.
me to attend their annual summer ultrasound training.
Afterward, the Fellowship directors provided me with Train the Trainers
lecture and source materials to improve my knowledge After much deliberation, and once the ultrasound train-
and understanding of ultrasound. ing was included in the SOCM and SFMS courses,
USASFC made it policy for the SF BN Surgeon or PA
As a former 18D, I had operational experience. As a to become credentialed in the FAST examination with
physician assistant (PA) and a lifelong learner, I focused their local MTF. USASFC avoided this requirement for
that experience on orienting the ultrasound education as long as possible while encouraging the BN Surgeon
specifically for the 18D. I filtered relevant information and PAs to become proficient enough in ultrasound to
from the Ultrasound Fellowship lectures and rearranged properly supervise their 18Ds. With the FAST examina-
slides in an order that made more sense to me in pre- tion becoming a required and testable skill to graduate,
senting the material. The final step included a review by it made sense to have their future medical supervisors
the Fellowship directors to ensure the material was not competent in that same skill.
distorted by the changes. This sequence to review and
modify the Fellowship material extended to every one of In the spring of 2014, a separate training track was
the core capabilities and eventually became the SOLCUS developed for the SF BN Surgeon and PAs to facilitate
program of instruction in use today. the credentialing process. Once again, the Ultrasound
Fellowships provided the instructors. Each SFG coor-
The solution to conquer the seemingly monumental dinated to have their BN Surgeons and PAs attend the
task of training every SFG was actually quite simple FAST examination training to meet the credentialing
and worked out well for each of the parties involved. process outlined in the 2008 American College of Emer-
USASFC did not have qualified instructors yet. How- gency Physicians Emergency Ultrasound Guidelines.
6
ever, they did have the money within the SFGs to sup- Once each provider reached a predetermined number of
port the training. The three Fellowship programs had acceptable FAST examinations, the Fellowship Director
the qualified instructors but no funding to support the addressed a Certificate of Training to their MTF. The
temporary duty (TDY) to travel and conduct the train- memo stated that the provider was trained and skilled in
ing. An existing Memorandum of Agreement (MOA) the FAST examination and requested the additional skill
between USASOC and Medical Command provided the be added to their credentials. I was the first provider
foundation on which to base a new agreement between to validate this process through Womack Army Medical

Editorials 63