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The Fetal Medicine Foundation (FMF) UK has established a certification process for the ultrasound examination performed at 11-14 weeks of pregnancy. It aims at ensuring that medical doctors performing this type of ultrasound scan have received adequate training and that the high standard of performance can be reliably maintained by means of ongoing follow-up training and auditing measures. In early 2002, the certification process for Germany was transferred to the FMF-Germany. Laboratory certification, however, continues to be awarded by the FMF UK.
Standardised first-trimester screening includes both the theoretical and practical training of doctors performing ultrasound examinations, and it involves ongoing quality reviews of their work in this field. In addition, a standardised laboratory analysis of the mother`s blood sample is carried out. This ensures that the performing laboratories will work in a uniform manner, which in turn guarantees high standards of performance.
Both the certification process and the course material have been adapted to German language use. Participants who have successfully completed both the theoretical examination (multiple choice questionnaire) and the practical examination are certified by the FMF-Germany and then listed as registered sonographers on the websites of both the FMF-Germany and FMF UK.
In order to maintain their certification status, the doctors´ recognition of and participation in a continuous quality assurance programme is mandatory. This quality assurance programme provides for the regular submission of specific measurement data and ultrasound images to the FMF-Germany. Particular importance is attached to the fact that certification is restricted to individuals and not transferable to entire departments or practices. The same applies to the distribution of measured values and to the ultrasound images which must be personally obtained as part of the audit. If this requirement is not met, recertification will be denied.
  The certification process in detail
The preliminary requirement for admission to the certification process of the FMF-Germany is a presentation of evidence to the effect that the applicant has sufficient knowledge in the field of prenatal sonography. The minimum requirement to this end is an ultrasound qualification corresponding to DEGUM Level I, or comparable ultrasound education and training. Applicants who are not yet specialists in gynaecology must prove their ultrasound qualification by submitting a DEGUM Level I certificate. FMF Certificates of Competence in nuchal translucency measurement obtained in other European countries are recognised by the FMF-Germany under the above conditions.
  The requirements for the certification of medical doctors performing the 11-14 week
ultrasound scan are as follows:
  Participation in a theoretical course on the 11-14 week ultrasound scan which must be recognised by the FMF-Germany (confirmation on the participation in the theoretical part) and successful participation in a multiple-choice question (MCQ) examination (confirmation as to the successful completion of the theoretical examination).
  Successful completion of a practical examination: It comprises the submission of 3 images showing that the candidate has the ability to measure nuchal translucency correctly, and it includes a practical demonstration of an NT measurement. The 3 submitted images must have been obtained as a result of correct measurement and are the prerequisite for admission to the practical demonstration. The instructor may issue
a confirmation on the successful completion of the practical examination only on condition that the 3 images submitted to the instructor/examiner are sufficient evidence of correct NT visualisation and measurement, and provided that practical NT measurement has also been successfully performed.
  The complete set of documents (confirmation on the successful completion of the theoretical and practical examination, DEGUM Level I Certificate) is then sent to the office of the FMF-Germany. After successful certification, the candidate is awarded a Certificate of Competence issued by the FMF-Germany and is registered on the internet page of the FMF-Germany.
  The certificate entitling to the performance of the 11-14 week ultrasound examination can only be obtained personally.
  The practical examination can be repeated at a later training course run by the FMF-Germany or in the framework of a study visit at an FMF training centre.
  Recertification is required in 12-month time intervals. It demands compliance with the requirements of the audit (good distribution of measured values, high-quality ultrasound images as well as correct focusing. Otherwise, recertification may be made contingent upon the applicant´s participation in re-training measures (aiming at a substantial improvement of performance).