Registered Phlebology Sonographer (RPhS)

Requires:  Passing the one-part Phlebology Registry Examination

Who Should Apply:  Professionals working in the area of Phlebology Ultrasound

Specialty Exam Fee: $350

If you have any additional questions, please contact CCI Headquarters at 800-326-0268 or Applicant_Support@cci-online.org.  Thank you for your continued dedication to the cardiovascular profession.
 

RPhS Navigation

All applicants must meet the following criteria:

  1. Have a high school diploma or general education diploma at the time of application.
     
  2. Fulfill on (1) of the qualifications of the exam for which you are applying. See qualifications listed in the tables below.
     
  3. Provide typed documentation to support the qualification under which you are applying. Required documentation for each qualification is listed below.

CCI reserves the right to request additional information.

Qualifications: Non Physician Applicants

Qualification
Prerequisite #

Qualification Prerequisite

Supporting Documentation

1

Hold an active RVS or RVT credential plus six (6) months (full-time or full time equivalent) of diagnostic ultrasound experience in chronic venous insufficiency at the time of application.
AND
36 CME's in last four (4) years documented in CVI disease, ultrasound diagnosis, or vascular anatomy.

Employment Verification Letter (from a supervising physician or credentialed lab director)
AND
Verification of status as "ACTIVE" from appropriate credentialing agency (example-copy of registrant card)
AND
CME Documentation

2

An associate degree or equivalent college hours (62 semester hours) in health, science, natural science, nursing, engineering or any primary science and one (1) year (full-time or full-time equivalent) diagnostic ultrasound experience in chronic venous insufficiency.
AND
36 CME's in last four (4) years documented in CVI disease, ultrasound diagnosis, or vascular anatomy

 

Completion certificate and/or educational transcripts
AND
Employment Verification Letter
AND
CME Documentation

3

A baccalaureate degree in health, science, natural science, nursing, engineering or any primary science and six (6) months (full-time or full-time equivalent) years of diagnostic ultrasound experience in chronic venous insufficiency at the time of application.
AND
36 CME's in last four (4) years documented in CVI disease, ultrasound diagnosis, or vascular anatomy

Completion certificate and/or educational transcripts
AND
Employment Verification Letter
AND
CME Documentation

4

Two years (full-time or full-time equivalent) experience in diagnostic ultrasound in chronic venous insufficiency at the time of application.
AND
36 CME's in last four (4) years documented in CVI disease, ultrasound diagnosis, or vascular anatomy

Employment Verification Letter
AND
CME Documentation

 

Qualifications: Physician Applicants

Qualification
Prerequisite #

Qualification Prerequisite

Supporting Documentation

5

Valid license to practice medicine at the time of application
AND
Holds Certification through the American Board of Phlebology or holds an active RVS, RVT, or RPVI credential
AND
Performed or directly supervised a minimum of 75 venous ultrasound studies per year for the two years prior to the application.

Copy of Medical License
AND
Verification of status as “ACTIVE” from appropriate credentialing agency (example-copy of registrant card)
AND
Notarized letter that from a supervising physician, credentialed lab director, or office manager that verifies the number of venous studies performed or directly supervised and the period of time during which the studies were performed. (Physicians in solo practices may sign off on their letter.)

6

Valid license to practice medicine at the time of application
AND
Performance and interpretation of at least one hundred (100) venous ultrasound studies per year for each of the two (2) years preceding the submission of this application. 

Copy of Medical License
AND
Notarized letter that from a supervising physician, credentialed lab director, or office manager that verifies the number of venous studies performed or directly supervised and the period of time during which the studies were performed. (Physicians in solo practices may sign off on their letter.)

7

Completion of a residency or fellowship that includes specialized clinical training in phlebology ultrasound performance and interpretation. Performing or directly supervising venous ultrasound studies, a minimum of 200 obtained during the training program.

Completion certificate and/or educational transcripts
AND
Notarized letter from program director/supervisor that verifies the program’s length, the number of studies and the period during which the studies were performed.

Please note that these qualifications are still under review by the CCI Board of Trustees

Click here for sample Employment Verification Letter (Non-physicians), Clinical Verification Letter (Physicians), and Resident/Fellow Letter.

CCI requires the Employment Verification Letter (Non-physicians) contain the following:

1) Employer’s original, official letterhead or stationery.
2) Indicate the date the letter was signed by employer/supervisor.
3) Indicate the name of the applicant.
4) Indicate full- or part-time employment.
5) Indicate the time period of employment.
6) Indicate the primary duties of applicant, related to the field of cardiovascular technology.
7) Original signature of direct supervisor, who must be an MD or hold an active RCCS, RCES, RCIS, RCS, RDCS, RDMS, RPhS, RVS or RVT credential.

CCI requires the Clinical Verification Letter (Physicians) contain the following:

1) Clinical Site’s original, official letterhead or stationery.
2) Indicate the date the letter was signed by the clinical supervisor.
3) Indicate the name of the applicant.
4) Indicate the number of venous ultrasound studies.
5) Indicate the time period during which the studies were performed.
6) Original signature of the lab director, supervising physician, office manager. (Physician in solo practice may sign off on their letter.)
7) Letter must be notarized.

CCI requires the Resident/Fellow Letter contain the following:

1) Program’s original, official letterhead or stationery.
2) Indicate the date the letter was signed
3) Indicate the name of the applicant.
4) Indicate the date or expected date of completion.
5) Indicate the program length, program specialty, the number of venous ultrasound studies performed and/or supervised during training.
6) Original signature of by Division or Department Head or Fellowship Training Director.
7) Letter must be notarized.

Exam Overview Thursday, November 19th 2009 8:15 AM





This examination matrix is provided to illustrate the general distribution of questions and the relative weight or emphasis given to a skill or content area on the examination.




Maintain Information, Facility, and Safety   10%
Diagnose Patients   20%
Perform Diagnostic Test   30%
Treat Patients Non-Surgically   12%
Treat Patients Surgically   28%
Total 100%




The list below describes general areas of knowledge that are needed in order to perform the tasks identified.  This knowledge will apply across multiple tasks.
Regulatory and Compliance Standards (e.g. OSHA, HIPAA, informed consent, medical records)
Medical ethics

Medical terminology

General anatomy

Cardiovascular anatomy and physiology (normal and abnormal)
Venous anatomy, physiology, and pathophysiology

Vascular hemodynamics

Venous disease process and progression 

Diagnosis and treatment of lymphatic disease

Basic math and statistical skills (formulas, exponents, decimals, scientific notation)
Basic pharmacology

History & physical

   *Vascular signs and symptoms

   *Risk factors (family history, genetics)

   *CEAP classification

   *Pre- and post-treatment

Basic Life Support (BLS)

Safety practices for patients and staff

    *Universal Precautions/infection control

    *Sterile procedure

    *Ergonomics

Ultrasound physics

    *Ultrasound instrumentation

    *Ultrasound modalities (e.g., Spectral Doppler, Color Doppler, B-mode)
Vascular anomalies and normal variances

Nonsurgical interventions (e.g., medications, risk factor modification)
    *Sclerotherapy (visual and ultrasound-guided)

    *Compression therapy

    *Physical therapy

Open-surgical venous procedures

Minimally-invasive venous procedures

    *Thermal ablation

    *Phlebectomy

Other testing modalities (e.g., CT, MR, plethysmography)
Exam correlation with other imaging modalities

Complications of venous treatment





The task list below describes the activities which an RPhS is expected to perform on the job.  All examination questions are linked to these tasks.
Duties
and Tasks		 Percent of Exam Number of Items
A Maintain Information, Facility, and Safety 10% 15
1 Perform Universal Precautions
2
2 Triage Patient Status
2
3 Inspect Electromechanical Equipment 2
4 Perform Preventive Maintenance
2
5 Optimize Workspace
2
6 Implement Continuous Quality Improvement 3
7 Secure Patient Information
1
8 Archive Medical Records
1
B Diagnose Patients 20% 30
1 Obtain Patient Information
1
2 Perform Patient History
4
3 Perform Physical Exam
5
4 Establish Differential Diagnoses
6
5 Design Diagnostic Plan
4
6 Analyze Patient Data
6
7 Evaluate Post-Treatment Status
4
C Perform Diagnostic Test 30% 45
1 Confirm Indications for Study
3
2 Position Patient
2
3 Select Appropriate Equipment
3
4 Select Appropriate Transducer
3
5 Select Instrumentation Settings
7
6 Perform Study Protocol
11
7 Document Exam Findings
3
8 Store Test Images
2
9 Consult Unusual or Abnormal Findings 
9
10 Give Patient Discharge Instructions
2
D Treat Patients Non-Surgically 12% 18
1 Provide Conservative Treatment
5
2 Perform Visual Sclerotherapy
5
3 Provide Compression Therapy
4
4 Treat Lymphedema
3
5 Arrange Physical Therapy
1
E Treat Patients Surgically 28% 42
1 Obtain Informed Consent
1
2 Perform Open Surgical Procedure
9
3 Perform Minimally Invasive Treatment 16
4 Perform Ultrasound Guided Procedures 16
Total 100% 150

1. Pulsatility on pulse doppler is consistent with
a. AV fistula.
b. Iliac occlusion.
c. Patent foramen Ovale.
d. Tricuspid regurgitation.

2. Ultrasound guided foam sclerotherapy:
a. is less effective than liquid sclerotherapy
b. is commonly used for telangiectasia and reticular veins less than 2mm in diameter
c. is frequently associated with neurologic side effects
d. is effective in the treatment of incompletely ablated saphenous veins

3. Spectral Doppler reveals phasic venous flow in the right common femoral vein and aphasic flow in the left common femoral vein. What is the MOST LIKELY pathologic finding?
a. Left iliac vein stenosis
b. Right iliac vein stenosis
c. Left femoral vein stenosis
d. Right femoral vein stenosis

4. When performing a venous Duplex Ultrasound exam, the sensitivity and specificity in detecting reflux are increased when the patient is in what position?
a. Supine
b. Standing
c. Decubitus
d. Trendelenburg

5. 2D/Greyscale imaging is used during a venous duplex ultrasound to_____________.
a. check for reflux
b. visualize vessels and possible echogenic material within the vessels
c. check for vein patency
d. detect decreased or absent flow

Answers:
1. d 2. d 3. a 4. b 5. b

The textbooks listed in the following section are intended as a recommended resource when preparing for examination. Any general text related to the content on the examination may be used. It is not necessary to use all of the texts identified. They are provided as suggestions only. CCI does not endorse nor recommend any third party review course or material.

  1. Vein Diagnosis And Treatment: A Comprehensive Approach , Robert Weiss, Craig Feied, and Margaret Weiss (2000)
  2. The Vein Book, John J. Bergan, 2006
  3. Venous Ulcers by John J. Bergan and Cynthia Shortell, 2007
  4. Sclerotherapy: Treatment of Varicose and Telangiectatic Leg Veins by Mitchel P. Goldman MD, John J. Bergan MD FACS Hon FRCS(Eng), and Jean-Jerome MD Guex MD FACPH, 2006
  5. Introduction to Vascular Ultrasonography (Fifth Edition), William Zwiebel, 2004
  6. Vascular Anatomy and Physiology: An Introductory Text, Ann C. Belanger, 1990
  7. Introduction to Vascular Scanning: A Guide for the Complete Beginner  (Introductions to Vascular Technology)(3rd Edition), Donald P. Ridgway, 2004
  8. Duplex and Phlebology, Michel Shadeck, 1994
  9. American College of Phlebology: The Fundamentals of Phlebology: Venous Disease for Clinicians, 2nd edition, Helane Fronek, MD editor,
  10. Atlas of Human Anatomy, 4th Edition by Frank H. Netter MD (2006)
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