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 one (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.

 

Qualification Prerequisite # Qualification Prerequisite Supporting Documentation
RPhS1 Hold an active RVS or RVT credential plus six (6) months (full-time or full-time equivalent) of diagnostic ultrasound experience in venous disease at the time of application.

AND

36 CMEs in last four (4) years documented in venous disease, ultrasound diagnosis, or vascular anatomy.

Employment Verification Letter (from a supervising physician or credentialed lab director) (Should be not older than six months from the date the application is received at CCI Headquarters)

AND

verification of status as “ACTIVE” from
appropriate credentialing agency
(example: copy of registrant card)

AND

CME Documentation (See page 62 for required format)

RPhS2 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 venous disease.

AND

36 CMEs in last four (4) years documented in venous disease, ultrasound diagnosis, or vascular anatomy.

Completion certificate and/or educational transcripts

AND

Employment Verification Letter (Should be not older than six months from the date the application is received at CCI Headquarters)

AND

CME Documentation (See page 62 for required format)

RPhS3 A baccalaureate degree in health, science, natural science, nursing, engineering, or any primary science and six (6) months (full-time or full-time equivalent) of diagnostic ultrasound experience in venous disease at the time of application.

AND

36 CMEs in last four (4) years documented in venous disease, ultrasound diagnosis, or vascular anatomy.

Completion certificate and/or educational transcripts

AND

Employment Verification Letter (Should be not older than six months from the date the application is received at CCI Headquarters)

AND

CME Documentation (See page 62 for required format)

RPhS4

Two years (full-time or full-time equivalent) experience in diagnostic ultrasound in venous disease at the time of application.

AND

36 CMEs in last four (4) years documented in venous disease, ultrasound diagnosis, or vascular anatomy.

Employment Verification Letter (Should be not older than six months from the date the application is received at CCI Headquarters)

AND

CME Documentation (See page 62 for required format)

RPhS5

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

Diagnostic ultrasound experience in venous disease indicated by performing or directly supervising a minimum of 150 venous studies within 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 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.)

RPhS6 Valid license to practice medicine at the time of application

AND

Diagnostic ultrasound experience in venous disease indicated by performing or directly supervising a minimum of 200 venous studies within the two years prior to the application.

Copy of Medical License

AND

Notarized letter 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.)

RPhS7 Valid license to practice medicine at the time of application

AND

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.

Copy of Medical License

AND

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.

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

Examination Matrix

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.

CONTENT CATEGORY APPROXIMATE % OF EXAMINATION
A. Maintain Information, Facility, and Safety 10%
B. Diagnose Patients 20%
C. Perform Diagnostic Test 30%
D. Treat Patients Non-Surgically 12%
E. Treat Patients Surgically 28%
TOTAL 100%

Knowledge List

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 ultrasoundguided)
  • 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

Task List

The task list below describes the activities which a Cardiographic Technician is expected to perform on the job. All examination questions are linked to these tasks. 

     Duties and Tasks  % of Exam
A   Maintain Information, Facility, and Safety 10% 
  1 Perform universal precautions  
  2 Triage patient status  
  3 Inspect electromechanical equipment  
  4 Perform preventive maintenance  
  5 Optimize workspace  
  6 Implement continuous quality improvement  
  7 Secure patient information  
  8 Archive medical records  
B   Diagnose Patients  20%
  1 Obtain patient information  
  2 Perform patient history  
  3 Perform physical exam  
  4 Establish differential diagnoses  
  5 Design diagnostic plan  
  6 Analyze patient data  
  7 Evaluate post-treatment status  
C   Perform Diagnostic Test  30%
  1 Confirm indications for study  
  2 Position patient  
  3 Select appropriate equipment  
  4 Select appropriate transducer  
  5 Select instrumentation settings  
  6 Perform study protocol  
  7 Document exam findings  
  8 Store test images  
  9 Consult unusual or abnormal findings  
  10 Give patient discharge instructions  
D   Treat Patients Non-Surgically 12%
  1 Provide conservative treatment  
  2 Perform visual sclerotherapy  
  3 Provide compression therapy  
  4 Treat lymphedema  
  5 Arrange physical therapy  
E   Treat Patients Surgically 28%
  1 Obtain informed consent  
  2 Perform open surgical procedure  
  3 Perform minimally invasive treatment  
  4 Perform ultrasound guided procedures  
    TOTAL  100%

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. Bergan, John J., and Cynthia K. Shortell. Venous ulcers. Amsterdam: Elsevier Academic Press, 2007.
2. Caggiati, A, Bergan, J., Gloviczki, P, et al. Nomenclature of the veins of the lower limb: Extensions, refinements, and clinical application, J of Vasc Surg 2005; 41: 719-24
3. Caggiati, A, Bergan, J., Gloviczki, P, et al. Nomenclature of the veins of the lower limb: An international interdisciplinary consensus statement, J of Vasc Surg 2002; 36: 416-22
4. Fronek, Helane. American College of Phlebology: Fundamentals of Phlebology Venous Disease for Clinicians Venous Disease for Clinicians, 2nd ed. London: Royal Society of Medicine Press, 2007.
5. Goldman, Mitchel P., John Bergan, and Jean-Jerome Guex. Sclerotherapy treatment of varicose and telangiectatic leg veins, 5th ed. Edinburgh: Mosby, 2011.

6. Netter, Frank H., and Carlos A. G. Machado. Netter’s atlas of the human body, 4th ed. Hauppauge, N.Y.: Barron’s, 2006.
7. Ridgway, Donald P. Introduction to vascular scanning: a guide for the complete beginner, 3rd ed. Pasadena, Calif.: Davies, 2004.
8. Shadeck, Michael. Duplex and Phlebology. Idelson-Gnocchi Publishers, 1994.
9. Size, Gail P, Lozanski, Laurie, Russo, Troy. Inside Ultrasound’s Vascular Reference Guide, 1st ed. Inside Ultrasound, Inc., 2013.
10. Weiss, Robert A., Craig Feied, and Margaret A. Weiss. Vein diagnosis and treatment: a comprehensive approach. New York: McGraw-Hill, Health Professions Division, 2001.
11. Zwiebel, William J., and John S. Pellerito. Introduction to vascular ultrasonography, 5th ed. Philadelphia, Pa.: Saunders, 2005.
12. Joseph Zygmunt; Olivier Pichot; Tracie Dauplaise. Practical Phlebology: Venous Ultrasound, 1st ed. CRC Press, 2013.

"Loyal to the Profession of Cardiovascular Technology"Copyright © 1968-2014 Cardiovascular Credentialing International