"Up skill" in TOE

Prior to starting my job as a cardiologist in New Zealand I was required to "up skill"  to obtain competency in a technique that required me to place a ultrasound probe down a patient's mouth and into their esophagus. While a ultrasound of the heart can be performed by placing a probe on the chest for a close look of the heart, to rule out clot or infection of the valves, this transesophageal technique is essential. As I looked about for training opportunities I found the only programs available were for anesthesiologist. They use this technique to monitor the heart during surgery. I decided the best course was to do two preceptorships one at Duke University Medical Center and one at one at The University of Nebraska Medical Center. Duke because of its reputation and Nebraska because they offered a online review of the studies you do in practice. Having signed up for two courses I looked about for someplace where I could get hands on experience doing the studies. I soon realized that cardiology training programs are not interested in training anyone who is not their cardiology fellow in transesophageal echocardiography. Fortunately cardiologists Mike Koren and Ramon Castello agreed to preceptor me a Memorial Hospital. Thanks to these physicians and their cardiology colleagues at Memorial I was able to perform 40 of these TEE procedures (TOE in New Zealand they spell esophagus with a O). So Im off to New Zealand with a new skill, ready to make my mark on Kiwi Cardiology!