A basic principal of the privileging and credentialing process is that a surgeon must have adequate judgment and excellent training to perform ultrasound with safety and accuracy. However, guidelines for credentialing must be flexible and reasonable. While general guidelines may be applicable to all surgeons, subspecialty differences in practice, ultrasound utilization, and clinical applications must be considered. All surgical ultrasound examinations are not the same in scope, complexity, or difficulty.

Criteria for establishing the standards required for a surgeon to be granted ultrasound privileges should take into account the surgeon’s overall experience and extensive skills obtained through residency and fellowship training and the application of these skills during ongoing patient care activities. Standards should be uniform when considering a surgeon’s application for privileges in ultrasound. Privileges should be considered and granted for each category of ultrasound after a careful process of consideration and a thorough review of the surgeon’s training and experience. While ultrasound principles and instrumentation are similar regardless of the clinical activity, the ability of a surgeon to perform one ultrasound examination in an acceptable fashion does not automatically guarantee competency to perform another type of ultrasound study. For example, skill and certification in performance of the focused assessment with sonography for trauma (FAST) examination do not imply that a surgeon possesses adequate skills in laparoscopic, intraoperative, vascular, or breast ultrasound. Each area of surgical ultrasound has different requirements for training and mandates different skill sets. One size does not fit all.