Fetal Echocardiography (FE)

You can now take the SPI and FE examinations online from the comfort of your own home. Learn more! ​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​

If you are not a physician but are interested in applying for the ARDMS RDMS or RDCS credential with an FE specialty, please visit the FE specialty page on the ARDMS website.

The Fetal Echocardiography (FE) examination tests the requisite fetal echocardiography knowledge, skills and abilities to sonographer-level professionals.

As a physician, you are eligible to take many of the examinations offered by the APCA companion council, ARDMS. While ARDMS manages the FE examination and the associated Registered Diagnostic Medical Sonographer (RDMS) or Registered Diagnostic Cardiac Sonographer (RDCS) certifications, APCA, its companion council created exclusively to serve physicians, will be your destination to apply, prepare for, schedule and maintain all your certifications. You will log into MY APCA for information regarding the examination and to apply online.

Applicants may pursue the FE specialty under either the ARDMS Registered Diagnostic Medical Sonographer (RDMS) or Registered Diagnostic Cardiac Sonographer (RDCS) credentials. Once the FE examination is passed under the selected credential, it cannot be switched. To earn an RDMS or RDCS credential with an FE specialty, you must pass the Sonography Principles & Instrumentation (SPI) examination and the FE examination within five years. After passing the SPI examination, you can earn additional ARDMS credentials without having to retake the SPI examination, provided you maintain active status.

You must wait until the next administration to retake the FE examination if you do not pass the examination.

The FE examination assesses the knowledge, skills and abilities in the areas of normal and abnormal fetal cardiac anatomy, physiology, pathology and hemodynamics before delivery.

Applicants may pursue the FE specialty under either the RDMS or RDCS certification. Once the FE examination is passed under the selected certification, it cannot be switched.

As a windowed examination, scores for the FE examination will be available approximate 60 days after the close of the administration. For more information, review the “Scoring” tab.

We periodically​ conduct an FE Practice Analysis and update the FE examination to reflect the frequency and importance of FE tasks being performed by sonographer-level professionals.

The latest FE Practice Analysis was conducted in 2016. Click to view the 2016 FE Practice Analysis Results​​.

All questions on the Fetal Echocardiography (FE) examination will fall under the domains and subdomains listed in the FE content outline. It is essential that you review the FE content outline to understand what will be covered in the examination.

​The FE examination is three hours and contains 150 multiple-choice questions, which include hotspot questions. The hotspot questions are Advanced Item Type questions​ that assess and measure your practical sonography skills.​

In order to earn the RDMS or RDCS certification from ARDMS with an FE specialty, you must pass the Sonography Principles & Instrumentation (SPI) examination and the FE examination within five years.

After passing the SPI examination, you can earn additional certifications without having to retake the SPI examination, provided you maintain active status.

Note: The FE Examination is a windowed examination. Therefore, it is only offered during select periods of the year. Please refer to the “Schedule” tab for upcoming dates.

ARDMS functions under policies intended to demonstrate impartiality, high ethical standards and validity of its certification assessments.

ARDMS does not restrict Applicants, Candidates or becoming a Registrant/Certificant based on limiting conditions, such as membership of an association or professional society of any organization. ARDMS will not unfairly impede or inhibit access to its certification to Applicants, Candidates or Registrants/Certificants who meet our stated policies regarding qualification requirements, renewal requirements and/or passing ARDMS’ psychometrically sound certification assessments.

Candidates must pass the Sonography Principles and Instrumentation (SPI) examination and the corresponding specialty examination within five years, regardless of sequence. Candidates who do not complete both examinations within five years must retake the examination previously passed.

Note: The five-year rule​ does not apply to Registrants seeking additional specialties under a certification already earned. For example, if you have the RDMS certfication with AB, the five-year rule is not applicable if you want to add another RDMS specialty (OB/GYN, BR, FE, PS). There is no time limit to add additional specialties to a certification already earned, provided you maintain Active status.

However, if you earned the RDMS with the old UPI physics examination and AB (or any other RDMS specialty), and then passed the SPI examination, you would need to pass one of the RDCS, RVT or RMSKS specialties to meet the five-year rule requirement for the SPI examination. In this situation, adding an additional RDMS specialty after passing the SPI examination (or vice versa) would not meet the five-year rule requirement since you would be adding a specialty to a certification already earned.

The five-year rule is based on the calendar year (January 1 through December 31). The five-year period begins the day the first examination is passed, and it includes any time that remains in that year plus the next five years. For example, a candidate who passed the first ARDMS examination on June 6, 2011, is required to pass the second examination by December 31, 2016.

You will be considered a Re-applicant for the FE examination:

  • If you were previously approved to sit for any of the following Sonographer-level specialty examinations:
  1.  Abdomen (AB)
  2. Adult Echocardiography (AE)
  3. Breast (BR)
  4. Fetal Echocardiography (FE)
  5. Obstetrics and Gynecology (OB/GYN)
  6. Pediatric Echocardiography (PE)
  7. Pediatric Sonography (PS)
  8. Vascular ​Technology (VT​
  • If you were previously approved to sit for the SPI examination under a prerequisite (excludes approval of the SPI examination under the SPI Examination Requirement) .

Applying as a Re-applicant:

  • If you have a current FE Clinical Verification (CV) Form on file, you will need to submit the application and examination fee only. The application will automatically be approved and you will be able to schedule within a day.
  • If you do not have a current FE CV Form on file, you will need to submit the application, the examination fee and a current FE CV Form. To access your active CV Forms, please log into MY APCA  and click on “Clinical Verification Form” under “Application Center.”

You must wait until the next administration to retake the FE examination if you do not pass it.

To sit for the FE examination and earn the RDMS or RDCS certification, First-Time physician applicants must meet the education/licensure and clinical requirement of the physician prerequisite.

If you are not a physician or do not meet the requirements of the physician prerequisite, please visit the FE specialty page on the ARDMS website to review the SPI Requirement and General Prerequisites chart. The prerequisites vary based on education and clinical experience.

Click to view the SPI Requirement and General Prerequisites​​.

To earn an ARDMS credential, Applicants must choose and meet the requirements of a prerequisite. Review the Prerequisite Prep tool to help guide you through the prerequisite selection process and to select a prerequisite that best meets your education and clinical ultrasound experience.

Re-Applicant – A re-applicant is a Candidate or Registrant who has previously applied and been approved by ARDMS to take or has taken an ARDMS examination and who is applying to take another examination; this does not include an individual who has only been approved for MSKS, MW examinations and approval of the Sonography Principles & Instrumentation (SPI) examination under the SPI Examination Requirement Pathway. Re-applicants should apply as such and thus this guide isn’t necessary for you.

You will be considered a Re-applicant for the AB examination:

  • If you were previously approved to sit for any of the following Sonographer-level specialty examinations:
  1. Abdomen (AB)
  2. Obstetrics and Gynecology (OB/GYN)
  3. Breast (BR)
  4. Fetal Echocardiography (FE)
  5. Pediatric Sonography (PS)
  6. Adult Echocardiography (AE)
  7. Pediatric Echocardiography (PE)
  8. Vascular Technology (VT)​
  • ​​If you were previously approved to sit for the SPI examination under a prerequisite (excludes approval of the SPI examination under the SPI Examination Requirement)​

Applying as a Re-applicant:

  • If you have a current FE Clinical Verification (CV) Form on file, you will need to submit the application and examination fee only. The application will automatically be approved and you will be able to schedule within a day.
  • If you do not have a current FE CV Form on file, you will need to submit the application, the examination fee and a current FE CV Form. To access your active CV Forms, please log into MY APCA  and click on “Clinical Verification Form” under “Application Center.”

You must wait until the next administration to retake the FE examination if you do not pass it.

The FE examination fee is $275 USD, which includes a $100 USD non-refundable processing fee. If you take an ARDMS examination at an international test center (outside the U.S., Canada and Mexico), you will be charged an additional non-refundable $50 USD fee when you schedule your examination. This fee is subject to change without notice.

Reimbursement Information for U.S. Armed Forces Veterans: 

Learn more about the GI Reimbursement Program for United States Armed Forces Veterans. ​

The FE Examination is a windowed examination. Therefore, it is only offered during select periods of the year.​ See schedule below.

FE Examination Application Dates FE Examination Administration Dates
December 13, 2022 – February 21, 2023 March 7, 2023 – April 6, 2023
June 6, 2023 – August 15, 2023 August 29, 2023 – September 28, 2023

As a physician, once you are ready to apply for an ARDMS examination, follow the steps below:

  • Log in to MY APCA and choose the “Apply Online” option.
  • Complete the online application form and submit payment. If you are a first-time applicant, you are required to choose a general prerequisite under which to apply.
  • Gather your supporting documentation and submit at time of application
  • To upload your documentation to your MY APCA account, click the “My Resources” tab, then “Upload Documents”. For “File Type” select “Application Documents”.

For more details, please visit the RDMS, RDCS and RVT How to Apply Guide​​​.

Once we have reviewed your information, we will email you with either an Examination Confirmation Letter (ECL) or a request for additional documentation. When you receive the ECL, you may contact Pearson VUE to schedule an examination appointment during your eligibility period.  The eligibility period will be listed on your ECL or check above to view the current FE examination administration dates.

If you are found ineligible to take the examination, your application will be partially refunded (less the $100 USD processing fee per examination).

Based on your prerequisite or requirement selection​​, the necessary supporting ​documentation must be received at the time of your online application submission.

Note: We do not retain application documentation received prior to receipt and payment of the online application. Any documentation received prior to the completed online application will be discarded.​​​

Application Letter Requirements

When applying for the FE examination, if your prerequisite selection requires documentation of clinical experience, please note that application letter(s) must:

  • Be an original, official letter with the address and telephone number indicated
  • Include the current date (mm/dd/yyyy)
  • State actual dates of employment or program
  • Contain original signatures (stamped and/or computer generated signatures are not acceptable); letters cannot be signed by a relative of the applicant
  • Provide a physician’s medical license number or Certification (ARDMS or APCA) number

Employment letters must indicate full-time or part-time training/experience AND must include the total number of paid clinical hours.

Program completion letters must include the total number of hours in the program and state individually, the number of didactic and clinical hours in the program.

Sample Letters

Provided are some sample letters that may correspond with your prerequisite requirements:

Patient Log (All Certifications)

CV Form

For Applicants who apply under a prerequisite other than physician prerequisite – Degrees earned internationally must be evaluated prior to selecting a prerequisite. We require a course by course evaluation. Click here​ ​for complete list of Evaluation Agencies for International Degrees.

The application checklist is a helpful, online tool that lets you track the status of your submitted application. To view it, log into MY APCA and visit “Application Checklist” from the “Application Center” drop down menu.

Once we have reviewed your documentation, you can find out what documentation we accepted and what additional documentation we may still need by selecting “View Checklist.” If “View Checklist” is not available, it simply means we have not yet reviewed your documentation.

​If you are found eligible to take an examination, we will email you an Examination Confirmation Letter (ECL) within one to two days of application approval and you will be able to schedule your appointment at that time. The ECL will also be posted to your MY APCA account and will include your eligibility period to schedule and take your examination.

If you need special accommodations, please select “Yes” for “Special Accommodations” in the application and submit the following along with your completed application:

  • An original copy of a letter dated within the past five years and typed on official letterhead from a qualified physician or health care provider who specializes in the disability. This letter must document the disability and its severity, describe the applicant’s limitation due to the disability and state exactly what accommodations are recommended. The letter must contain an original signature and the physician’s or provider’s credentials.
  • An original copy of a comprehensive medical evaluation/report of the diagnosed disability from the physician or health care provider, dated within the past five years.
  • A completed Americans with Disabilities Act (ADA) Special Accommodations Questionnaire​​,​ which must be submitted each time you apply for an examination.

For more information, visit Americans with Disabilities Act​.​

The FE examination is only offered during select periods of the year. See schedule below.

FE Examination Application Dates FE Examination Administration Dates
December 13, 2022 – February 21, 2023 March 7, 2023 – April 6, 2023
June 6, 2023 – August 15, 2023 August 29, 2023 – September 28, 2023

Once your FE application has been approved, an Examination Confirmation Letter (ECL) will be emailed to you so that you can schedule an appointment with Pearson VUE – ARDMS’ official testing vendor. The ECL will include your eligibility period based on the set administration dates and you are encouraged to schedule promptly to ensure availability.

If you have not done so already, visit Pearson VUE to:
• Create a Pearson VUE account
• Search for seat availability
• Locate a test center
• Schedule an examination
• Contact Pearson VUE Customer Service

If you are taking the examination at an international test center (outside the U.S., Canada and Mexico), a $100 USD non-refundable fee and Value Added Tax (VAT) will be charged by Pearson VUE. All international scheduling fees and associated VAT will be charged at the time the examination is scheduled. The fees and associated VAT are subject to change without notice, and they are non-refundable.

To reschedule the date and time of your examination during your eligibility period, you must contact Pearson VUE(1-877-258-9220) at least 96 hours prior to the scheduled examination date and time.

Please note: This is a windowed examination and extensions are not available.  You can reschedule your appointment for another time within your stated eligibility period.  However, if you cannot take it within your stated eligibility period, please follow the cancellation procedure.

To cancel an examination appointment, you must contact Pearson V​​UE (1-877-258-9220) and cancel the scheduled appointment no later than 96 hours prior to the scheduled examination appointment time. You will receive a cancellation email from Pearson VUE.

To request a partial refund, you must wait 24 hours after canceling the appointment with Pearson VUE and then submit a cancellation/partial refund request no later than 96 hours prior to the last date of the eligibility period.

To submit this request:

  • Log in to MY APCA account
  • Visit “My Examination/Application Status” under “Application Center.”
  • Select the examination you wish to request a partial refund for. ​​
  • Complete and submit the form

We will refund your examination fee, less the $100 USD processing fee per examination, unless we receive your request too late, you never schedule your examination or you do not keep your scheduled examination appointment. Then, the entire examination and processing fees are forfeited.

Please note: This is a windowed examination and extensions are not available.  You can reschedule your appointment for another time within your stated eligibility period.  However, if you cannot take it within your stated eligibility period, please follow the cancellation procedure.

When you arrive at a test center, be prepared to:

  • Check in with a Test Center Administrator
  • Present one valid photo identification (ID); see Test Center Identification Requirements
  • Provide a digital signature
  • Have your palm vein scanned
  • Take a test-day photograph

Note: The only thing that you can bring into the testing room is you. The test centers have lockers you can use to store personal belongings. Study materials as well as food and drink are prohibited in the test center. No visitors, guests, pets or children are allowed.

Important: Review ARDM’s Examination Admission Compliance ​​policies to ensure you are not refused admission at the test center and do not conduct unauthorized examination behavior.

Test centers will provide white boards for notes during the examination upon request.

If you need special accommodations, please select “Yes” for “Special Accommodations” in the application when you apply.

Taking a practice test or two is a great way to prepare for your actual examination. We offer a Fetal Echocardiography (FE) Practice Test that simulates the computer interface used in the actual test center environment. The FE practice test review is comprised of 30 sample questions and is 30 minutes long.

After you complete a practice test, you will be emailed a report that shows the number of questions you answered correctly. While the report is an indication of your knowledge, the practice tests results should not be used to predict how well you will perform on the actual test at the test center.

See FAQs for additional information.​

Each practice test costs $45 USD.

You can now register for a FE practice test by signing into your MY APCA account and clicking the Sign Up/View Practice Test option in the Application Center tab. You can also view the computer system requirements in your MY APCA portal. For any general questions or technical problems regarding the practice tests, please call APCA at (800) 943-1709  or email practicetests@inteleos.org.

Before your session begins, you should review the test tutoria​l. Please note you will not get a chance to review the test tutorial during the actual practice test, so please prepare accordingly. Once your session begins, you have 30 minutes to complete the practice test.

Register for a FE practice test, by signing in your MY APCA account.  ​

The FE examination covers the following content areas. All percentages are an approximate distribution of the questions across the content areas.

FE Content Outline​​

Assess Anatomy  [18%]
     •Assess anatomy and physiology

Evaluate Pathology and Pathophysiology [21%]
     • Assess abnormal perfusion and function
• Evaluate for congenital anomalies

Integrate Data [31%]
     • ​Assess fetal diagnostic images​

Perform the Exam [30%]
     • Gather pertinent medical history prior to the exam
• Perform ultrasound exam

Please note: All percentages are approximate.

Your score report will display and include performance feedback for these content areas.

After all of your diligent preparation and hours spent studying, here are a few valuable tips to help make your examination day a success:

  • Double check that you know where the test center is before examination day and give yourself plenty of time to get there. Remember, you MUST arrive and register at least 30 minutes before the examination begins.
  • Get a good night’s sleep before you take your examination. Being well rested and relaxed when you take your examination will help you concentrate.
  • Bring one form of current and valid identification that complies with the test center identification ​​requirements.​​​​​
  • Travel light. The only thing you can bring into the testing room is you. You can store your personal belongings — your car keys, watch, smartphone, purse, backpack, etc. — in lockers at the test center. The following items are not allowed in test centers: study materials, food, drink, visitors/guests, pets and children.
  • Request a white board if you plan to jot down notes during the examination. Test centers are using white boards (rather than paper) in an effort to “go green.”
  • Be advised that the use of a calculator for this examination is prohibited.  However, you may utilize the White Board provided at the test center or the digital White Board provided for online proctoring examinations for manual calculations.

Good luck!​

Even though we offer practice examinations and sample questions, we do not offer study materials for our examinations – but our sister organizations do. You can find materials at:

The FE examination features Advanced Item Type questions​​, which assess and measure your practical sonography skills. They will include hotspot questions in which you will receive questions about individual images, and you will use the cursor to mark the correct answer directly on the image.

Watch the video presented by APCA’s companion organization for sonographers, ARDMS: How to Answer a Hotspot Question.

The FE examination evaluates the fetal echocardiography knowledge and skills you must demonstrate as a sonographer-level professional.  The primary test result is a PASS or FAIL decision. In addition, you will receive a scaled score, ranging from 300 to 700. A scaled score of 555 is required to pass all ARDMS examinations.

The scaled score is not a percentage of correct answers, nor is it built on a “curve” where a certain percentage of scores would pass and a certain percentage would fail. To learn more, visit Notification of Results and Scoring​​.

Examination results and a full score report will be available approximately 60 days after the close of the examination administration. At that time, an email will be sent to you with instructions on how to access your score report in MY APCA​.

Candidates receiving a confirmed passing score on all required examinations and meeting all other requirements will be awarded a certification. For information on the ARDMS’ scoring methods, visit Notification of Results and Scoring​​.

Candidates who do not pass are invited to re-apply.

You can request a score verification for a $35 USD fee, payable by check, money order or credit card. Score verification ensures that the computer counted the correct and incorrect answers appropriately, but it does not review the questions and answers.

You must submit the completed Exam Score Ve​rification Form​​​ ​within 30 days of receipt of the examination score. The Exam Score Verification Form will be returned if incomplete, unsigned or unpaid.

When deciding whether to have your score verified, please consider that examinations are scored electronically with a high degree of accuracy, and it is unlikely that verification will alter your original score.

​Below are the pass rates for the FE examination for the past three years. As this is a sonographer-level examination, this pass rates are reflective of all examinees (both sonographers and physicians).

2022:
First-time takers: 74%
Overall: 71%
2021:
First-time takers: 76%
Overall: 70%
2020:
First-time takers: 76%
Overall: 73%

2019:
First-time takers: 77%
Overall: 70%
2018:
First-time takers: 65%
Overall: 59%

2017:
First-time takers: 76%
Overall: 67%​

2016:
First-time takers: 79%
Overall: 73%​

2015:
​First-time takers: 75%
Overall: 69%​

2014:
First-time takers: 78%
Overall: 74%

2013: 
First-time takers: 75%
Overall: 72%

2012:
First-time takers: 80%
Overall: 74%​