How do I?


Advanced PTEeXAM® Advanced Perioperative Transesophageal Echocardiography

For licensed physicians performing advanced perioperative TEE examinations.  

Scope of Work

The application of an advanced perioperative TEE examination is to utilize the full diagnostic potential of perioperative TEE including direction of the perioperative surgical decision-making process.

  1. Ability to provide a current medical license with expiration date or letter of good standing. 
  2. Valid Advanced PTEeXAM® Testamur status during the certification application period 
  3. Completed a Cardiothoracic Anesthesiology and/or Critical Care fellowship or be a practicing Anesthesiologist

Testamurs seeking NBE Certification will apply online by uploading the required documentation. Once an application is complete, the Certification Committee will meet to review applications twice a year, and applicants will be notified in writing of the decision. Incomplete applications will not be reviewed by the Certification Committee until all requirements are met. 

Certification applicants should select one of the applicable pathways listed below. For more detailed information please refer to the Advanced PTEeXAM® Certification Handbook. 


Supervised Training within ACGME Fellowship  

Required Documentation 

  1. Current Medical License including expiration date 
  1. Medical Board Certificate 
  1. Fellowship Certificate (Optional) 
  1. Notarized Letter from Fellowship (document cases completed during training) 
  1. Log of studied but not performed cases completed during training.  


Practice Experience 

Required Documentation 

  1. Current Medical License including expiration date 
  2. Medical Board Certificate 
  3. Fellowship Certificate (Optional) 
  4. Notarized Letter from Hospital/Practice (document cases completed in practice within the four (4) consecutive years, with a maximum of no more that 10 years prior to the application.) 
  5. Fifty (50) hours of AMA Category 1 CMEs devoted to echocardiography in the preceding two years 

Maintenance of Testamur or Diplomate Status 

Testamurs and Diplomates of the NBE are required to take the RePTE® examination in either their 8th, 9th, or 10th year surrounding their 10-year anniversary date to maintain their status with the NBE. Individuals who allow their status to lapse will have their names removed from the NBE’s online Testamur/Diplomate listing page.

If a Diplomate does take and pass the RePTE® examination in the compulsory timeframe but does not submit the required documentation for recertification, the candidate is eligible to apply for recertification at any time before the expiration of their Testamur status; however, when they do apply for recertification he or she will have to pay a $200.00 reinstatement fee along with the recertification requirements. Once their application for recertification is approved, their status will be changed from Testamur to Diplomate of the level in which they were approved.

If a Testamur/Diplomate does NOT take and pass the RePTE® examination in the compulsory timeframe, the individual must pass the RePTE and pay a $200.00 reinstatement fee at the time of application. Additionally, Diplomates who do not take the RePTE® in the required 3-year period must meet the initial certification requirements and the CME requirements for recertification along with the $200.00 reinstatement fee.

If Testamur or Diplomat e status has lapsed more than 9 years, applicants must take the Advanced PTEeXAM.

Example for 2004 Initial Examination Pass Date:

Action Year
Initial Examination Passed 2004
Eligible for Recertification Examination 2021 to 2023
Retake Initial Examination 2024 or later

KEY POINT –At any point after their certification has lapsed, applicants may attempt the initial Advanced PTEeXAM and receive certification for 10 years from the year the most recent exam was passed

*All letters documenting cases completed during training or practice, must be on official letterhead, signed by an approved signor, and notarized, dated and stamped by a notary/justice of the peace/lawyer(barrister) at the time of witnessing the signing of the letter in person. All letters must be the original and not a copy of the original document.*

Supervised Training 

Sample notarized Letter from Fellowship

Sample Log of studied but not performed cases completed during training

Practice Experience 

Sample notarized Letter from Practice/Hospital

Contact a Certification Specialist
Our Certification team is available M-F 8:45am-4:45pm EST