Ultrasonography is considered safe but highly operator dependent. Ultrasonography is being used increasingly in gynecology and obstetrics; however the training of novices in transvaginal ultrasound is performed differently with respect to the orientation of the ultrasound image, which often differs between operators and institutions. The image may be oriented top- down (transducer at the top) or bottom-up (transducer at the bottom). The different orientations of the image are a challenge for novices when being supervised by senior clinicians with different preferences for image orientation. As for now, there is no international consensus on image orientation and there is no evidence to support the superiority of one over the other in terms of learning curves and educational outcomes such as skills transfer. Transvaginal ultrasound is, like all other kinds of ultrasound, associated with long learning curves and is therefore time-consuming and requires extensive training. Transvaginal ultrasound is often associated with some discomfort to the patient, which can be reduced with adequate initial training. It therefore seems reasonable to determine how to provide the most effective initial transvaginal ultrasound training to reduce unnecessary patient discomfort and improve diagnostic accuracy through accelerated learning curves.