Background: Point-of-care ultrasound (POCUS) training was recently endorsed by the Alliance for Academic Internal Medicine (1) and the demand for training is increasing among internal medicine (IM) residency programs (2). Longitudinal POCUS training increases knowledge and skill retention compared to stand-alone workshops (3,4), but few programs currently provide longitudinal training due to institutional barriers, such as lack of trained faculty (2,5).

Purpose: To overcome local barriers and offer a 3-year longitudinal POCUS training experience, we created a unique IM POCUS residency track that primarily leverages external resources through the Society of Hospital Medicine – American College of Chest Physicians (SHM-ACCP) POCUS Certificate of Completion (COC) program (6). The goals of this track are to equip IM physicians with basic competency in POCUS and to create future leaders in IM POCUS education. The track’s objectives are to provide longitudinal training to enhance knowledge, skills, and comfort in procedural and diagnostic ultrasound applications; to obtain certification in POCUS through the SHM-ACCP POCUS COC program; and to develop POCUS champions who can increase institutional capacity for POCUS training. Here we report our initial 3-year experience.

Description: Program Design: POCUS track residents receive longitudinal ultrasound training during all three years (Table 1). Our program accepts 4 residents per year with a total of 12 residents on the POCUS track. Residents attend two live POCUS CME courses, complete online modules, build an image portfolio, and take final knowledge and skills assessments to complete the SHM-ACCP POCUS COC program. Residents also participate in 1-month rotations on procedural and diagnostic POCUS applications, and provide peer-to-peer POCUS teaching to junior residents and medical students. Outcomes: POCUS track residents in all 3 years (n=12) were surveyed in April 2021 with a response rate of 100%. The POCUS track increased both use and comfort with diagnostic and procedural applications (Table 2). All residents (100%) rated being satisfied or very satisfied with the POCUS track and would recommend it to prospective applicants. Similarly, all residents (100%) rated being satisfied or very satisfied with the individual components of the POCUS track, including the SHM-ACCP POCUS COC program, POCUS Elective, and POCUS teaching opportunities. All 3rd-year POCUS track residents (100%) successfully completed the SHM-ACCP POCUS COC program prior to graduation and felt participation in the track was advantageous for their job search or fellowship applications. Per POCUS track residents, the most commonly reported barriers to utilizing POCUS were time constraints (83%), lack of available ultrasound equipment (83%), and lack of trained faculty to supervise (58%).

Conclusions: Our POCUS track leverages external educational resources to offer longitudinal POCUS training to IM residents. The SHM-ACCP POCUS COC program overcame our shortage of local POCUS-trained faculty who could train, provide feedback, and assess the knowledge and skills of our POCUS track residents. By serving as instructors, POCUS track residents increased our institutional capacity to provide POCUS training to junior residents and medical students. Our POCUS track can serve as a model for IM residency programs interested in providing longitudinal training to its residents but lack the required resources or local expertise to offer such training.

IMAGE 1: Table 1 – Curricular Components of a 3-year POCUS Track during Internal Medicine Residency

IMAGE 2: Table 2 – Frequency of Use and Comfort Level with Diagnostic and Procedural POCUS Applications by POCUS Track Residents