For the emergency medicine and critical care physician competency in ultrasound is becoming essential.
The people I truly look up to in my specialties all recognise that bedside ultrasonography is an integral part of patient assessment.
However, the hows and whos of learning and teaching bedside ultrasonography remain a murky quagmire.
This is how I think it should be.
Every training scheme should have specialists skilled in the day-to-day use of bedside ultrasound who are equally adept in teaching these skills to others. Trainees should be expected, and should in turn demand, that they use ultrasound in their day-to-day practice and by the end of their training be proficient in diagnosing AAAs, performing eFAST scans, performing ultrasound-assisted procedures and using it to differentiate undifferentiated shock patients. Sonography skills will be meaningfully tested in Fellowship exams.
Trainees should not have to dip into their own pockets to attend expensive courses. They should not have to obtain superfluous additional certificates and qualifications. They should not have to complete meaningless logbooks (unless such logbooks are used effectively for reflection and meaningful discussion with a mentor).
In the future you won’t be an emergency medicine or critical care doctor unless you can inspect, palpate, percuss, auscultate, ultrasound and cogitate. Taking histories is integrated into our training. Examining patients is integrated into our training. Mastering ECG interpretation is integrated into our training. So must bedside sonography, and in the same way.
The real challenge is perhaps in teaching the teachers…