POCUS Curriculum Overview

Bedside point-of-care ultrasound (POCUS) is becoming a pivotal necessary skill in internal medicine. The use of point-of-care ultrasound (POCUS) has shown clinical benefit to patient care within the field of internal medicine. The Alliance of Academic Internal Medicine (AAIM) supports the integration of POCUS across the longitudinal training environment. Our program offers integrated longitudinal training in POCUS throughout the 3 years of residency. This is composed by a mix of lectures and complimentary practice sessions, as well as hands-on sessions with patients in the medical ICU and cardiac care unit, under the supervision of the chief residents and certified pulmonary and critical care medicine faculty.

Each floor team has its own designated handheld ultrasound which is incorporated in daily floor rounds. We also have advanced state of the art ultrasounds available in the intensive care units and emergency department. The curriculum is designed to gradually increase in complexity as the academic year progresses. We encourage residents to become proficient in obtaining ultrasound imaging and interpretation of frequently encountered ultrasound findings.

At the end of the first academic year 1-2 residents are selected as “POCUS Champions”. These residents are encouraged to participate active in the curriculum, teach POCUS skills junior residents and medical students and participating in ongoing quality improvement efforts for the curriculum.

Curriculum Goal:

• At the end of the residency, residents will be competent in the basics of ultrasound physiology and identifying physiologic structures while differentiating them from pathologic presentations.
• Residents will become proficient in independently performing POCUS assessment of various organ systems, and capable of teaching these skills to junior residents.
• Residents will become proficient, competent and able to use POCUS to expedite time to diagnosis, improve procedural techniques, and provide high quality of care.

Teaching methods:

• Short didactic sessions and practice sessions with hands-on scanning and real time feedback of technique.
• Case-based discussion and interpretation of pathologic findings.
• Hands – on practice sessions with real patients.
• Pre and post curriculum assessment, survey and standardized competency assessment.

Lecture Series

Ultrasound Basics; Ultrasound science & physics, devices and cloud network, probe selection, knobology.

Lung and Diaphragm POCUS – Interpreting artifacts and profiles. Pneumothorax. BLUE protocol.

Introduction to Cardiac POCUS I – Cardiac windows & Views. LV Function.

Introductions to Cardiac POCUS II – Right Ventricle Assessment.

IVC – Evidence & pitfalls, Image acquisition and measurements, distensibility and collapsibility indexes.

Abdominal POCUS – eFAST, renal ultrasound, gallbladder.

Cardiac Arrest POCUS – RUSH, EGLS protocols.

Ultrasound-guided procedures – Lumbar puncture, central venous catheter, paracentesis, peripheral lines.

Clinical Vignette session – comprehensive case based discussion with imaging findings.

Hands-on practice sessions.

Resident Publications & Quality Improvement

Varrias D, Palaiodimos L, Balasubramanian P, Barrera CA, Nauka P, Melainis AA, Zamora C, Zavras P, Napolitano M, Gulani P, Ntaios G, Faillace RT, Galen B. The Use of Point-of-Care Ultrasound (POCUS) in the Diagnosis of Deep Vein Thrombosis. J Clin Med. 2021 Aug 30;10(17):3903. doi: 10.3390/jcm10173903. PMID: 34501350; PMCID: PMC8432124.

Clinical proficiency of residents in point of care ultrasound (POCUS) and self-perception of quality of training. Jose Cano, Sheetal Mathai, Marko Novakovic, Juan Torrado, and Jee Young. Jacobi Medical Center, Department of Adult Primary Care, Internal Medicine Residency, 2021.

Juan Carlos Ruiz, Jorge Ataucuri-Vargas, Errold Reid, Harmeen Goraya, Mohammed Abbasi, Robert Faillace, Perminder Gulani, Why wait until fellowship? The feasibility of point of care ultrasound training for internal medicine residents: Part 1. Milford Fulop Poster Competition, Jacobi Medical center/Albert Einstein College of Medicine,  Bronx, NY. 2018

Juan Carlos Ruiz, Jorge Ataucuri-Vargas, Errold Reid, Harmeen Goraya, Mohammed Abbasi, Robert Faillace, Perminder Gulani, Why wait until fellowship? The feasibility of point of care ultrasound training for internal medicine residents: Part 2. Milford Fulop Poster Competition, Jacobi Medical center/Albert Einstein College of Medicine,  Bronx, NY. 2018.

About Us:

Dr. Hassan Patail, Director of the Internal Medicine POCUS Curriculum, Pulmonary & Critical Care Attending.

Gabriel Hernandez Romero, MD, Chief Resident, POCUS Curriculum Course instructor

Tinatin Saralidze, MD, Chief Resident, POCUS Curriculum Course instructor

For more information about our POCUS curriculum please email jmc.chiefs@nychhc.org

Additional Resources:

5 Minute Sono.

Ultrasound of the Week.

CORE Ultrasound

American Institute for Ultrasound in Medicine (AIUM).

Asynchronous Crowdsourced Education for Clinical Ultrasound (ACE4CUS).

Massachusetts General Hospital Emergency Ultrasound. MGH Emergency Ultrasound Educational Website. 

Society for Academic Emergency Medicine. Ultrasound. 

Sonoguide. Hoffmann B. Introduction to Emergency Ultrasound. 

SonoSpot: Topics in Bedside Ultrasound. 

MOBILE Apps

Resus

POINT OF CARE ULTRASOUND – Ohio State University 

Shock Echo – EGLS

Evidence Atlas