Variability in Ultrasound Education among Emergency Medicine Residencies

OBJECTIVE Education in emergency ultrasound (EUS) has become an essential part of emergency medicine (EM) resident training. In 2009, comprehensive residency training guidelines were published to ensure proficiency in ultrasound education. The American College of Emergency Physicians (ACEP) recommends that 150 ultrasound exams be performed for physician competency. Our goal is to evaluate the current ultrasound practices among EM residency programs and assess the need for further formalization of EUS training. METHODS We generated a survey using an online survey tool and administered via the internet. The survey consisted of 25 questions that included multiple choice and free text answers. These online survey links were sent via email to EM ultrasound directors at all 149 American College of Graduate Medical Education EM residency programs in April 2008. We surveyed programs regarding EUS curriculum and residency proficiency requirements and descriptive statistics were used to report the survey findings. RESULTS Sixty-five residency programs responded to the survey. The average number of ultrasound exams required by programs for EUS competency was 137 scans. However, the majority of programs 42/65 (64%) require their residents to obtain 150 scans or greater for competency. Fifty-one out of 64 (79%) programs reported having a structured ultrasound curriculum while 14/64 (21%) of programs reported that EUS training is primarily resident self-directed. In terms of faculty credentialing, 29/62 (47%) of residency programs have greater than 50% of faculty credentialed. Forty-four out of 61 (72%) programs make EUS a required rotation. Thirty-four out of 63 (54%) programs felt that they were meeting all their goals for resident EUS education. CONCLUSION Currently discrepancies exist between EM residency programs in ultrasound curriculum and perceived needs for achieving proficiency in EUS. Although a majority of residency programs require 150 ultrasound exams or more to achieve resident competency, overall the average number of scans required by all programs is 137 exams. This number is less than that recommended by ACEP for physician competency. These data suggest that guidelines are needed to help standardize ultrasound training for all EM residency programs.