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Point of care ultrasound (POCUS) has oftentimes been touted as the stethoscope of the future. Improvements in technology have now lowered costs, making it more accessible to all physicians. Currently, there is no structured training program for POCUS and most POCUS users acquire knowledge during their respective specialist training by learning from peers or by attending ad-hoc courses. As POCUS gains traction, there is increasing interest in introducing training during medical school. We conducted an introductory course to POCUS for a batch of 9 medical students during their Internal Medicine rotation. The session was focused on orienting students to the ultrasound machine, knobology and imaging acquisition of the venous system. The instructors also shared with the students the scenarios whereby POCUS may aid diagnosis and clinical management. A survey was conducted after the course to assess the students' understanding and interest in further sessions. Prior to this session, the medical students were only introduced to ultrasound during their obstetrics rotation. After the session, 89% of the students have a better understanding of how POCUS can be integrated into daily clinical practice. 89% of the students were also more confident in handling the ultrasound machine. All the students felt that POCUS can enhance their learning, and should be included in the Internal Medicine curriculum. As POCUS becomes more widely practised, consideration should be made to include it as a component of medical school training. While there are concerns that it will divert attention and resources in a packed curriculum, the interactive nature of ultrasound training, its direct correlation with anatomy, integration with clinical scenarios, makes it a powerful tool to potentially enhance clinical teaching. [ABSTRACT FROM AUTHOR]

In recent years, there have been increasing interest in point of care ultrasonography (POCUS) in General Internal Medicine in Singapore. Internal Medicine Physicians have found it to be a useful adjunct to diagnostics and procedures. Yet a lack of a formal training program has been identified previously as a major barrier in acquiring POCUS skills. This has resulted in a wide variation in skills amongst senior residents and practising internal medicine physicians With the aim of introducing POCUS to Singhealth Advanced Internal Medicine Residency Program, the Department of Internal Medicine in Singapore General Hospital organized our first pilot POCUS course in January 2019. The course was targeted at Advanced Internal Medicine senior residents and focused on image acquisition of the heart, lungs, pleura, genitourinary and lower limb venous systems. A survey was conducted before and after the course, exploring the knowledge, confidence level and skills amongst our senior residents. Our survey revealed that most of our 12 participants had prior experience in POCUS, and their knowledge was picked up mainly during previous clinical rotations (8 of 12), while some had also attended courses (5 of 12), or learnt from their peers (5 of 12). Ultrasound was most commonly used for procedures like central line insertion (10 of 12), thoracocentesis (8 of 12) and abdominal paracentesis (6 of 12). 7 participants had utilized POCUS to evaluate hypotension, 3 for deep vein thrombosis, 2 for dyspnea and 2 for acute kidney injury. All participants agreed that POCUS is an important skill for Internists. While knowledge and confidence in image acquisition for the various systems amongst participants were generally varied and low before the course, there was a marked improvement in all components being surveyed after the course. The participants were more confident and familiar with the required views, landmarks and structures to identify when performing ultrasonography of the various systems. This survey highlights the fact that POCUS is already utilized in an ad-hoc manner in our Internal Medicine service. There is a need to develop a structured training program with a rigorous assessment to standardize the competency of POCUS users in order to ensure patient safety and improve quality of care. [ABSTRACT FROM AUTHOR]