Ultrasound Training

Welcome to the ultrasound training and practice section of the RCEM website. There is also a complementary section with additional resources on RCEMLearning.

We hope you find the information and resources you need through this webpage; if you don’t please contact us as we are always looking at ways to improve things!

The Ultrasound Sub-committee 

The Ultrasound Subcommittee (USSC) of the College maintains this section; the USSC informs the Education Committee with regards to ultrasound training issues for emergency medicine. However, there are many aspects of point-of-care ultrasound (PoCUS) training and practice that transcend specialty boundaries and so we welcome clinicians from other specialties using our resources and are happy to collaborate!

The current membership of the Group can be found here: US Special Interest Group membership.

Regional ultrasound leads 

We want to ensure each of the regions of the United Kingdom and Ireland have leads for ultrasound training. The leads are primarily responsible for overseeing ultrasound training for emergency medicine trainees; however, they will also be tasked with promoting PoCUS and identifying problems to the USSC. An up to date list of these leads can be found here: US Regional Leads . The roles and responsibilities for the regional ultrasound leads can be found here: Roles and Responsibilities of the Regional Reps.

Training in point-of-care ultrasound 

From 2010, the higher specialty curriculum for emergency medicine incorporated PoCUS as a mandatory element. This means that from 2013 trainees need to be signed off at CORE level prior to CCT being awarded. The USSCs primary role is to support this. Regional panels will not allow an EM trainee to pass the final ARCP without Final Sign-off documentation being presented.

The pathway for training follows key steps which are shown here: Pathway for PoCUS. There are many applications for PoCUS; an application being a discrete focused use, for example evaluation of the abdominal aorta for abnormal dilation. For higher specialty training in emergency medicine there are four clinical applications, termed CORE (formerly Level 1):

  • Focused Assessment with Sonography in Trauma (FAST)
  • Assessment of the Abdominal Aorta for Aneurysm (AAA)
  • Focused Echocardiography in Life Support (ELS)
  • Ultrasound Guided Vascular Access (VA)
There are also two components to training that are mandatory for any PoCUS practice:

  • Understanding the Physics of Ultrasound
  • Good Governance in PoCUS

There are modules in RCEMLearning for all of the above (ELS is currently in development and will be available imminently).

The RCEM EMUS booklet is our core guide which includes information on the assessment process.

From 2014 the USSC preferred method of assessment will be via OSCE or Finishing School format; this usually involves more than one assessment (by RCEM accredited assessors) on models, patients or simulation (usually as mixture).  There are all four CORE competences assessment documents on the RCEM ePortfolio portal.

Enhanced practice 

When you are thirsty for more than the four clinical Core applications, you may want to embark on training for enhanced applications, i.e. hepatobiliary, renal, DVT, early pregnancy, thoracic, cardiac etc. The same principles apply; you will need to undertake initial training via an approved course +/- on line learning and then undertake supervised practice for your experience. You should keep a log of training scans and also reflect on a few cases in more detail. There is an Enhanced (formerly Level 2) RCEM document written in 2008 (we will be updating it soon) which can help you: RCEM US Level 2 guidance

Good governance for point-of-care ultrasound 
There are many questions which the USSC receives regarding issues such as who can supervise and assess trainees and how does the assessment process work? We have produced guidance for this – click here: RCEM Governance Statement.

Safety is paramount when using ultrasound on patients. The USSC recommends that users of diagnostic ultrasound refer to the British Medical Ultrasound Society guidance on safety.

We will shortly be producing guidance on writing department ultrasound guidance, which will include recommended equipment cleaning regimes. Examples will be provided also.

International point-of-care ultrasound 

Members of the USSC were pivotal in contributing to the latest IFEM ultrasound curriculum guidance - the RCEM Ultrasound Curriculum is compliant to the principles in this document.