LAUSR

F or more than 2 decades, clinician-performed ultrasound (CPUS) examinations have been a required component of emergency medicine (EM) residency training programs. Due to the need for leaders in the field to develop advanced techniques, perform scientific investigations, and manage ultrasound (US) programs in both academic and clinical settings, more than 100 EM US fellowships have been established nationally since 1997. Many graduates of these fellowships are involved in teaching at medical school, residency, and fellowship levels, resulting in a high proportion working in academic settings, with high rates of job satisfaction. As the utility of CPUS has become more widely recognized, more than 50 US medical schools have integrated US into their preclinical and clinical curricula. This has resulted in many medical school graduates entering residency programs with a substantial degree of US exposure and the expectation that US will be an integral part of their residency training and clinical practice. Beyond this, a recently published expert consensus described a model for the development of system-wide clinical US programs, which will require substantial collaboration across specialties and departments. In internal medicine (IM) practice, however, CPUS (also frequently referred to as point-of-care US) is less widely established. This potentially results in the undesirable situation in which trainees have greater specific knowledge and experience than their supervising residents and faculty. This discrepancy is not due to a lack of awareness of the utility of CPUS in IM, as its applications are well described, with multiple subspecialties releasing consensus guidelines. A needs assessment and national guideline for IM CPUS training have been published in Canada, and the American College of Physicians has recently released a statement on the importance of CPUS in IM, but the development of expertise within IM practice environments and subspecialties remains a Supplemental material online at jultrasoundmed.org