Using ultrasonography in everyday internists’ practice

Is ultrasonography a useful skill in everyday internists’ practice? Should it be a mandatory part of medical training?

Khalid Azzam, MD: Absolutely. Using ultrasound for physical examination and procedural applications in clinical practice is a very useful tool; I highlighted the advantages previously [see Main advantage of PoCUS]. Gradually, with the availability of technology, it will be a part of these tools that an internist should always go to. With the advance of handheld ultrasound, they are becoming better and better. They improve quality and reduce costs, and everyone will end up using them.

And it is happening already. More and more medical schools in the United States, in Canada, and across the world are introducing that in their curriculum. We are having students that are using ultrasound from their first anatomy class and on into their clinical practice. Residency programs across the world are introducing curricula for point-of-care ultrasound (PoCUS). At McMaster University, last year [in 2017] we piloted a graduate curriculum for internal medicine residents. We were able to publish and have it available in the literature for anyone to use. We are second year into that right now.

So yes, we need to know the tool, we need to know how to use it, we need to make it available to undergraduates and postgraduates. I think the biggest [difficulty] right now is how to get all the internists in practice to learn how to use ultrasound. I think in the future, in the next 10 years every internist will be using PoCUS. Those who are not trained in PoCUS will struggle. There are new concepts coming up, which are the nonscanning faculty who could just look at images and learn if they cannot get the dexterity of acquiring images… All these things are coming up in medical education.

To shorten my answer: yes, it should be introduced in undergraduate and postgraduate programs and as part of continuing education for internists. It is the tool of the future and it will improve patients’ outcomes. We know that.