Point of Care Ultrasound (POCUS) Designated Emphasis (DE) will provide medical students the opportunity expand upon their first year University of California Riverside (UCR) School of Medicine (SOM) gross anatomy curriculum, to enhance their understanding of pathology, diagnostic assessment and procedural skills, while preparing them for an essential technology in the future of medicine. The longitudinal integration of POCUS will provide a scaffolding approach to the implementation ultrasound into the development of a physician.

Students must complete the DE requirements by May of their fourth year of medical education. The DE is awarded in conjunction with the medical degree (M.D.) and will appear on transcripts as “M.D. with a Designated Emphasis in Point of Care Ultrasound.”

Designated Emphasis Requirements:

Year 1 Program Goals

These first-year program goals are a part of the Gross Anatomy lab curriculum that is for all students.

During year 1, students will develop a foundational understanding of ultrasound technology, including basic physics, ability to optimize imaging, and utilization of different modes of ultrasound. This will allow students to explore anatomy with ultrasound that is being covered in blocks associated with gross anatomy lab. This will enhance both the student's understanding of anatomy and basic image acquisition skills. Students are expected to:

• Complete flipped classroom assignments: Students will prepare for their hands-on learning session by viewing ultrasound videos and reviewing a study guide.
• Take part in both a pre- and post-quiz, with additional quiz questions integrated into the block exams.
• Prior to each hands-on session there will be a pre-session didactic to scaffold on top of their flipped classroom learning assignment, providing an opportunity for deeper learning and to answer conceptual and image interpretation questions.
• Participate in small group hands-on training to use ultrasound simulators and practice ultrasound image acquisition to explore sonographic anatomy.

Year 2 Program Goals

Focus for the students during year 2 will be to scaffold pathology onto the basic anatomy they learned in year 1. 

Students in good standing at the end of their first year can apply for the ultrasound designated emphasis and its MS2 selective (Ultrasound Student Instructor Selective - MDCL289). Ultimately this will also appear on their transcripts as ultrasound student instructor.

Successful applicants will become part of the annual Ultrasound Student Instructor Cadre (USSIC), whose members will teach the hands-on ultrasound curriculum to the first year medical students. USSIC members will also gain invaluable leadership experience by participating in a USSIC committee. USSIC requirements include:

• Document an ultrasound and simulation log to add to the student's ultrasound portfolio
• Complete SonoSim training
• Complete probe practice
• Attend annual USSIC Ultrasound Games
• Complete USSIC enrollment quiz
• Attend USSIC preparatory session didactic / hand-on training
• Participate in one USSIC committee
• Complete USSIC ultrasound instructional requirement
• Complete educational theory curriculum for instructors

Year 3 Program Goals

Students in good standing at the end of their second year endeavoring to continue in the POCUS DE will enroll in the third year Core Integrated Training in Ultrasound (CITrUS) selective that will be integrated into many of their core third year clerkships.

MS3 will be given a CITrUS Passport with scanning requirements unique to each clerkship to help facilitate institutional site compliance. CITrUS members will perform Free Open Access Medical education (FOAM) assignments and quizzes, followed by assigned ultrasound application practice, and documenting an ultrasound log. Practice review sessions can be performed remotely using ultrasound teleguidance for student convenience.

• Internal Medicine clerkship applications: Lung, Cardiac, Renal
• Surgery clerkship applications: Soft tissue, Abdominal (Biliary, Small Bowel Obstruction, Hernia)
• Pediatric clerkship applications: Lung, Abdominal (Appendix, Pyloric Stenosis, Intussusception)
• Family Medicine clerkship applications: Lung, Musculoskeletal, Aorta
• OB/Gyn clerkship applications: Pelvic
• Emergency Medicine clerkship applications: FAST, Ocular, Procedure

Year 4 Program Goals

Students in good standing endeavoring to continue in the Core Integrated Training in Ultrasound (CITrUS) will enroll in a fourth year ultrasound elective. Students completing all four years of POCUS DE will have developed an ultrasound portfolio and earned a CITrUS certificate that can be used to demonstrate merit. CITrUS portfolio requirements include:

1. Ultrasound elective rotation (4 weeks) and associated ultrasound log
2. Capstone project rotation (2 weeks)
3. POCUS Instruction
4. POCUS OSCE
5. Ultrasound conference attendance/participation