The President's Letter: Ultrasound in Medical Education
July 25, 2013
I believe there is no more important issue facing ultrasound than its incorporation into undergraduate medical schools' curricula. Many of you saw the visionary presentation of Dean Richard Hoppmann, MD, at the 2012 AIUM Annual Convention in Phoenix, Arizona. Here at New York University School of Medicine, Uche Blackstock, MD, RDMS, an emergency department physician, is developing a multidisciplinary collaborative integrated preclerkship and clerkship curriculum. Consider the following:
It's another typically busy day at the medical center. A critical care fellow supervises a senior resident placing ultrasound-guided central vascular access in a hypotensive septic elderly patient in the medical intensive care unit. In the outpatient surgery suite, an anesthesiologist prepares a patient for rotator cuff surgery by performing an ultrasound-guided interscalene brachial plexus block for regional anesthesia. In the echocardiography lab, a cardiologist assesses a patient admitted the night before with a non-ST segment elevation myocardial infarction for wall motion abnormalities and cardiac function. An obstetrics and gynecology attending performs a pelvic ultrasound examination on a young woman being ruled out for an ectopic pregnancy, appreciates an intrauterine pregnancy, and discharges the patient home safely.
Over the last 20 years, ultrasound performed at the bedside, by clinicians, has revolutionized the way medicine is practiced. In these diverse cases, the use of ultrasound was critical in providing patients with effective and quality clinical care. Although currently being used for diagnosis, management, and procedural guidance by physicians in numerous and diverse specialties, a significant gap currently exists between what medical students are being taught and how they are expected to practice on completion of their training. Future physicians will be expected to be familiar with the use of ultrasound in their clinical practice, regardless of specialty. At this time, medical educators have a unique and timely opportunity to use ultrasound at the bedside as an innovative teaching modality in the undergraduate medical curriculum.
Handheld ultrasound will transform how medical students are taught in the preclinical curriculum as well. Students will never experience learning medicine the same way. They will be able to scan a live model and appreciate the gallbladder as its lies within the main lobar fissure of the liver. They will have a deeper understanding of the cardiac cycle by viewing the diastolic and systolic phases of a live beating heart. During clerkships, students will learn how bedside ultrasound can be used to make important diagnoses and to allow them to safely perform critical procedures. Bedside ultrasound as a teaching tool will enhance what students have learned traditionally and help reinforce important concepts.
An integrated ultrasound curriculum will require a multidisciplinary collaborative effort by a medical school faculty. This approach will ensure that students receive comprehensive exposure to ultrasound from all perspectives. Medical educators are responsible for ensuring students are well equipped for future clinical practice. Ultrasound, as I see it, will have a dual role in undergraduate medical education. First, it can and should be incorporated into preclinical learning to teach anatomy, physiology, and pathology. Second, there is almost no clinical clerkship, as outlined by the scenarios above, that does not already or else will soon utilize bedside ultrasound. The future is now.
The AIUM's Ultrasound in Medical Education Interest Group, chaired by David P. Bahner, MD, RDMS, has developed an outstanding online portal to assist those with an interest in integrating ultrasound into medical school curricula. This one-stop clearinghouse includes a mentor program; educational information from multiple organizations; and a tool kit that features curriculum examples, links to online lectures, sample proficiency assessments, tips on discussions with medical school leadership, instructor pools, equipment, and more. We encourage you to explore the Ultrasound in Medical Education Portal
. If you know of additional resources that should be included, e-mail MedEd@aium.org
AIUM membership for students, residents, and fellows allows these individuals access to helpful ultrasound-related resources and the opportunity to network with experts in medical ultrasound--an excellent complement to the clinical training they receive. This membership category is $25 and offers students the full array of member benefits. The students of today are the future leaders of the AIUM. I hope you will share this opportunity
with those with whom you are in contact.
Steven R. Goldstein, MD