The Current State of Ultrasound Training in Canadian Emergency Medicine Programs: Perspectives From Program Directors

ACADEMIC EMERGENCY MEDICINE 2012; 19:1073–1078 © 2012 by the Society for Academic Emergency Medicine Abstract Objectives:  There is a paucity of data about emergency ultrasound (EUS) training in emergency medicine (EM) residency programs accredited by the Royal College of Physicians and Surgeons of Canada (Royal College) and the College of Family Physicians of Canada (CFPC). Historically the progress of EUS in Canada has been different from that in the United States. We describe the current state of EUS training in both Royal College and CFPC-EM programs. Methods:  All Royal College EM program directors and all CFPC-EM program directors were invited to participate in a website-based survey. Main outcome measures were characteristics of currently offered EUS training. Results:  The response rate of the survey was 100% (30/30). EUS is part of the formal residency curriculum in 100% (13/13) of Royal College EM programs and in 88% (15/17) of CFPC-EM programs. EM resident rotations in ultrasound (US) are provided by 77% (10/13) of Royal College programs but only 47% (8/17) of CFPC-EM programs. There are specific requirements for numbers of EUS exams to be completed by graduation in 77% (10/13) of Royal College programs and 47% (8/17) of CFPC-EM programs. EM faculty and residents make clinical decisions and patient dispositions based on their EUS interpretation without a consultative study by radiology in 100% (13/13) of Royal College programs and 88% (15/17) of CFPC-EM programs. However, 69% (9/13) of Royal College programs and 53% (9/17) of CFPC-EM programs have no formal quality assurance program in place. Conclusions:  EUS training in Canadian EM programs is prevalent, but there are considerable discrepancies among residency programs in scope of training, curricula, determination of proficiency, and quality assurance. These findings suggest variability in both the level and the quality of EUS training in Canada. Resumen Objetivos:  Existe escasa informacion sobre la formacion en ecografia urgente (EU) en los programas de residencia de Medicina de Urgencias y Emergencias (MUE) acreditados por el Royal College of Physicians and Surgeons de Canada (RCPS) y por el College of Family Physicians de Canada (CFPC). Historicamente, el progreso de la EU en Canada ha sido diferente al de Estados Unidos. Se describe la situacion actual de la formacion en EU tanto en los programas de MUE del RCPS como del CFPC. Metodo:  Se invito a todos los directores del programa de MUE del RCPS y del CFPC a participar en una encuesta electronica. Los principales resultados recogidos fueron los tipos de formacion en EU actualmente ofertados. Resultados:  El porcentaje de respuesta de la encuesta fue del 100% (30/30). La EU es parte del plan oficial de formacion de la residencia en el 100% (13/13) de los programas de MUE del RCPS y en el 88% (15/17) del CFPC. El 77% (10/13) de los programas del RCPS incluye rotaciones en EU para los residentes de MUE, pero solo el 47% de los del CFPC. Se requiere realizar un numero de examenes especificos de EU para graduarse en el 77% (10/13) de los programas del RCPS y en el 47% (8/17) de los del CFPC. Los residentes y profesores de MUE toman decisiones clinicas y de ubicacion del paciente basandose en sus interpretaciones de la EU sin consultar con radiologia en el 100% (13/13) de los programas del RCPS y el 88% (15/17) de los del CFPC. Sin embargo, el 69% (9/13) de los programas del RCPS y el 53% (9/17) de los del CFPC no tienen un programa oficial que garantice in situ la calidad. Conclusiones:  La formacion en EU en los programas de MUE en Canada es prevalente, pero existen discrepancias considerables entre los programas de residencia en el ambito de la formacion, el plan de estudios, la determinacion de la competencia y la garantia de la calidad. Estos hallazgos sugieren variabilidad tanto en el nivel como en la calidad de la formacion en EU en Canada.