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How to get certified in POCUS?

This is one of the commonest questions I get. First, as previously mentioned, the American College of Emergency Physicians policy statement on emergency ultrasound recommends that a trainee should perform 25–50 ultrasounds per core application and a total of 150–300 scans as part of POCUS training. Recently, a study reported that EM residents who performed more than 300 scans performed better on observed structured clinical examination (OSCE) compared to those who performed less. Interestingly, plateau effect was noted around this number.

We all know that competency is not just about the number and the learning curve varies among trainees. However, there has to be some benchmark or threshold to grant POCUS privileges to physicians albeit with a quality assurance system in place. Hospitals typically use this EM guideline when reviewing nephrologists’ (or internists’) application for POCUS privileges. This is good for fellows who are trained in ultrasound during their nephrology fellowship and have relevant documentation available. On the other hand, practicing physicians and fellows without POCUS training have to rely on external certifications.

There are certifications available for basic as well as advanced POCUS. For example, POCUS certification academy offers certifications in individual sonographic applications after the applicant passes an online examination and submits the proof of performing a set number of scans (e.g. 20 for lung, 30 for cardiac etc). American College of Chest Physicians offers a well-organized certification program in collaboration with Society of Hospital Medicine. However, this is relatively expensive. American Society of Diagnostic and Interventional Nephrology offers certification in comprehensive renal ultrasonography but not in other applications at this time (new guidelines expected in 2021). In addition, nephrologists interested in advanced echocardiography can take the critical care echo examination administered by the National Board of Echocardiography (NBE). No matter how you get trained/certified, continued scanning is the key to becoming an expert. Otherwise, POCUS skills decay super fast. Hope this helps!

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