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At Marshfield Clinic Health System, our Internal Medicine Residency Program offers a comprehensive, integrative, three-year longitudinal curriculum in Point-of-Care Ultrasound (POCUS). Residents develop the skills to acquire and interpret focused cardiac, pulmonary, abdominal, soft tissue, and procedural ultrasound images, ultimately integrating this information into patient management decisions.

POCUS is becoming an essential skill in internal medicine, with proven clinical benefits for patient care. Supported by the Alliance of Academic Internal Medicine (AAIM), our program integrates POCUS training across all three years of residency through a combination of lectures, practice sessions, and hands-on patient. Training is supervised by our POCUS champions and internal medicine faculty certified by the American College of Chest Physicians (CHEST) and the Society of Hospital Medicine (SHM).​​​

Program Features

Integrated Longitudinal Training

• Gel Rounds: Every team is encouraged to perform POCUS on patients during daily rounds, incorporating ultrasound evaluations into routine patient care.
• Advanced Equipment: State-of-the-art ultrasound machines are available in the intensive care units and emergency department.
• Progressive Complexity: The curriculum increases in complexity as the academic year progresses, ensuring residents become proficient in ultrasound imaging and interpretation.
• POCUS Devices: The program recently acquired new state-of-the-art handheld POCUS devices for each team on the floor. These devices are great tools for enhancing residents' clinical skills and efficiency.
  
  

POCUS Champions

At the end of the first academic year, 1-2 residents are selected as "POCUS Champions." These residents actively participate in the curriculum, teach POCUS skills to junior residents, medical students, and engage in quality improvement efforts. Please see this brief PowerPoint.

Curriculum Components

Introductory Boot Camp

• Intern Orientation: A half-day intensive training covering the fundamentals of sonography, cardiac ultrasound, lung/pleural ultrasound, DVT scans and Abdominal scans.
• Workshops: Utilizing a flipped-classroom approach to maximize hands-on scanning time with live models, high-fidelity simulation, and multimedia didactics.

Procedure-based Workshop

• A half-day workshop integrating POCUS into common bedside procedures, including central venous catheterization, and arterial lines.

Interactive Lectures

• Supplementary Skills: Various lectures on POCUS topics that include image review, interpretation practice, and hands-on scanning.

Outpatient Didactics

• POCUS Lectures: Outpatient didactics that include POCUS lectures to further enhance residents' ultrasound knowledge and skills.

Quality Improvement Projects and Grand Rounds

• QI Projects: Residents participate in quality improvement projects focused on POCUS to enhance patient care and safety.
• Grand Rounds: Regular grand rounds presentations on POCUS topics to keep residents updated on the latest advancements and practices.

Mini-Rotations

• POCUS electives: During this 2-week POCUS rotation, residents acquire ultrasound images, review them with faculty, complete an image portfolio, and apply for internal credentialing.
  

At Marshfield Clinic Health System, we are committed to providing our residents with the skills and knowledge necessary to excel in the ever-evolving field of internal medicine through our robust POCUS training program.