Dear sir/madam,
Point of care ultrasound (POCUS) in the hands of the non-radiologist has seen a steady growth in popularity amongst emergency, intensive care and acute medical physicians. Increased accessibility to portable, purpose-built ultrasound machines has meant that clinicians often have access to a safe and non-invasive tool to enhance their management of the unwell.
Focused Acute Medicine Ultrasound (FAMUS) is the point of care ultrasound curriculum created to aid the management of the acutely unwell adult patient. Following a survey of trainees and consultants, it was apparent that there was a strong desire for Acute Medics to be able to use point of care ultrasound to aid their clinical diagnostic skills. The FAMUS committee was set up to develop competencies using the evidence base available.
FAMUS stands in contrast to traditional radiology training modules, which focus on carrying out comprehensive assessments of anatomy and pathology. Instead, FAMUS delivers a syndrome-based sonographic assessment with the aim of ruling out gross pathology and interrogating underlying physiology. It serves as a useful adjunct to history and clinical examination by way of providing key information quickly and non-invasively. Furthermore, it provides a feasible way to monitor response to treatment or progression of disease and thereby providing useful dynamic information quickly and safely.
The accreditation in FAMUS involves the sonographic assessment of three systems: lung, abdomen and the deep veins of the lower-limb. Accrediting in each one involves theoretical learning, a formal course attendance and achieving a set number of supervised and mentored scans. As well as technical skills, the candidate must demonstrate competence in recognising key pathology and drawing appropriate conclusions about each scan, including when to refer for departmental imaging.
FAMUS was met with enthusiasm by trainees and consultants in acute medicine, and its popularity rises as more courses are becoming available for accreditation paired with increasing access to portable ultrasound units. It is envisioned that this will continue to grow and formal ‘train the trainer’ courses have been held in order to increase the pool of available supervisors.
Currently, FAMUS is endorsed by the Society for Acute Medicine and recognised by the AIM training committee as a specialist skill that can be undertaken during specialist training. It has been proposed that FAMUS should be considered for integration into the acute internal medicine (AIM) curriculum, which will be re-written for 2022 in line with the GMC’s revised standards for curriculum and assessment.
Thus we present in this letter, a curriculum mapping exercise that utilises a ‘knowledge, skills, behaviours’ framework in order to be considered for the AIM curriculum rewrite. We believe this will provide a standard and framework to integrate focused ultrasound in AIM training programmes with the aim of ultimately incorporating FAMUS as a core skill for all AIM trainees.
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References
- Smallwood, N et al. (2015). A UK wide survey on attitudes to point of care ultrasound training amongst clinicians working on the Acute Medical Unit. Acute medicine, 14(4), pp.159-164.
- Smallwood N et al. (2014). Focused Acute Medicine Ultrasound (FAMUS) - point of care ultrasound for the Acute Medical Unit. Acute Medicine, 15(4), p.193
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