Author: William Wilson, Adam Gowdy / Editor: Liz Herrieven / Codes: SLO6 / Published: 23/09/2025
So, you’ve decided to embark on your PoCUS journey, congratulations! If you’ve felt lost and confused, read on, and if you haven’t – carry on reading, nonetheless. This guide looks at the key components of the curriculum, making it easier to navigate your journey from novice to proficient practitioner. Let’s break it down!
Step 1: What You Need to Master (AKA The Ultrasound Buffet)
The RCEM curriculum (found here) requires competence in two main areas: ultrasound-guided procedures and bedside diagnostic Ultrasound Studies. Here’s the menu:
Ultrasound-Guided Procedures:
- Peripheral IV access
- Central IV access
- Fascia Iliaca Compartment Block (FICB)
Bedside Diagnostic Ultrasound Studies:
- FAFF/FAST/eFAST
- AAA assessment
- Echo in Life Support (ELS)
- Ultrasound-assisted shock assessment
And don’t forget the generic competences:
- Physics/settings/safety/ergonomics: because knowing how the machine works is kind of important and will help you understand when and when not to trust what you see.
- Clinical governance and administration is important for safety and learning, as well as when working on a QIP!
Step 2: Embrace the Entrustment Scale (you’ve seen this before)
The new curriculum has moved from the earlier “Level 1 triggered assessment model” to a “stepwise and continuous process for acquisition, progression, and maintenance of skills and knowledge using entrustment scales.” A reminder about the current entrustment scales:
Like any other SLO competency, to reach Level 4 you’ll need to prove your competence through a mix of assessments, reflections, and logbook entries.
Step 3: Build your portfolio (AKA How to Prove You’re Not Faking It)
RCEM wants you to build a solid case for your ultrasound skills. This is how you can go about it –
- Study Days:
- Introductory (CT1)
- Intermediate (CT2-3)
- Advanced (ST4-5)
- Assessments:
- DoPS: Show off your probe skills – keep an eye on this, as it will soon change on rizr (Kaizen).
- Mini-CEX: Prove you can talk and scan at the same time.
- CbD: Explain what the different blobs on the screen are and how they affect patient management.
- Logbook & Reflections:
- Record your scans, reflect on your practice and store images securely (no patient faces/names, please).
- RCEMlearning eModules
- Create your own image/video library
Pro tip: If you’re feeling extra ambitious, go for a postgraduate certificate or degree – why stop at Level 4?
Step 4: Study Days (Where the Magic Happens)
It was previously mandatory that you attend a level 1 course to get to grips with the basics. This is no longer essential, however we would still recommend attending one, as it will help to develop a strong foundation. Don’t forget to use your study leave and budget for this. Deanery study days should look like this:
- CT1: Learn the basics (physics, settings, and how not to drop the probe).
- CT2-3: Master IV access, AAA, and eFAST. Bonus points if you can say “focused assessment of the abdominal aorta” without stumbling.
- ST4-5: Become the ED’s go-to person for hypotension protocols and lung ultrasounds.
Step 5: Logbooks (Your Ultrasound Diary)
Yes, you’ll need to keep a logbook. No, it doesn’t have to be fancy. This shows engagement and progression along the competency levels. The Kaizen ePortfolio is your go-to, but feel free to use any platform. (Royalty free shout outs to: Eolas, SonoClip and tidyUltrasound)
What to include:
- Number of scans
- Reflections (e.g. “Today I learnt how to use TGC”)
- Images and videos (stored securely, your governance lead is watching).
Scans can be downloaded from ultrasound machines onto USB devices, ensure that you do not send patient details along with the transfer – there is usually an option to remove patient details before sending. Speak to your departmental lead if you aren’t sure how to do this (you definitely don’t want to be caught with patient identifiable scans). These images can then be uploaded onto your laptop. We would recommend having a file for each indication.
There has been some confusion regarding the number of scans you need to do. The current curriculum is based on competency rather than definite numbers, meaning that some people may require less scans and others perhaps more to achieve competency. The number of scans and reflections outlined in the curriculum are only indicative, so don’t chase numbers, chase greatness!
Step 6: Assessments (The Ultimate Test)
RCEM has ditched the old, triggered assessments for a more holistic approach. Now, you’ll be assessed through:
- DoPS: under watchful eyes.
- Mini-CEX: show you can integrate PoCUS into clinical decisions.
- CbD: discuss cases where ultrasound saved the day (or at least didn’t make things worse).
And remember, simulation counts, keep collecting your evidence and move up the entrustment ladder!
Step 7: Optional Extras (For the POCUS nerds)
Want to go above and beyond? Consider:
- FAMUS / FUSIC / FEEL / EGLS / BSE / EACVI: Because acronyms are fun.
- Postgraduate Certificates/Degrees: For when you want to impress your colleagues at parties.
Final Thoughts: You’ve Got This!
Mastering PoCUS is a journey, not a sprint. There will be days when you feel like a rockstar and days when all you can see is grey slush. But with RCEM’s curriculum guidance, a supportive training program, and a dose of humour, you’ll get there. The earlier the start the better you’ll be, and the bigger difference you’ll make for your patients.
So, grab that probe, channel your inner ultrasound ninja, and remember – even the best of us started by mistaking the bladder for an aorta.
TL;DR:
- The 2021 RCEM curriculum replaced triggered assessments with the entrustment scale.
- Build your portfolio with study days, assessments, and logbook.
- Attend progressive study days, join PoCUS clubs, and reflect on your scans.
- Keep a logbook and document your progress.
- Master ultrasound-guided procedures (IV access, FICB) and diagnostic studies (FAST, AAA, ELS, Shock assessment).
- Optional extras like FAMUS, FUSIC and postgraduate degrees are for the ultrasound enthusiasts, but we would recommend looking into lung ultrasound in more depth.
Now go forth and scan like a pro!
Disclaimer: No probes were harmed in the making of this blog.
One Response
Great Blog