Letters to the Editor
In Reply to Georgakarakos et al: We appreciate the kind letter from Drs. Georgakarakos, Georgiadis, and Lazarides, whose comments raise the interesting question of what constitutes appropriate undergraduate medical education (UME) ultrasound course content.
The purpose of medical student training in the United States should be to prepare the future clinician to rapidly and safely evaluate the patient. Clearly, venous and arterial disease produces significant morbidity and mortality. Ultrasound training is thus important in UME, since it has the potential to provide better understanding of the physiology in peripheral artery disease and may augment students’ understanding and their ability to diagnose the disease. This is supported by a sentinel study by Wittich1 in 2002, where focused echocardiography performed by medical students was shown to produce improved cardiac physical examination accuracy. This finding was likely related to students’ directly visualizing the anatomy and physiology corresponding to characteristic findings on the physical exam.
We agree that active learning to perform focused peripheral vascular ultrasound examinations can augment students’ understanding of cardiovascular pathophysiology. But should skill in such examinations be considered a core competency or an enriched competency? Future medical student ultrasound training should define the topics of both these types of competencies and the training needed to attain them. Despite early programs, such as our own advanced ultrasound program, we feel that a national discussion on which components of ultrasound education are needed in UME is becoming imperative.
David P. Bahner, MD, RDMS
Associate professor, director of ultrasound in emergency medicine, and director, Emergency Medicine Ultrasound Fellowship, Department of Emergency Medicine, Ohio State University College of Medicine, Columbus, Ohio; firstname.lastname@example.org.
Nelson A. Royall, MD
Resident, Department of Surgery, Orlando Health, and resident instructor, University of Central Florida College of Medicine, Orlando, Florida.
1. Wittich CM, Montgomery SC, Neben MA, et al. Teaching cardiovascular anatomy to medical students by using a handheld ultrasound device. JAMA. 2002;288:1062–1063