To evaluate integration of musculoskeletal ultrasonography (MSKUS) education in Physical Medicine & Rehabilitation (PM&R) training programs in 2014-15, when the American Academy of Physical Medicine & Rehabilitation and Accreditation Council for Graduate Medical Education (ACGME) Residency Review Committee both recognized it as a fundamental component of physiatric practice; to identify common MSKUS components of PM&R residency curricula; and to identify common barriers to integration.
Survey of 78 ACGME-accredited PM&R residency programs.
The 2015 survey response rate was over 50%, and respondents were representative of programs across the U.S. Most programs (80%) reported teaching MSKUS, while a minority (20%) required mastery of ultrasonography skills for graduation. Ultrasonography curricula varied, though most programs agreed that the scope of resident training in PM&R should include diagnostic and interventional MSKUS, especially for key joints (shoulder, elbow, knee, wrist, hip, and ankle) and nerves (median, ulnar, fibular, tibial, radial, and sciatic). Barriers to teaching included insufficient expertise of instructors, poor access to equipment, and lack of a structured curriculum.
MSKUS has become a required component of PM&R residency training. Based on survey responses and expert recommendations, we propose a structure for MSKUS curricular standards and milestones for trainee competency.
1Department of Physical Medicine & Rehabilitation, The Ohio State University Wexner Medical Center, Columbus, Ohio. (MAB, RDT, SCC)
2Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio. (DPW, DPB)
3Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts
4Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
CORRESPONDENCE: Marcie Bockbrader MD PhD, The Ohio State University Department of Physical Medicine & Rehabilitation, 480 Medical Center Drive
Columbus, OH 43220, Tel: 614-286-0305, Fax: 614-293-3809, Email: Marcia.Bockbrader@osumc.edu
$ Current affiliation: Department of Orthopedics, Tufts University School of Medicine, St. Elizabeth’s Medical Center, Boston, Massachusetts
* Current affilitation: Regenerative Orthopedics and Sports Medicine (ROSM), Washington, DC
The authors declare no competing interests and no financial benefits associated with this project. No external funding or grants were used to support this work. No financial benefits to the authors are associated with this work. Portions of this study were presented at the Program for Academic Leadership during the 2015 and 2016 Annual Meetings of the Association of Academic Physiatrists (San Antonio, Texas, March 11-14, 2015 and Sacramento, California, February 17-20, 2016), Society of Ultrasound in Medical Education (Portland, Oregon, October 10-12, 2014), and at the 2015 and 2016 Annual Conventions of the American Institute for Ultrasound in Medicine (Orlando, Florida, March 21-25, 2015 and New York, New York, March 17-21, 2016). The authors acknowledge the Ohio State University Faculty Teaching Scholars Certificate Program, the Association of Academic Physiatrists Program for Academic Leadership, and the Ohio State University Department of Physical Medicine & Rehabilitation for their support of this project.