Curriculum

Loma Linda University School of Medicine Ultrasound Curriculum

OVERALL GOAL: Develop point-of-care ultrasonography skills to manage patients

YEAR-1

GOALS Year-1:

  1. Develop the skills necessary to show and recognize normal ultrasound images of the eye, thyroid, cardiovascular, pulmonary, and abdominal organ systems in conjunction with the normal physical exam.

OBJECTIVES Year-1:

  1. Perform the following ultrasounds using appropriate technique:
    1. Ocular
    2. Thyroid
    3. Vascular
    4. Pulmonary
    5. Abdominal
    6. Cardiac
  2. Identify normal ultrasound findings for the following ultrasounds:
    1. Ocular
    2. Thyroid
    3. Vascular
    4. Pulmonary
    5. Abdominal
    6. Cardiac

YEAR-2

GOALS Year-2:

  1. Begin to recognize abnormal ultrasound images, perform more advanced ultrasound applications, and begin to understand techniques used for ultrasound procedural guidance.

OBJECTIVES Year-2:

  1. Perform the following ultrasounds using appropriate technique to evaluate for abnormal pathology for the following organ systems:
    1. Abdominal
      1. Hepatitis
      2. Appendicitis
      3. Ascites
      4. Hemoperitoneum
      5. Cholecystitis
      6. Liver abscess
      7. Urinary retention
    2.  Pulmonary
      1. Pneumonia
      2. Pleural effusion
      3. Emphysema
      4. Pulmonary edema
      5. Pneumothorax
    3. Soft tissue/Musculoskeletal
      1. Differentiate between skin, nerve, muscle, and tendon
      2. Cellulitis
      3. Abscess
      4. Necrotizing Fasciitis
    4.  Cardiac
      1. Endocarditis
      2. Myocarditis
      3. Pericardial effusion/tamponade
      4. Aortic Dissection
      5. Abdominal Aortic Aneurysm
      6. Diastolic versus Systolic heart failure
      7. Regional wall motion abnormality
      8. Valvular pathology
    5.  Obstetrics/Gynecology
      1. Oligohydramnios and Polyhydramnios – Measurement of Maximum vertical pocket
      2. Vertex or breech presentation – Locate presenting fetal part
      3. Viable pregnancy – Locate fetal heart and measure fetal heart rate.
  2. Perform and demonstrate ultrasound-guided techniques for procedures on pathologic phantoms to evaluate the following conditions:
    1. Meningitis – Lumbar puncture
    2. Pleural effusion or Empyema – Thoracentesis
    3. Ascites and Spontaneous Bacterial Peritonitis – Paracentesis
    4. Blood Stream Infections and Sepsis – Vascular access

YEAR-3

GOALS Year-3:

  1. Develop proficiency in performing basic ultrasound applications on live patients and be comfortable with techniques used for ultrasound procedural guidance relevant to core clinical rotations.

OBJECTIVES Year-3:

  1. Obstetrics/Gynecology: Demonstrate the ability to perform and interpret findings on a 2nd or 3rd trimester obstetric patient for the following ultrasounds:
    1. Maximum vertical pocket
    2. Fetal heart rate (using M-mode)
    3. Fetal position
  2. Surgery: Demonstrate the ability to perform and interpret findings for the following ultrasound:
    1. Extended Focused Assessment with Sonography for Trauma.
  3. Family Medicine: Demonstrate the ability to perform and interpret findings for the following ultrasounds:
    1. Abdominal aortic aneurysm
    2. Basic echocardiographic exam
    3. Breast cysts/masses (optional and needs to be arranged with clerkship director in advance)
    4. Thyroid nodules/masses (optional and needs to be arranged with clerkship director in advance)
  4. Internal Medicine: Demonstrate the ability to perform and interpret findings for the following ultrasounds:
    1. Basic echocardiographic exam
    2. Evaluate fluid status using the inferior vena cava
    3. Perform ultrasound-guided procedures

YEAR-4

GOALS Year-4:

  1. Become proficient in the knowledge, attitudes, and skills necessary to perform point-of-care ultrasounds relevant to the student’s medical specialty of interest.

OBJECTIVES Year-4:

  1. Emergency Medicine and Critical Care Ultrasound Elective:
    1. Demonstrate skills and understanding in the utilization of ultrasonography in evaluating emergency department and critically ill patients.
    2. Demonstrate an understanding of the scope of practice and role of bedside point-of-care ultrasound in relation to comprehensive examinations performed by Radiology.
  2. Orthopedics/Sports Medicine Ultrasound Elective:
    1. Demonstrate skills and understanding in the utilization of ultrasonography in evaluating orthopedic patients.
    2. Demonstrate an understanding of the scope of practice and role of bedside point-of-care ultrasound in relation to comprehensive examinations performed by Radiology.