141 - Trends in ultrasound use during physical medicine and rehabilitation residency training

Prevalence of ultrasound use is increasing across medical specialties due to its ease of access, lack of exposure to radiation, and ability to do point of care testing. In 2015, the Accreditation Council for Graduate Medical Education (ACGME) set the minimum requirement for ultrasound at 10 to graduate from physical medicine and rehabilitation (PM&R) residency. This minimum is not evidenced based; however, it is largely accepted that higher procedure volume is associated with improved learning. In addition, physiatry residents highly value ultrasound training. The objective of this study was to evaluate for changes in ultrasound use among physiatry residents.

Design:

Each resident individually self-reports their cases, and ACGME publishes aggregated procedure logs in September of each year for the graduating class. Data on ultrasound use were reviewed for 2016-2017 and 2022-2023. 2016-2017 was selected to avoid issues with procedure recording in the first year. T-test was used to assess for differences.

Results:

There were 77 programs and 404 residents in 2017 which increased to 91 programs and 467 residents in 2023. The total number of procedures grew from an average of 533.7 (range:262-2,103) in 2017 to 560 (range:235-3,830, p=0.25) in 2023. Ultrasound guidance accounted for 5.85% of procedures in 2017 and 8.75% in 2023 (p=0.001). Extremity ultrasound increased from 2.47 in 2017 to 3.39 in 2023 (p=0.005). Performed procedures increased from 427.4(range:181-1,787) in 2017 to 444.1(range:134-2,646) in 2023. Performing ultrasound guidance increased from 5.52% of procedures in 2017 to 8.2% in 202 (p=0.001). Performing extremity ultrasound increased from 2.15% in 2017 to 3.27% in 2023. Over 20% of residents did not meet ACGME criteria for ultrasound in 2023, similar to the graduating class of 2017.

Conclusions:

Despite increasing ultrasound use, over 1/5th of residents remain unable to meet the minimum criteria. Programs should address this deficiency, as applicants highly value this skill.