Information about the rotation

Medical Student Rotators

A warm welcome to the Medical Student Emergency Ultrasound Rotation at USC. Below you will find information about your rotation:

Rotation requirements:

As a prerequisite complete the timed pre-rotation assessment.
Complete ten 6-hour scanning shifts during the course of the 2-week rotation, where you personally scan at least 5 patients a day. Create your own scanning schedule and email us your proposed schedule by the first Tuesday of the rotation.
Complete online self study. Please read the following sections in Sonoguide prior to the first Wednesday of the rotation: Introduction, Physics, FAST, Aortic Aneurysm, Cardiac, Gall Bladder, Renal, Early Pregnancy, Soft Tissue, and Vascular Access, at a minimum. You are welcome to read additional sections of interest. If you are interested in additional online self-study, we can direct you to numerous excellent online resources.
Attend ultrasound education day every Wednesday 9am-12pm in GH 1050-1.
Attend DEM grand rounds every Thursday in GH 1645, 9am-1pm.
Prepare a case presentation. Choose an interesting case that you saw during your rotation and prepare a 5-8 minute powerpoint/keynote to present the clinical case (history and physical, labs/studies), the ultrasound images, and relevant teaching points. You can ask any US faculty how to obtain US images.
Read and present assigned journal club articles during Wednesday conference (these will be emailed to you in advance.)
Take the online post-rotation assessment test, which concludes your rotation.

Scanning shift details:

One of the ultrasound team members will meet you on your first Monday at 7am in the ED West doctors’ room. One of them will orient you to how the ultrasound machines work, where the machines are located, how to scan, and how save and interpret your studies.
During your scanning shifts, you should scan independently as well as with residents and faculty. Scanning independently will allow you to become more comfortable holding the probe and operating the machine, but is likely to be more useful after you have had some proctored time with faculty. If you are scanning independently, be sure to introduce yourself to the attending and resident caring for the patient you plan to scan AND inform the patient that you are learning and the results of the ultrasound will be reviewed by someone with more experience and will not impact his or her immediate care. Your goal is to scan at least 5 patients per day (scans where you are actually holding the probe, not observing.) You will find this easiest to accomplish by wheeling a machine around the department and scanning whatever seems interesting. Ask residents working clinically if they have interesting cases to ultrasound. Alternatively, any patient with chest pain, abdominal pain, or dyspnea may be appropriate to ultrasound.
While we expect you to scan during the days Monday through Friday, you are welcome to scan on weekends or overnights if you prefer.
Ultrasound faculty are available to scan with you during their scanning shifts, but you need to email them in advance to set up a time. You can view the scanning shift schedule by clicking “Calendar & Events” at the top of this page. Try to scan with a different faculty member each week so you are exposed to different teaching styles. Please email faculty members directly to reserve a time to scan
Ultrasound Faculty can be reached on the Ultrasound VoIP x91646 (from a department phone) during their scanning shifts.

Saving your ultrasound studies:

Save all of your scans on the machine by entering M4A or M4B (whichever you are assigned) under reading doctor and enter the c-number of the person scanning with you under referring doctor. Also make sure to input the medical record number for each scan. Your QPATH password will be emailed to you.
Enter your interpretation in Qpath. We will review your scans each week. We will orient you on how to submit worksheets in QPATH on the first day of your rotation.
Try to submit worksheets on the day that you perform the scans, to aid you in remembering the scan and to allow adequate time for US Faculty QA. Feel free to call attention to interesting scans during Wednesday didactics.

Letters of recommendation:

We will consider writing letters of recommendation for students who complete a 4 week rotation. Please contact me if you are interested in a letter from the Emergency Ultrasound Division.

Rotation Contact:

Talib Omer, MD RDMS

PGY-I Rotators

zeLAC+USC DEM RESIDENT PGY 1 Ultrasound Rotation

Rotation Length

2 weeks

ACGME Milestone

Uses goal-directed, focused ultrasound for the bedside diagnostic evaluation of emergency medical conditions and diagnoses, resuscitation of the acutely ill or injured patient, and procedural guidance.

Rotation Requirements

Pre-rotation assessment prior to starting your rotation

10 six-hour scanning shifts over the course of the 2 week rotation, during US faculty scanning sessions.

Completion of the day 1-10 online modules including the 10 post-module quizzes.

Completion and interpretation of at least 100 ultrasound scans.

Attendance at weekly didactic session (Wed 9am-12pm)

Presentation of assigned journal club articles.

Case presentation of interesting ultrasound case.

Presentations should be powerpoint or keynote format, 5-8 minutes, and no more than 10 slides (1 on HPI, exam, vitals, 2-3 with bedside US images, 1-2 for formal radiology if necessary, 1 follow up, and 1-2 teaching points about US findings or an interesting diagnosis).

Attend cadaver lab (if applicable during your rotation).

Completion of online self study on ACEP Sonoguide (Physics, FAST, Aortic Aneurysm, Cardiac, Gallbladder, Renal, Early Pregnancy)

Completion of post-rotation assessment.

Goals and Objectives

Demonstrate appropriate fund of knowledge regarding US “knobology.”(MK)

Obtain adequate images for the core emergency ultrasound indications, and troubleshoot/find alternate views on difficult patients. (PC)

Correctly perform and interpret the following core emergency ultrasound indications: the extended FAST exam for trauma patients, intrauterine pregnancy, aorta, cardiac (yes/no effusion), gallbladder, renal/bladder (hydronephrosis), DVT, lung (pneumothorax or pulmonary edema), ocular (retinal detachment), and procedural guidance for line placement. (MK,PC)

Recognize inadequate image acquisition and seek help from US faculty. (PBL, ICS)

Communicate important findings to patients and/or their medical team. (ICS)

Demonstrate respect, compassion and integrity towards patients and their families during US examinations. (PR)

Punctually attend all mandatory clinical and educational sessions, and complete rotation requirements. (PR)

Patient Care (PC): Patient Care: Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.

Medical Knowledge (MK): Residents must demonstrate knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care.

Practice-Based Learning(PBL): Residents must be able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence, and improve their patient care practices.

Interpersonal and Communication Skills(ICS): Residents must be able to demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients, their families and professional associates.

Professionalism(PR): Residents must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.

Systems-Based Practice(SBP): Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value.

Feedback Mechanisms

The EM resident will receive informal direct feedback during scanning shifts and will have a formal evaluation at the end of his/her rotation reviewing: number of scans performed, QA results, and areas for improvement.

PGY-II Rotators

LAC+USC DEM RESIDENT PGY 2 Ultrasound Rotation

Rotation Length

2 weeks

ACGME Milestone

Uses goal-directed, focused ultrasound for the bedside diagnostic evaluation of emergency medical conditions and diagnoses, resuscitation of the acutely ill or injured patient, and procedural guidance.

Rotation Requirements

10 six-hour scanning shifts over the course of the 2 week rotation, during US faculty scanning sessions.

Completion and interpretation of at least 100 ultrasound scans.

Attendance at weekly didactic session (Wed 9am-12pm)

Presentation of assigned journal club articles.

Case presentation of interesting ultrasound case on second Wed of rotation.

Presentations should be powerpoint or keynote format, 5-8 minutes, and no more than 10 slides (1 on HPI, exam, vitals, 2-3 with bedside US images, 1-2 for formal radiology if necessary, 1 follow up, and 1-2 teaching points about US findings or an interesting diagnosis).

Attend cadaver lab (if applicable during your rotation).

Completion of the advanced online resident curriculum.

Completion of online self study: Completion of the ACEP Sonoguide online self study: (DVT, Soft Tissue, Musculoskeletal, ENT, Testicular, Ocular, Procedures)

Completion of the pre-rotation and post-rotation assessment.

Teaching a station at medical student ultrasound course (if applicable during your rotation).

Goals and Objectives

Obtain adequate images for the core emergency ultrasound indications, and troubleshoot/find alternate views on difficult patients. (PC)

Successfully integrate ultrasound findings into direct patient care in a busy clinical environment. (PC)

Exhibit mastery of the following core emergency ultrasound indications: the extended FAST exam for trauma patients, intrauterine pregnancy, aorta, cardiac (yes/no effusion), gallbladder, renal/bladder (hydronephrosis), DVT, lung (pneumothorax or pulmonary edema), ocular (retinal detachment), and procedural guidance for central line placement. (MK,PC)

Acquire and correctly interpret ultrasound images for advanced emergency indications: peripheral nerve blocks, musculoskeletal (effusions, fractures), pediatric (appendicitis, intussusception), volume assessment (RUSH exam). (PC,MK)