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The role of ultrasound in modern medical curricula: A medical student perspective

We would like to thank the authors of the article “Integrating ultrasound into modern medical curricula” (Patel et al., 2017) for their timely and thoughtful piece of research regarding the role of ultrasound in medical education. This is a key issue in an evolving anatomy and medical education curriculum which we believe is likely to take on greater importance for practising physicians and impact upon patient care. We wanted to provide some thoughts on the role of ultrasound in anatomy education from our perspective as current medical students. There are clearly many benefits from integrating ultrasound teaching into the medical curricula. The authors rightfully state there is an increased use of ultrasound for diagnostic and management purposes in multiple specialties (Patel et al., 2017). Given that this trend will likely continue, so it is likely that future hospital physicians will require a basic familiarity with this technology. We perceive a future where students trained in ultrasound technology will have additional clinical skills to assess patients and perform clinical procedures, both as students and clinicians. These factors suggest that the implementation of ultrasound into an integrated medical education programme will be beneficial for both students and the medical profession. However there are several limitations that we believe are important to consider regarding the introduction of ultrasound into modern medical curricula: one potential issue is the loss of any ultrasound-specific skills and knowledge learned if students do not have the chance to use and consolidate them in clinical practice. Another issue is the current lack of standardization regarding ultrasound proficiency which will inevitably result from the differing programmes and teaching methods currently employed. We are concerned that in the absence of a standardized assessment there may be students graduating from different medical schools with significantly differing levels of clinical ability and technical proficiency. An additionally pertinent issue the authors raised is that of cost—the integration of ultrasound into medical curricula would necessitate funding to cover the implementation of any course, but the question arises as to what the source of this funding would be. Whether public or private in origin, any funding source would have to be sure of costeffectiveness and reciprocal benefit, which would require data from cost-analyses, few of which are available at the moment. In the current climate of medical specialization, it could also be argued that there may be increased costeffectiveness by funding increased training and recruitment of sonographers and/or radiologists, as opposed to adding to the remit of physicians in other specialties. The authors’ article highlights interesting observations regarding the timing of ultrasound teaching in different programmes; the aims of earlier implementation are anatomy education, whereas those later on are practical skills and clinical applications. While the authors noted that students expressed preference for regular, practically orientated sessions, further long-term studies are needed to follow-up on these findings to elucidate whether these actions are beneficial or simply solely reflect student preference and have no impact on their later practice. Other practical issues must be considered from an anatomical perspective, for example whether cadaver-based teaching for anatomy is preferable over ultrasound-based, and whether ultrasound’s greatest benefit to anatomy education is as an adjunct to cadaverbased learning? Another issue is that ultrasound would require specific staff training and time commitments, which may not be logistically possible. The authors rightfully point out potential ethical pitfalls whereby any volunteers should be checked before teaching sessions to identify possible pathologies and avoid unethical scenarios arising. There also remains the dilemma of equitable distribution of the limited time and resources for different areas of the medical education curriculum. Would the inclusion of ultrasound teaching necessitate the loss of another aspect of the curriculum, and by which measure(s) would this involve? Would such comparisons be valid? In conclusion, we agree with the authors’ view that ultrasound has an expanding role in modern medical practice, and that integration into medical curricula would be beneficial for medical students in the short term and long term. There seems to be a number of important issues regarding implementation that must be fully explored and addressed to successfully integrate ultrasound into the medical curriculum, however we feel that these are outweighed by the significant advantages and that this is a worthwhile direction to pursue.