The Canadian Internal Medicine Ultrasound (CIMUS) group has developed a consensus statement outlining mandatory point-of-care ultrasound (POCUS) competencies for ultrasound-guided thoracentesis, paracentesis, and central venous catheterization (CVC) for internal medicine physicians. This initiative involved 27 voting members representing 17 Canadian academic institutions across eight provinces. Through a structured three-round voting process, members evaluated 46 procedural competencies, including general, thoracentesis-specific, paracentesis-specific, and CVC-specific skills. The consensus determined 28 competencies as mandatory, 3 as optional, and 11 as superfluous, while 4 competencies failed to reach a clear decision.
POCUS is now considered the standard of care for these procedures, as it improves success rates and minimizes complications. However, the lack of clearly defined competencies has led to inconsistent training standards in Canada. The CIMUS recommendations aim to address this gap, ensuring internal medicine trainees acquire the skills necessary for safe and effective procedural performance. The identified competencies include general skills like real-time needle visualization and advanced techniques such as assessing vessels before puncture and catheter placement.
The consensus process was informed by published competencies and updated literature, emphasizing patient safety, procedural success, feasibility of teaching, and learnability within the Canadian postgraduate medical education framework. The CIMUS group recommends these mandatory competencies be integrated into national curricula to standardize training and enhance procedural outcomes. This initiative underscores the importance of ultrasound in improving the safety and accuracy of bedside procedures in internal medicine.
