Guide
Which modalities the curriculum covers, what the expected scan numbers are, and why the curriculum describes them as guidance rather than a threshold.
Written by Dr Thomas Porter, emergency medicine registrar. Published 27 August 2026. Last reviewed 27 August 2026 against the 2025 Update.
The current curriculum is the RCEM 2021 curriculum as amended by the 2025 Update, which took effect on 6 August 2025. The update revised several special learning outcomes, including SLO6, under which point-of-care ultrasound sits.
Detailed POCUS guidance remains in Appendix 3 of the RCEM Point of Care Ultrasound (PoCUS) Curriculum 2021. The 2025 Update restates the expected scan numbers for the diagnostic modalities within the main curriculum document.
Appendix 3 divides point-of-care ultrasound into two groups, and the distinction determines how each is assessed.
Appendix 3 notes that the diagnostic modalities are introduced in intermediate training and developed during higher training, whereas the procedural modalities are the focus of core training.
For the diagnostic modalities, the 2025 Update states: “Entrustment based - for guidance approximate number of scans expected: ELS 10; AAA 25; Shock Assessment 25; eFAST/FAFF 25. Scans recorded in the logbook throughout training.”
The POCUS training progression tracker, the form trainees complete with their local ultrasound lead, sets these out per modality under the heading “Approx expected number (RCEM)”, and asks for five or more case reflections for each.
Appendix 3 gives the same figures with one difference: it records vascular access as a single entry of 5, where the tracker separates peripheral and central access at 5 each. The curriculum supports the tracker’s split, since both Appendix 5 and the 2025 Update require a “DOPS assessment for peripheral and central vascular access” as separate assessments.
Every document that states these figures describes them as guidance. Appendix 3 states the principle directly: “The goal of training is to achieve competency rather than rigid adherence to a fixed number of training scans however an indicative minimum number of scans is provided as guidance to both trainees and trainers about the number of scans that would reasonably be expected of a trainee.”
It also sets out what happens where the figures are not reached: “If the indicative number of scans is not met by the end of the training programme then the supervisor should record on e-portfolio that they are aware of this but this should not impede progress if the appropriate entrustment level for the stage of training has been obtained.”
RCEMLearning puts the same point more briefly: “The number of scans and reflections outlined in the curriculum are only indicative, so don’t chase numbers, chase greatness!”
The operative standard is therefore the entrustment level attained for the stage of training. The scan count is evidence towards it and is expected to be recorded, but it is not itself the threshold for progression.
Competence is recorded on the entrustment scale, which runs 1, 2a, 2b, 3 and 4. The progression tracker marks level 4 as “Required for HST completion”, and marks 2b as “Required for ACCS” against peripheral IV access, central IV access and fascia iliaca block. The SLO6 entrustment scale guidance describes level 4 as full competence and states that continuing professional development is required to maintain skills once it has been reached.
The two groups of modalities carry different requirements, and conflating them is the most likely source of confusion:
The entrustment scale guidance also links scanning frequency to level, suggesting at least one scan per fortnight at entrustment 1 and one scan per week at entrustment 4.
Appendix 3 states that “DOPS remains the primary assessment tool for all PoCUS modalities in keeping with other practical skills and procedures”, and separates two things that are assessed differently: obtaining an adequate image, and interpreting it correctly.
For the procedural modalities the 2025 Update sets out DOPS assessment for peripheral and central vascular access, together with either a DOPS assessment for fascia iliaca nerve block or simulated practice with reflection recorded.
The progression tracker asks for the date of the DOPS for each module and notes that DOPS should be completed on Kaizen. Simulation is acceptable: Appendix 3 states that it “is an acceptable method of gaining experience of abnormal findings or pathology”, and that DOPS assessments may be completed on simulated patients. Image interpretation is assessed through a combination of logbook, e-learning modules and formal assessment in RCEM examinations.
Appendix 3 sets out suggested milestones rather than fixed deadlines.
Appendix 3 adds that “it should be the exception that sign off is not achieved by the end of ST5”.
These requirements are recorded on the ePortfolio and reviewed at ARCP. Some deaneries present them differently on their own ARCP paperwork, and trainees should confirm the position against the form their panel will use rather than relying on the indicative figures alone.
Quotations are reproduced for reference with attribution. Requirements change: check the current documents on the RCEM website before relying on any figure here. LogEM is an independent app and is not affiliated with or endorsed by the Royal College of Emergency Medicine.
LogEM keeps POCUS separate from procedures and tracks each modality against these targets, with entrustment levels recorded per modality. See the POCUS logbook, or import an existing logbook.
LogEM is an independent app. It is not affiliated with or endorsed by the Royal College of Emergency Medicine.
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