Dalhousie DEM PoCUS Fellowships

Dalhousie University – Department of Emergency Medicine

Point of Care Ultrasound Clinical-Academic Fellowship



Member of the Canadian Society of EM-PoCUS Fellowships – PoCUS.ca



Fellowship Director, Dalhousie University, Saint John – Dr. David Lewis

Fellowship Director (Research), Dalhousie University, Saint John – Dr. Kavish Chandra and Dr. Paul Atkinson

Fellowship Director, Dalhousie University, IWK – Dr. Emma Burns and Dr. Kirstin Weerdenburg

Assistant Fellowship Director, Dalhousie University, Saint John – Dr. Kyle Traboulsee

Overview and Objectives

The Dalhousie University Department of Emergency Medicine Point of Care Ultrasound (PoCUS) Elective Fellowship Program is based at the  Saint John Regional Hospital (SJRH) with an optional up to 1-month placement in Pediatric PoCUS at the IWK Health Centre Pediatric Emergency Department.  Our PoCUS Program began in 2009 and has been one of the leading programs in Canada for research and education. We are very proud of our program and excited that you are considering joining us. The information below outlines the nature and scope of the Fellowship options, with a breakdown of the individual components that comprise your educational experience. Particular attention is paid to how we plan on providing you with the tools you need to succeed in your career in each discipline, and on the expectations we have of you.

3-month Clinical PoCUS Fellowship

The Clinical PoCUS Fellowship (3-months) is designed for physicians in practice wanting to develop PoCUS expertise, either generally or with a focus on a specific set of PoCUS applications (see above) and gain an introduction to academic PoCUS and PoCUS program management. It will include selected components of the 12-month Dalhousie Emergency Medicine Clinical Academic PoCUS Fellowship.

The four primary components of our fellowship programs include:

  1. Clinical: optimizing image acquisition and interpretation skills for both core and advanced emergency and point of care ultrasound applications
  2. Education: developing lecturing and teaching skills by developing an emergency ultrasound lecture portfolio and contributing to the program’s educational mission. Acquiring expertise at bedside ultrasound teaching and assessment.
  3. Administration: understanding the critical components required to run an emergency ultrasound program, set up and deliver educational events/courses and how to best utilize information technologies for image archiving, database management, and quality assurance.
  4. Research: understanding the state of emergency ultrasound research by participating in ultrasound journal club activities and developing an independent research project from its inception to publication.

Eligibility and Requirements

Dalhousie Emergency Medicine Clinical PoCUS Fellowship (3 Months)

  • EM (or other acute specialty e.g. IM, FM, Surgery) Resident in Canadian Royal College or Canadian College of Family Physicians Residency Programs
  • Canadian board-certified physician (holding either FRCP, CCFP-EM or CCFP certification)

Dalhousie Emergency Medicine Clinical Academic PoCUS Fellowship (12 months)

  • Canadian board-certified physician (holding either FRCP, CCFP-EM or CCFP certification) and licensed with the New Brunswick College of Physicians and Surgeons with current medical liability insurance
  • International Visa Sponsored Fellows (Saudi Arabia, Kuwait, Oman, UAE, Qatar, Bahrain – Via Dalhousie IMG Visa Sponsored Fellowship program application) For details contact Charles Hsuen, Visa/IMG Programs Manager [email protected]

Funding and Fellowship Tuition Fees

Canadian Residents will need to come with their own funding via their own Residency Program.

Canadian physicians who wish to undertake the 3-month clinical PoCUS fellowship will need to be self-funded. Locum shifts are available at many of our site hospitals including Saint John.

For Canadian physicians who have graduated residency and who wish to undertake a 3 or 12-month fellowship, the position may include a locum appointment (pending Nominations/Privileges agreement) as a part-time attending physician in the Department of Emergency Medicine in the Saint John Region group of hospitals including Sussex, St Joseph’s UCC, Charlotte County and Saint John Regional Hospitals, and as such, it is available only to individuals meeting requirements for medical licensure in New Brunswick (https://cpsnb.org/en/licensure-in-new-brunswick).

International Visa Sponsored Fellows are funded directly via the Dalhousie IMG Visa Sponsored Fellowship program.

Fellowship tuition fees are applicable to all programs and further information is available on application. For residents these will need to be covered by their Residency program.


A. Dalhousie Emergency Medicine Clinical PoCUS Fellowship (3 months)

For self-funded Physicians, there is a degree of flexibility with the schedule and program requirements depending on the physician’s pre-fellowship PoCUS skill level, their requirements and their geographical location.

  • 1-2 Scanning shifts per week – Supervised by PoCUS faculty
  • 4-8 Supervised PoCUS sessions per month – 2hr dedicated bedside PoCUS teaching
  • Assist with Resident and Student PoCUS teaching
  • Self-Directed learning to cover Ultrasound Physics and Instrumentation (see below) and other selected components of the Fellowship program.
  • Participation in PoCUS Journal club and Rounds
  • Participation in PoCUS QA and Q-Path review
  • Participation in local PoCUS courses
  • Completion of 2-3 PoCUS Pearls https://sjrhem.ca/tag/pocus-pearl/
  • Successful completion of Summative Assessment

B. Dalhousie Emergency Medicine Clinical Academic PoCUS Fellowship (12 months)

Your weekly schedule requirements are approximately 36 hours per week and are very variable from week to week. In general, you should expect to spend approximately:

  • Approximately 16hrs/week – clinical / scanning shifts per week.
  • Approximately 20hrs/week – fellowship responsibilities; including scanning practicals, tutorials, teaching, academic work, QA, and research/administrative work.
  • You will be required to teach and assist with local PoCUS courses.
  • You will present at journal club and rounds.


You are expected to read the provided materials to enhance your knowledge in the field. The topics to be covered are outlined below. You will be provided with material to cover all of these topics.

A. Ultrasound Physics and Instrumentation

  1. Units and Measurement
  2. Sound
  3. Pulsed Ultrasound
  4. Intensity
  5. Interaction of Sound and Media
  6. Range Equation
  7. Transducers
  8. Sound Beams
  9. Axial and Lateral Resolution
  10. Display modes
  11. Two-dimensional Imaging
  12. Temporal Resolution
  13. Pulsed Echo Instrumentation
  14. Displays
  15. Image Processing and Dynamic Range
  16. Hemodynamics
  17. Doppler
  18. Image Characteristics and Artifacts
  19. Quality Assurance
  20. Bioeffects

B. Emergency Point of Care Ultrasonography (PoCUS)

a. Core applications

  1. Abdominal/FAST
  2. Basic Cardiac
  3. Lungs and Thorax
  4. Abdominal Aorta
  5. IVC / Shock
  6. First Trimester Pregnancy
  7. Vascular Access

b. Advanced applications

  1. Advanced Cardiac
  2. Gallbladder
  3. DVT
  4. Renal
  5. Musculoskeletal
  6. Soft tissue
  7. Pediatric applications
  8. Regional anesthesia/nerve blocks
  9. Procedural guidance
  10. Ocular
  11. Bowel
  12. Doppler

c. Indications

d. Limitations

e. Literature-based evidence

f. Algorithms for incorporation of ultrasound into clinical practice


  • Read Point of Care Ultrasound in Emergency Medicine and Resuscitation (Oxford 2016).
  • Supplement your textbook learning with completion of online resources
  • The full list of current recommended resources is available sjrhem.ca/programs/ultrasound
  • Become familiar with the operations of the Vimedix Ultrasound simulator
  • Stay up-to-date with current literature, reading and reviewing ultrasound-related articles. Maintain a library of articles that for review.
  • Optional: You will be given support to prepare, acquire eligibility for and to take the Canadian Point of Care Society (CPoCUS) exam for the CPoCUS Core IP or Expanded Applications certification track (depending on level of competency at start of Fellowship).
  • Optional: If you meet the eligibility requirements, you will be given support to adjust the components of this Fellowship to support an application for recognition of a Royal College of Physicians and Surgeons of Canada Area of Focused Competence Diploma in Acute are Point of Care Ultrasonography.


Most importantly during your fellowship, you must become an expert user of PoCUS. The skills you acquire in doing so will be invaluable to your career in emergency medicine and will make you a better clinician. Your skills need to reach a level where you feel confident in your own scans, both in identifying and ruling out pathology, and in knowing when the exams are inadequate to do so.

We will directly observe your scanning when possible and assess your images and interpretations for adequacy when not. You will have scanning shifts with an Emergency Physician PoCUS faculty when they are working clinically and a number of shorter supervised dedicated scanning sessions.

  • Expected to perform a minimum of 250 scans per 3-month block
  • Log your scans and interpretations on Q-Path
  • Have a sample of your scans reviewed by the Fellowship Directors for both adequacy of image acquisition and interpretation.
  • Perform external QA. Record when a patient that you scan has an “official” study performed (i.e. a formal echo, ultrasound, CT scan, operative report) and compare your findings to that study.
  • Spend approximately 16 hours a week scanning.
  • Seek out pathology and novel applications of ultrasound where possible. Your scanning should not be limited to established applications.
  • Know how to acquire video clips as well as still images, and when each is appropriate.
  • Adhere to and enforce departmental policies regarding machine cleanliness and maintenance.

There is also an option to perform up to 1 month of scanning in pediatric applications at the IWK Health Centre Pediatric Emergency Department. The expectations would be the same as stated above.

Teaching / Scholarship

Learning to teach ultrasound is a fundamental portion of your fellowship. Your teaching experience will consist of both lecturing and hands-on teaching. This is an essential component to your ultrasound fellowship experience.


  • Develop your own emergency ultrasound lecture portfolio consisting of at 2-4 lectures (depending on the duration of your fellowship). These need to be high-level case-based lectures covering at least scanning technique, normal and abnormal findings, treatment algorithms, and most importantly a critical review and appraisal of the current literature related to that application.
  • Prior to presentation, you must review your lecture with the PoCUS Fellowship faculty.
  • Present at PoCUS Fellowship and EM Grand Rounds.
  • Spend individual time doing hands-on scanning with rotating residents and students.
  • Participate in teaching of EM staff
  • Contribute 4 -6 FOAMed publications to our website including PoCUS Pearls / PoCUS Rounds
  • Learn how to present academic work and images for website and social media – e.g. infographic, image colourization, etc


Emergency ultrasound is at the cutting edge of clinical research in emergency departments across Canada and worldwide. New applications and uses are frequently being studied and tested and can make immediate impact on clinical practice. We feel strongly that Dalhousie University Department of Emergency Medicine can and should be among the leaders in this field. Participation in research is an integral component of your fellowship.

We will provide you with all the mentorship, resources, and support that you need to pursue your research endeavors.


  • Actively seek and enroll patients in all ultrasound research projects. When you are on a scanning shift by yourself, research enrollment should be as important as educational scanning.
  • Support and advise other learners with their ultrasound related research projects.
  • Develop at least 1 research project. As the primary investigator, you should undertake all aspects of this research, including but not limited to idea conception, protocol authorship, IRB approval, consent and data forms, advertisement of the study, patient recruitment and enrollment, follow-up, data analysis, statistical analysis, and manuscript authorship.
  • Present at least one project at a regional, national or international conference.
  • Submit at least one project as lead author for publication in a peer-reviewed journal.
  • Meet deadlines for submission of research project abstracts. Be aware that the deadline for the annual CAEP conference (Usually in June) can be as early as December.


A keen understanding of the administrative aspects of emergency ultrasound is a necessity for successful implementation of an emergency ultrasound program in any emergency department. Administrative issues are primarily but not exclusively financial, medico-legal, or political in nature. We will do our best to ensure exposure and familiarity with each of these topics.


  • Attend all ultrasound interest group meetings, department meetings, ultrasound research meetings.
  • Understand the various medico-legal aspects of performing and documenting emergency ultrasounds.
  • Understand the politics and business behind ultrasound machine companies.
  • Understand the nature of the politics of emergency ultrasound on a national level.
  • Aid in the organization and implementation of a recruitment and selection process for future fellows.
  • Attend a national Emergency Ultrasound Committee meeting—CAEP Emergency Ultrasound Committee.
  • Read the CAEP, CPoCUS and IFEM Emergency Ultrasound Guidelines
  • Participate in setting up ultrasound courses given within or outside of the hospital.
  • Understand the process of marketing, organizing and budgeting for an ultrasound course, dealing with those who have paid to attend and supporting the invited faculty.

Quality Assurance

Reviewing ultrasound images is an essential skill. To ensure that you are performing high-quality sonography, your images and videos will all be reviewed by the Fellowship Directors or deputy to assure that they support your interpretations. We refer to this as internal QA. In addition, there is external QA which compares your findings to Diagnostic Imaging findings. To further hone your skills and prepare you for a directorship of your own, you will perform Q-Path QA review for all users and give them feedback on their scans.


  • Participate in QA of departmental exams.

Image Management

As technology progresses, so does sophistication of ultrasound machines and systems. With increased usage of ultrasound in the emergency department, appropriate image storage and management becomes more imperative.


  • Aid in the maintenance of an organized image storage and retrieval system (Q-Path). Keep the Teaching Files up to date with appropriate keywords for easy searching.
  • Learn how to configure an ultrasound machine to record video and still images.
  • Understand the process of how to edit and convert digital images and clips from the ultrasound machine into ones that can be used in a presentation.
  • Make Keynote / Powerpoint presentations incorporating video clips and GIF files.


Your scanning technique and images will be reviewed on a continual basis. You will receive verbal feedback on these. At the end of the Fellowship/Elective you will receive a summative assessment of Emergency PoCUS knowledge and competency. The details of this assessment will vary depending on the duration of your Fellowship/Elective and will be provided to you when you start.

You will meet with the Fellowship Directors every six weeks. At each meeting, we will review your performance and progress in line with the listed objectives. You will also have the opportunity to evaluate the Fellowship, the faculty, and your own performance. These evaluations are meant to be constructive, and to help shape the fellowship experience into one that meets your needs.


Resident PoCUS Electives / Fellowship

Contact our Postgraduate Program via our admin

Dalhousie Emergency Medicine Clinical Academic PoCUS Fellowship (3/12 months)

Expressions of interest are made in writing via email to Dr. David Lewis at the address below. An application form will be sent for completion. Selected applicants will be invited to a video interview. Appointment to a Fellowship will be decided by the Dal EM Fellowship committee.

Canadian physicians applying to the 3 or 12-month Fellowship  will be jointly interviewed by the Dal EM Fellowship Director and the SJRHEM Nominations committee.

12 Month Fellowships commence 1st week September

3 Month Fellowships commence 1st week September or 2nd week January

Application Closing Date for all Fellowships applications is November 1st

Dalhousie Emergency Medicine Clinical PoCUS Fellowship (3-months) Application Form

Download (PDF, 432KB)

Dalhousie Emergency Medicine Clinical Academic PoCUS Fellowship (12-months) Application Form

Download (PDF, 442KB)