The current state of ultrasound training in pulmonary residency programmes in the Netherlands: an educational review

Thoracic ultrasound (TUS) is becoming a key diagnostic tool in pulmonary medicine. However, use of this tool may vary between older pulmonologists with less TUS experience and younger generations, including residents, who see the need for TUS training. This review explores nationwide differences in ultrasound training and seeks to improve education quality. We surveyed all Dutch pulmonary medicine programme directors and residents with four sections: baseline questions, applicability, skills and attitude, and future perspectives. Between March and June 2024, we distributed the questionnaire to 193 residents and 26 programme directors. 72 residents (37%) and 19 programme directors (78%) responded. While ultrasound was widely available (95%), the integration with electronic health records remained limited (53%). The majority of respondents considered TUS an essential skill: 92% of the residents and 78% of programme directors (p=0.279). However, several barriers hindered effective training, including a lack of supervisors (reported by 67% of residents), supervisor time constraints (35%), limited access to ultrasound equipment (28%) and resident time constraints (28%). Pulmonary education must move beyond the mentor-apprentice model for ultrasound training, due to a lack of experienced mentors. This review highlights the need for a structured, standardised TUS training programme with proper infrastructure, supervision and hands-on practice.