In 2023, WONCA Europe was unequivocal : general practice requires reliable training in focused clinical ultrasound during residency. European primary-care ultrasound practices remain highly heterogeneous, and France lags behind in this field.To systematically review and synthesize the published literature regarding the education of general practitioners (GPs) and GPs in training (GPTs) in the use of ultrasonography with detailed information on modalities of teaching and assessing. Then, be able to suggest an ultrasound curriculum to general practice’s residents.This review was prospectively registered in PROSPERO, conducted according to the Cochrane recommendations and written following the PRISMA guidelines. We combined studies identified in a previous systematic review with studies from an updated literature search using a closer search string. Three reviewers independently screened articles, and one extracted data. The search was conducted on June 23, 2024.Twenty papers were included. Ultrasound training was described to include both theoretical and practical training sessions. Major part of the population studied was GPs (65%). Nearly half of papers described a formation on a unique competence. 88,8% of them were about a cardio-vascular scan skill. Didactic lessons were quasi systematic (95%). 45% of studies used theoretical training by homework as videos or manuals. 100% of practical training included focussed hands-on training sessions under direct supervision, while 20% papers described additional longitudinal practical training under indirect supervision. Most of the time, the models were volunteer patients. Ultrasound exam was described to include self-assessment (50%) and/or hetero-assessement (80%), written (55%) and/or practical (80%). When it was a practical test, the major part (56,4%) consisted of a concordance test with experts.The strengths of this study are the updated international literature review on ultrasound training for general practitioners and the double screening for full texts. The main shortcoming of this study is the lack of article’s exclusion on their quality.There was a large variation in ultrasound training programs and assessments for GPs and GPTs. However, we had enough data in order to create a Point-Of-Care Ultrasound (POCUS) curriculum design for general practice’s residency in XXX.

Point-of-Care Ultrasound (PCU), defined as "ultrasound performed in real time by the clinician at the patient's bedside," improves patient care, notably by reducing the time to diagnosis and initiation of treatment. PCU could also reduce inequalities in access to care in underserved areas. However, insufficient training and experience can have detrimental consequences for patients. In France, the training of future general practitioners (GPs) in PCU is underdeveloped. This training is therefore a major challenge for integrating this promising tool into GP practice.The objective of this study is to establish a consensus among GPs experienced in PCU regarding the relevant skills for an initial level of PCU competence for GPs.We used the Delphi method. The rating group consisted of GPs and emergency physicians trained in PCU and practicing PCU regularly for more than two years. During the first round, experts rated and commented on 41 clinical skills assessments (CSAs). A second round was conducted using a questionnaire adapted to the results of the first round. Experts rated the CSAs that had not reached a consensus in the first round.Ten practitioners completed both rounds of the Delphi assessment. Of the 42 skills evaluated, 15 CSAs were deemed appropriate for a first level of competence for GPs, such as abdominopelvic skills, the search for deep vein thrombosis, and pleural and peritoneal effusions. The experts generally considered that tendon and ligament examinations could not be included at level 1 due to their complexity.This is the first study that establish an expert consensus on the qualitative composition of a first level of CSA skills in general practice using the Delphi method. Our results are consistent with those in the literature for skills covering various anatomical areas. The number of experts is in accordance with the recommendations of the French high authority for health for this type of methodology.Our study identified skills that should enable the development of an initial training module for clinical skills assessment (CSA) for general practitioners or general practice residents. The training methods for each of the 15 selected skills need to be specified through further work.

The increased availability of ultrasound machines allows for their increasingly widespread use in family physician practices. Basic knowledge of anatomy, medical education, and a keen eye for detail, combined with thoroughness and experience, allows for the inclusion of ultrasound examinations in a standard medical examination.The author is a family physician with practices in a small town and a rural area. For decades, he has been observing the patient population under study, introducing numerous improvements to both clinics, such as computerization, telecommunications, rural rehabilitation, and POCUS ultrasound. He would like to share his experience with modern ultrasound technologies, particularly the use of TUS, multiscan, and the importance of AI programs for rapid POCUS diagnosis.In a world racing toward the future, it's not just technology that matters, but humanity and the fight for human dignity, quality of life, patient care, and equal access to diagnosis and treatment. POCUS, through its populist nature and universal access, brings the highest quality directly to every patient. It also democratizes the still-feudal systems in which the best and most expensive are reserved for a select few, both those who receive care and those who manage it.Can the diagnostic process be completed in most cases during a family doctor's examination? Do we have to rely on confirmation of the diagnosis in specialized centers in most cases? What impact does the widespread introduction of POCUS have on treatment costs?A revolutionary change is taking place in which the most sophisticated diagnostics appear in the hands of the most experienced primary care physicians.Whether we accept it or not, the world is changing and will continue to move forward. POCUS, tUS, multiscan and AI are a high-speed train that we may fear, but perhaps we should accept and embrace with all its benefits.

Point-of-care ultrasound (POCUS) is increasingly recognized as a valuable diagnostic tool in general practice. However, its actual use among French general practitioners (GPs) working in urgent care settings, such as SOS Médecins, a nationwide network of GPs providing home-based urgent primary care 24/7, remains poorly documented.To assess the prevalence, modalities of use, perceived impact, and barriers to the adoption of POCUS among GPs working in the SOS Médecins network across France.A national cross-sectional online survey was distributed to all eligible SOS Médecins physicians. The questionnaire addressed POCUS usage, clinical indications, equipment access, perceived benefits, training needs, and adoption barriers. Descriptive statistics were used, and comparisons between users and non-users were performed using chi-square or Fisher’s exact tests.Among 211 respondents, 47.4 % reported current POCUS use. Age group (p = 0.0208) and years of SOS Médecins experience (p = 0.0034) differed significantly between users and non-users. The main indications were abdominal pain (79.2 %), vascular assessment (76.2 %) and respiratory symptoms (65.3 %). Most users relied on portable devices (69.8 %) and performed focused scans (87.4 %). POCUS was perceived as positively impacting triage (86.0 %), treatment decisions (81.7 %), diagnostic accuracy (67.0 %), autonomy (59.0 %) and the doctor–patient relationship (50.0 %). Only 15.6 % reported billing for POCUS. Among non-users, barriers included lack of training (63.6 %), limited time (44.5 %), equipment cost (40 %) and doubts about utility (23.6 %). Over half (54.5 %) expressed interest in training.POCUS use was frequently reported, with a prevalence close to that observed in high-adoption countries. Indications were consistent with international primary-care data. Interpretation must consider possible selection bias. Reported barriers mirror global findings and underline the need for structured training and organisational support.With an adoption rate of 47.4% among respondents, this survey shows substantial POCUS use within SOS Médecins network, without reflecting national prevalence. Despite strong perceived usefulness, adoption remains limited by training gaps, organisational constraints during home visits, and unclear financial incentives. Strengthening undergraduate exposure, expanding structured continuing training, and clarifying reimbursement pathways may support broader and safer integration of POCUS in urgent primary care.

Ultrasound is becoming essential to confirm or ruling out a diagnosis in primary care medecine.With brief training and affordable devices, general practioners can acquire clinically relevant ultrasound skills that are usefull in their daily practice and consistent with evidence-based-medecine.(EBM). To demonstrate,through 10 concrete examples,the usefulness of ultrasound for general practioners in primary care practice.The ultrasound machine becaming the 21st century stethoscope.We use the proven educational framework of EESF( école d'échographie sans frontière) and CFFE (centre francophone de formation en échographie ) in Nïmes , training centers founded by professor J.M Bourgeois. We compare normal ultrasound images with pathological ultrasound images across several areas of interest for general practioners.We teach wich maneuvers should be performed to obtain this images.We aim to demonstrate,through imaging,the usefulness and speed of clinico-ultrasound maneuvers in ten specific situations. - musculoskeletal pathology :       bone fracture ?         supraspinatus tendon lesion ?  - abdominal pathology :      bladder volume ?      hydronephrosis ?      cholecystitis ?      peritoneal effusion ?      dilatation of the common bile duct ? - Thoracic pathology :      pleural effusion ? - Vascular pathology :      abdominal aortic aneurysm ?      atheromatous plaques at the carotid bifurcations ?The ultrasound device provides the often-isolated general practitioner with valuable assistance in managing the most common diagnoses. Although training and cost may appear to be obstacles, opportunities for education within universities or through continuing professional development organisms, both in-person and online, are significant.Ultrasound is becoming a decisive tool in primary care. By providing immediate answers to frequent clinical questions, it enhances diagnostic accuracy and patient safety. With accessible training and portable equipment, the general practitioner becomes a more efficient and autonomous clinician.

Heart failure (HF) is the most frequent cardiovascular pathology in primary care. Echocardiography is its gold standard for diagnosis, follow-up and prognosis. Point-of-care ultrasound (POCUS) is of growing interest in daily practice.This study aimed to systematically review the literature to evaluate left ventricular ejection fraction (LVEF) assessment of unselected patients in primary cares conditions by non-expert physicians with cardiac POCUS (cPOCUS).We searched in Medline, Embase and Pubmed up to January 2022 for interventional and non-interventional studies assessing LVEF with cPOCUS in unselected patients with suspected/diagnosed HF in hospital or outpatient settings, performed by non-expert physicians.Forty-one studies were included, involving 6432 patients, of whom 59.1% were outpatients. LVEF was assessed by 349 non-expert physicians after an initial ultrasound training course. The LVEF was mainly assessed by visual estimation (90.2%). The most frequent views were parasternal long/short axis, and apical 4-chamber. The median time of cPOCUS was 8 minutes. A strong agreement was found (Kappa = 0.75 [0.62 ; 0.83]) compared to experts when using different types of ultrasound devices (hand-held and standard), and agreement was excellent (Kappa = 0.84 [0.71 ; 0.89]) with the same device. Training course combined a median of 4.5 hours for theory and 25 cPOCUS for practice.This is the first systematic review specifically designed to evaluate the contribution of LVEF assessment in primary care conditions by non- expert physicians with cPOCUS in unselected patients with suspected or diagnosed HF. This study is strong (41 prospective studies, 6432 patients and 449 participants). Two independent reviewers analyzed strict inclusion criteria, study selection and data extraction. Nevertheless, lack of raw data, inhomogeneity and the large variations across studies limited our results. Finally, 75.6% of studies used hand-held US devices for non-experts compared to standard US devices for experts.  Only one similar work was found from Gibson et al. published in June 2020. It tends towards the same conclusions.The use of cPOCUS by non-expert practitioners after short training course appears to be an accurate complementary tool for LVEF assessment in daily practice. Its diffusion in primary care could optimize patient management, without replacing specialist.