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Steven Fox, MD
Steven Fox, MD
Internal Medicine · Cleveland, OH


Supporting Internal Medicine Ultrasound in Guyana


January 16th
Georgetown, Guyana

Project Description

I plan to travel to Georgetown Public Hospital Corporation (GPHC) in January 2020. I will serve as a visiting clinical instructor with the Internal Medicine (IM) Residency program, and focus on Point-of-Care Ultrasound (POCUS). POCUS is routinely used as part of clinical practice by IM residents at GPHC, and can greatly facilitate diagnosis and procedural guidance. There is additional need for ongoing education, longitudinal practice-based training, and mentorship in POCUS. I plan to support resident leaders who are taking initiative to increase effectiveness of POCUS education and implementation, to lead didactics, to work with small groups on hands-on image acquisition skills, and to supervise diagnostic POCUS exams and ultrasound-guided procedures (focusing on resident training in these). A major focus is understand limits of POCUS, how to perform responsibly, how to apply in the practical setting, and how to integrate findings with the clinical picture. I have been to GPHC previously, for 4 months as an IM resident in 2017 and 2018 (as a trainee), and for 2 weeks as a chief resident in 2019. During my most recent visit, I served as a clinical instructor doing similar work as described above. The program has expressed an interest in further longitudinal support of ultrasound education, and my return trip will be a part of an ongoing partnership.

Population Served

The primary focus will be on the Internal Medicine residents at GPHC. I will also lead didactics and may supervise procedural ultrasound for general medical officers and interns.

Expected Impact

This is part of a longitudinal effort for ultrasound training for IM residents. In-person visits are an important component of this effort, and this visit will serve that purpose. The training will hopefully enable IM residents (and subsequently, registrars) to use POCUS in a more effective fashion to expedite diagnosis and enhance patient safety going forward. A major goal is to provide mentorship for local initiatives to improve effectiveness of POCUS implementation and education at GPHC, which will carry forward after my visit because they are locally-organized and maintained.


Trip Photos & Recap

I spent my time working primarily with Internal Medicine resident physicians, and also with general medical officers and medical students. The primary focus was on clinical education in point of care ultrasound, and also on topics related to pulmonary and critical care medicine. My purpose was to help enhance education, training, and evaluation in these areas. A schedule was developed by the program leadership, to best support the program curriculum. In the mornings I rounded with the medical teams. In the afternoons I led hands-on point of care ultrasound sessions with small groups of residents, focusing on image acquisition, interpretation, and clinical application. This included a discussion of nuances, pitfalls, and how to apply point of care ultrasound in the practical setting. I also led several didactic sessions throughout the 2 week stay. My wife Patricia and I traveled together. She focused on gastroenterology education. We have been to Guyana several times now and always very much enjoy working with this group, and hope to continue to visit on future occasions.