National need assessment of point-of-care ultrasound training in emergency medicine residency programs in Pakistan: a cross-sectional survey of current practices, perceived needs, and barriers to implementation

Point-of-care ultrasound (POCUS) is increasingly recognised as an essential skill in emergency medicine training worldwide. However, in Pakistan, where emergency medicine is a relatively new specialty, the extent of POCUS training, perceived barriers, and educational needs within residency programs remain poorly defined. This study aimed to assess current POCUS training practices, identify perceived challenges in training and implementation, and explore learning preferences and essential training modules among EM physicians across Pakistan. A cross-sectional survey was disseminated nationally among emergency medicine residents and faculty using a structured online questionnaire. The survey assessed prior POCUS training, current utilization, perceived barriers, preferred learning modalities, and views on essential POCUS applications for residency training. Quantitative data were summarized using descriptive statistics. Responses to open-ended questions were analysed using conventional content analysis, whereby responses were systematically coded, grouped into categories, and synthesized into broader themes to identify common barriers, educational needs, and recommendations for curriculum development. A total of 193 participants responded, including 141 residents and 52 faculty members. Although 84% reported active use of POCUS in their emergency departments, only three participants (1.5%) had received formal POCUS training. No participating institution reported a structured POCUS curriculum or standardized training program. Residents and faculty showed similar patterns in their selection of essential POCUS modules, with extended focused assessment with sonography for trauma (E-FAST), focused cardiac ultrasound, and inferior vena cava assessment endorsed by more than 85% of respondents. The most frequently reported barriers were the absence of a structured curriculum (74.1%), lack of protected training time (44.6%), and limited availability of trained faculty (37.3%). Despite widespread use of POCUS and strong support among both residents and faculty, training in Pakistan remains largely informal and unstructured. These findings support the need for a nationally coordinated curriculum, faculty development initiatives, and institutional commitment to ensure the standardized and sustainable integration of POCUS into emergency medicine training programs.