Point-of-care Ultrasound in Internal Medicine Residency: A Multicenter Survey in Mexico

Background: Point-of-care ultrasound (POCUS) is increasingly recognized as an essential tool in Internal Medicine, its structured integration into residency programs remains still limited, particularly in low- and middle-income countries. In Mexico, the specific barriers to its implementation are not well characterized. This multicenter study was designed to assess current practices and perceived barriers to its integration. Methods: We conducted a multicenter cross-sectional survey of Internal Medicine residents and faculty in seven PEMEX hospitals (two tertiary, five secondary). Of 182 invited participants, 158 completed the questionnaire (response rate, 86%). The survey, pilot-tested and validated by experts, assessed perceived applicability, self-reported skill, knowledge, and frequency of POCUS use. Results: Overall, 96% of participants supported incorporating POCUS into Internal Medicine training and practice. Structured curricula were reported in 45% of tertiary and 41% of secondary hospitals. The most frequently taught applications were ascites, pleural effusion, and inferior vena cava assessment. Commonly performed procedures included central venous catheter placement, thoracentesis, and paracentesis; arterial blood gas analysis; arterial line placement were rarely performed. Thoracentesis training was more frequent in secondary than in tertiary hospitals (59% vs. 30%, P=0.001). The main barriers were lack of equipment (65.8%), shortage of trained instructors (57.5%), and insufficient institutional support (35.4%); equipment shortages were significantly higher in tertiary centers (40% vs. 8%, P<0.001). Conclusions: Although POCUS is widely valued among internal medicine residents and faculty in Mexico, its adoption is constrained by limited training, inadequate resources, and weak institutional support. These findings underscore the need for structured, competency-based curricula and national strategies to ensure equitable access, skill development, and safer patient care.