Focused Acute Medicine Ultrasound (FAMUS) is the point-of-care ultrasound accreditation run by the Society for Acute Medicine (SAM). It was designed for acute physicians and is open to any registered healthcare professional who looks after acutely unwell adults: doctors, nurses, advanced clinical practitioners, physician associates and allied health professionals.
Since February 2023 FAMUS has been modular. You accredit in the modules you need, one at a time.
The modules
| Module | Supervised scans (minimum) | Mentored scans (indicative) | Minimum training time | Core pathology |
|---|---|---|---|---|
| Thoracic | 10 scans (20 lungs) | 30 scans (60 lungs) | 6 months from first supervised scan | Increased lung water, consolidation, pleural effusion (including site marking), ruling out pneumothorax |
| Abdominal/renal | 10 scans | 30 scans | 4 months | Abdominal free fluid, hydronephrosis, bladder distension |
| DVT | 5 scans | A further 5 scans (10 legs) | 1 month | Ruling in DVT |
| Ultrasound-assisted lumbar puncture | 10 scans, including one patient who has a successful LP | Not required | 3 months | Site marking across all body habitus |
| Peripheral vascular access | 3 cannulations (one may be simulated) | A further 2 | Not set | Ultrasound-guided peripheral cannulation |
Points to note on specific modules:
- Thoracic. The pack sets indicative minimum pathology: 5 consolidation, 5 increased lung water and 20 pleural effusions, at least 5 of them site marked for intervention. You do not need to have seen a pneumothorax, but you must understand how to rule one out.
- DVT. The module teaches you to rule a DVT in. SAM states a negative point-of-care DVT scan should not rule out DVT, and a confirmatory departmental scan is standard practice. Since May 2025 DVT and peripheral vascular access are separate modules.
- Lumbar puncture. Only for clinicians already independent in performing LP. The supervised scans must cover a spectrum of body habitus and may include up to two on two different simulation manikins.
- Peripheral vascular access. Only for clinicians already competent at cannulation without ultrasound. This module is signed off locally: you do not register with SAM, SAM issues no certificate, and your trust's approved supervisors manage sign-off.
FAMUS does not include focused echocardiography. SAM recommends the Intensive Care Society's FUSIC Heart for this, alongside FAMUS thoracic, for managing breathless patients.
Your action plan: how to get it done
These steps are Wavelength's practical advice, built on the official requirements set out in this guide. Where a step quotes a rule, the rule comes from the source documents listed at the end.
Step 1. Find a supervisor before you pay anything
The supervisor is the person who oversees your training and signs your ACT. They must be registered on the FAMUS database for your module. SAM lists registered supervisors on its website, and recommends you confirm a supervisor before registering.
If nobody at your hospital is registered, SAM suggests three routes:
- Ask radiology. A consultant radiologist or experienced sonographer can apply to become your supervisor. Point out they do not need to watch every scan: mentors deliver most of the hands-on training, and the supervisor approves the mentors and signs the ACT.
- Ask a nearby supervisor at another hospital to oversee you remotely, with local mentors doing the practical training.
- Ask an experienced colleague to apply. Clinicians with plenty of scanning experience and teaching experience, but no formal accreditation, are welcome to submit a supervisor application to SAM.
Step 2. Identify your mentors
A mentor is anyone competent in the scan they oversee: a radiologist, a sonographer, a vascular scientist for DVT, or a FAMUS-accredited colleague. Mentors do not need to be registered with SAM, but your supervisor must agree they are suitable. Mentors supervise your early scans and review the images from scans you do alone. They cannot sign the ACT.
Step 3. Register with SAM
Complete the FAMUS registration form on the SAM website and pay per module: £40 for SAM members, £80 for non-members. The fee is non-refundable. You receive a confirmation email once payment arrives. Tick the box for the SAM-Butterfly National Cloud if you have a Butterfly probe: it lets you upload training scans and link with a supervisor for review.
Step 4. Complete the e-learning
Passing the FAMUS e-learning assessment on e-Learning for Healthcare (e-LFH) is mandatory for every module. It is free for NHS staff, and international users access it through eIntegrity for a fee. Complete "Ultrasound basics" once, then the module-specific package and assessment. Do this at the start and save the certificate.
Step 5. Book a FAMUS-approved course
A course is not mandatory, but SAM strongly recommends one. SAM recommends attending within three months of your first supervised scan. The thoracic pack allows the first supervised scan up to three months before the course, and recommends starting within three months after it. If you skip the course, you must show the theory knowledge during training, and your supervisor confirms it at the ACT.
Step 6. Do your supervised scans face to face
Your first scans should be directly supervised by your supervisor or a mentor. Complete the FAMUS anonymised reporting sheet for each one. Even if you supervise remotely later, SAM asks for the supervised scans to be face to face.
Practical ways to get them done:
- Book two or three sessions with your mentor on a ward or the acute medical unit and scan every suitable patient in that session.
- For thoracic, the respiratory ward and pleural clinic give you effusions and site marking. For abdominal/renal, ask on the gastroenterology or liver ward for patients with ascites.
- For DVT, ask to sit in on a departmental DVT list with a vascular scientist.
Once you meet the minimum and your mentor or supervisor is happy, they initial your report sheet to confirm you are ready for mentored practice.
Step 7. Build your mentored scans
Now scan alone. For every scan, complete a report sheet and save images covering the whole scan, labelled with the same training code (T1, T2, T3) so your mentor can match them. Your mentor reviews each report and images, often remotely, and countersigns it. There should be general agreement on the findings.
Until you are accredited, do not write training scan findings in the clinical notes or PACS, and do not base clinical decisions on them.
Step 8. Fill the pathology gaps
Check your logbook against the core pathology list every few weeks. If you are short of a pathology, ask colleagues to call you when one arrives, or ask a radiology colleague for a list where it is common. Scan normal patients too: SAM says recognising normal anatomy matters as much as finding pathology. Simulator scans count only when supervised and showing pathology, with a maximum of five in your logbook.
Step 9. Book the ACT with your supervisor
When the minimum time has passed, your logbook covers the core pathology and your mentors agree with your findings, book the ACT. It includes a witnessed scan (SAM does not recommend using a simulator for it), a review of your logbook and report sheets, and a check of your theory knowledge.
Step 10. Send the ACT to SAM
Send the signed ACT, with no patient identifiers on it, to the FAMUS administrator at famus@acutemedicine.org.uk. SAM confirms your accreditation in that module and records you on the database. From then on you may scan and report independently within the module's scope.
Timing
- The thoracic pack asks you to complete training within two years of your first supervised scan. Check the pack for your module.
- Minimum training times run from your first supervised scan, so the date of that scan matters.
- Prior experience helps. If you already hold RCR level 1 or British Thoracic Society thoracic competencies, your supervisor may shorten your mentored scans and training time. You must still complete the full number of supervised scans and the e-learning. SAM states RCR and BTS thoracic competencies are not interchangeable with FAMUS thoracic.
Staying accredited
FAMUS accreditation lasts three years. To renew it, you confirm ongoing regular scanning or teaching, with an up-to-date logbook if asked. The thoracic pack sets a minimum average of 20 thoracic scans a year, performed or supervised. Accreditation lapses if you cannot show this.
SAM also recommends:
- An audit plan for your first six months after accreditation
- Uploading images and reports to PACS where possible
- Regular audit as part of appraisal
After a year of accreditation with regular scanning, and ideally some teaching, you are likely to be suitable to apply as a FAMUS supervisor yourself.
FAMUS alongside other pathways
- Emergency medicine. RCEM lists FAMUS as complementary learning evidence. FAMUS does not replace RCEM PoCUS sign-off.
- Intensive care. The Intensive Care Society accepts FAMUS thoracic in place of FUSIC Lung as a prerequisite for FUSIC Haemodynamics, and accepts FAMUS-accredited clinicians as trainers for several FUSIC modules after 12 months.
Sources
Checked against these pages and documents on 4 October 2026.