In the UK, each specialty body runs its own point-of-care ultrasound (POCUS) pathway, with its own scans, assessments, supervisors and paperwork. The one you need depends on your specialty, where you work and what your employer asks for.
This guide compares the three main UK pathways side by side, then points to the main international pathways and frameworks. Each pathway is run by the organisation named against it. Wavelength is an independent education provider and does not accredit, credential or sign off anyone.
The UK details summarise our full RCEM, FAMUS and FUSIC guides, each checked against that body's own documents on 4 October 2026 and cited there. The section on international pathways and frameworks has not been checked against those bodies' documents, so it gives no requirements: follow the links to the official sources.
Sign-off, accreditation and credentialing
These three words describe different things, and they are often mixed up.
- Sign-off happens inside a training programme. RCEM sign-off is an entrustment decision by your supervisor or departmental PoCUS lead, recorded in your e-portfolio, that you can scan without supervision.
- Accreditation is awarded by a society after you meet its published standard. FAMUS and FUSIC accreditation are issued by the Society for Acute Medicine and the Intensive Care Society, module by module.
- Credentialing is your employer or health service authorising you to scan in its hospitals.
None of these comes from attending a course on its own. A course is one source of learning evidence.
Which pathway fits you?
| You are | Usually start with | Run by |
|---|---|---|
| An emergency medicine trainee in the UK | RCEM PoCUS sign-off | Royal College of Emergency Medicine |
| A UK emergency medicine doctor outside training, an ACP or a physician associate | The RCEM PoCUS syllabus, in the modalities within your scope | Royal College of Emergency Medicine |
| An acute or internal medicine clinician in the UK | FAMUS accreditation | Society for Acute Medicine |
| An intensive care, anaesthetic or acute clinician who wants focused echo | FUSIC accreditation, often FUSIC Heart first | Intensive Care Society |
| An emergency clinician in Europe | The EUSEM ultrasound curriculum, with your national rules | European Society for Emergency Medicine |
| An emergency clinician in Australia or New Zealand | Your health service's credentialing, using ACEM's recommended framework (policy P733) | Your health service, with a framework from the Australasian College for Emergency Medicine |
| An acute care clinician in Canada | The CPoCUS Acute Care CORE pathway | Canadian Point of Care Ultrasound Society |
| An emergency physician in the United States | ACEP's ultrasound guidelines, and your hospital's credentialing rules | American College of Emergency Physicians |
Many clinicians hold more than one. RCEM lists FAMUS and FUSIC as complementary evidence, and SAM recommends FUSIC Heart for focused echo because FAMUS has no cardiac module.
The UK pathways side by side
| RCEM PoCUS | FAMUS | FUSIC | |
|---|---|---|---|
| Run by | Royal College of Emergency Medicine | Society for Acute Medicine (SAM) | Intensive Care Society (ICS) |
| Who it is for | Emergency medicine trainees, and recommended for non-training EM clinicians | Registered healthcare professionals who look after acutely unwell adults | Any healthcare professional, of any grade and specialty |
| Structure | Six modalities within SLO6 of the EM curriculum | Five modules: thoracic, abdominal/renal, DVT, ultrasound-assisted LP, peripheral vascular access | Heart, Lung, Abdomen, DVT, Vascular and Haemodynamics, plus fTOE |
| Scan numbers | Indicative 5 to 25 per modality, not fixed targets | Minimum supervised scans (3 to 10) plus indicative mentored scans, with core pathology | Minimum totals of 10 to 50 per module, 5 to 20 directly supervised |
| Assessment | DOPS for every modality, plus Mini-CEX, CbD, ACAT or ESLE | Assessment of Completion of Training (ACT), including a witnessed scan | Triggered assessment, or a central assessment for Haemodynamics |
| Who signs off | Your supervisor or departmental PoCUS lead, at entrustment level 4 | A FAMUS supervisor registered with SAM for the module | A Mentor and Supervisor (Heart) or a Trainer (other modules) approved by the ICS |
| Time limits | Sign-off by the end of ST5 should be the norm, says RCEM | Minimum training time per module; thoracic within two years of the first supervised scan | Logbook within 12 months, first scan to last; access lasts 24 months |
| Paperwork | Evidence in the RCEM e-portfolio (risr/advance) | FAMUS report sheets, countersigned, and the ACT sent to SAM | FUSIC reporting form for every scan, and a summary training record through the FUSIC portal |
| Fees | No separate PoCUS fee is set out in the RCEM sources our guide cites | £40 per module for SAM members, £80 for non-members (peripheral access is signed off locally) | £65 to £195 per module, depending on module and ICS membership |
| Renewal | No renewal process is set out in the RCEM sources our guide cites | Every three years, with evidence of regular scanning | No formal reaccreditation cycle in the training packs |
Every figure above comes from the full guide for that pathway, where each one is cited to the body's own documents. Fees and versions change, so check the official page before you pay or plan.
RCEM PoCUS sign-off
PoCUS is a mandatory part of UK emergency medicine training. Since the 2021 curriculum there is no mandatory course, no finishing school and no fixed scan count. You build a triangle of evidence (learning, workplace-based assessment, and a logbook with reflections) until your supervisor trusts you to scan without supervision at entrustment level 4.
The six modalities are vascular access and fascia iliaca block (procedural, from core training), then abdominal aorta, eFAST or FAFF, echo in life support and shock assessment (diagnostic, in intermediate and higher training).
Read the RCEM ultrasound sign-off guide or the one-page RCEM summary.
FAMUS accreditation
FAMUS is modular. For each module you find a supervisor registered with SAM, register and pay, pass the e-learning on e-LFH, complete supervised scans face to face and mentored scans reviewed by a mentor, then your supervisor completes the ACT and you send it to SAM. A FAMUS-approved course is strongly recommended but not mandatory.
Read the FAMUS accreditation guide or the one-page FAMUS summary.
FUSIC accreditation
FUSIC is modular too. You find an approved mentor or trainer, register and pay, complete the online training or an approved course, collect your logbook within 12 months, pass a triggered assessment and submit your summary training record through the FUSIC portal. FUSIC Heart is the route many emergency and acute physicians take to focused echo.
Read the FUSIC accreditation guide or the one-page FUSIC summary.
International pathways and frameworks
Wavelength has not checked these pathways and frameworks against each body's current documents, so this page names them and links to the official sources rather than listing requirements. Scan numbers, assessments, time limits and renewal rules come from the body and from your country, health service or hospital: confirm them there before you plan your training.
Europe: EUSEM
The European Society for Emergency Medicine has an ultrasound section and publishes an emergency ultrasound curriculum. Read the EUSEM ultrasound section and check your national rules.
Australia and New Zealand: ACEM
The Australasian College for Emergency Medicine publishes policy P733, Recommendations for Health Service Credentialing: EM Ultrasonography. ACEM provides a recommended framework: credentialing itself is the responsibility of your health service, not ACEM. Check the current version and your health service's credentialing rules.
Canada: CPoCUS
The Canadian Point of Care Ultrasound Society publishes the Acute Care CORE pathway. Check CPoCUS for the current requirements.
United States: ACEP
The American College of Emergency Physicians publishes ultrasound guidelines. Check the current guidelines and your hospital's credentialing rules.
Using one logbook for more than one pathway
The rules on sharing scans between pathways are strict, so check each body's pack:
- Scans logged for FAMUS may count towards FUSIC if they meet every FUSIC rule, including review by your FUSIC mentor or trainer and the 12-month window.
- The Intensive Care Society accepts FAMUS thoracic in place of FUSIC Lung as a prerequisite for FUSIC Haemodynamics.
- RCEM lists FAMUS, FUSIC, FEEL, EGLS and BSE as complementary learning. None of them replaces RCEM sign-off.
Common mistakes that delay accreditation
These come up again and again across the pathways. Each one is avoidable.
- Starting to scan before the paperwork. FAMUS asks you to find a registered supervisor before you register. FUSIC asks you to register before anything else, and its 12-month clock starts with your first logbook scan.
- Treating the number as the finish line. RCEM numbers are indicative, and FAMUS and FUSIC minimums are a floor. Sign-off rests on the quality of your evidence and your supervisor's judgement.
- Counting scans that do not count. FUSIC allows no more than 10% of studies on healthy volunteers, and course scans no longer count as directly supervised. FAMUS counts simulator scans only when supervised and showing pathology, five at most.
- Leaving review to the end. Mentors and trainers who see your scans every few weeks correct technique early. Review at the end risks losing scans altogether.
- Rebuilding the logbook from memory. Log every scan on the day, with no patient identifiers. A logbook reconstructed before ARCP or an assessment rarely convinces anyone.
- Writing training findings in the notes. FAMUS and FUSIC ask you not to put training scan findings in the clinical record until a trained person has verified them. RCEM asks you to report under local policy and state your level. Follow your department's policy.
How Wavelength helps
Wavelength teaches point-of-care ultrasound and gives you tools to organise your evidence. It does not accredit anyone.
- Learn. Free Wavelength Pearls and Academy modules cover the applications in each pathway. The Core Emergency Ultrasound course is mapped to the RCEM curriculum. It is not RCEM, FAMUS or FUSIC accredited.
- Log. The free Wavelength POCUS logbook tracks your scans against RCEM, FAMUS and FUSIC targets, with sign-offs, assessments and training windows. Wavelength can apply one scan to multiple selected pathway trackers when it meets their configured criteria. Acceptance remains subject to each organisation, supervisor or local credentialing process. It also has editable international frameworks for EUSEM, ACEM, CPoCUS and ACEP, as starting points you adapt to local requirements.
- Submit. Exports in PDF, Excel or CSV carry a verification code and QR code, and the app shows the steps for your portfolio. It is not yet connected directly to any accrediting body's system, so you still complete each body's own forms.
Sources
The UK figures come from the full guides, which were checked against these and further documents on 4 October 2026 and cite every source:
- RCEM: Ultrasound education and training, 2021 curriculum
- RCEM Point of Care Ultrasound Curriculum 2021, Appendix 3
- SAM: FAMUS, how to accredit
- Intensive Care Society: FUSIC
Official pages for the international pathways and frameworks. Wavelength has not checked this page's wording against them, so treat them as the authority: