Every UK point-of-care ultrasound pathway asks for a logbook. RCEM uses it as one side of its triangle of evidence. FAMUS and FUSIC check it before your final assessment and reject it if it breaks their rules. A good logbook gets you signed off sooner. A poor one sends you back to rescan.
This guide covers what to record, how to protect patient confidentiality, and the rules each pathway applies when it counts your scans.
Set up your logbook in 20 minutes
The next two sections are Wavelength's practical advice. The rules they refer to come from the sources at the end.
- Choose one format. The e-portfolio log, a spreadsheet or an app. Keeping two copies means neither stays complete.
- Create the fields listed in the table below. Add a column for each pathway module you are working towards.
- Start your training reference numbering. Use one code per scan, for example L01, L02 for lung and AAA01 for aorta. Write the same code on the machine when you save images.
- Write down your targets for each module from the pathway documents, with your deadline: for FUSIC, 12 months from your first logbook scan.
- Agree a review rhythm with your supervisor or mentor now: a fixed 20 minutes every two to four weeks.
- Check your trust's rules on exporting images and using phones, and note who your information governance contact is.
The end-of-shift routine
Five minutes at the end of every shift keeps the logbook complete:
- Log each scan you did with its training reference, date, setting and supervision level.
- Record your findings and the image quality while you still remember the views.
- Flag scans for supervisor review, and send any sign-off requests the same day.
- Note any scan with a CT or departmental scan pending, so you check the result next week.
- Write one line of reflection on the scan you learned most from.
Once a week, look up the formal imaging results you flagged and add them. Once a month, total your scans by module and compare them with your targets.
Why the logbook matters
A logbook does three jobs:
- It proves volume and range. Your supervisor sees how many scans you have done, how recent they are and which pathologies you have met.
- It shows judgement. Findings compared with CT, formal ultrasound or the clinical outcome show whether your interpretation holds up.
- It drives learning. Reviewing scans with a supervisor is where most improvement happens. FUSIC's training packs say this outright: meet your mentor periodically, because leaving review to the end limits what you learn and risks losing scans altogether.
What to record for every scan
No pathway prescribes a single national format. RCEM states there is no set format and accepts any platform capturing the minimum dataset within national data protection standards. FAMUS and FUSIC provide their own reporting forms, and FUSIC requires its standard form for every training scan.
A complete entry carries these fields:
| Field | What to write |
|---|---|
| Training reference | A code such as T12 or AAA-07, never the patient's name, hospital number or date of birth |
| Date | The date of the scan, which pathways use to check time windows |
| Scan type and pathway module | For example eFAST, FAMUS thoracic, FUSIC Heart |
| Setting | ED, acute medical unit, intensive care, ward, simulation or healthy volunteer |
| Clinical question | One line: "Free fluid in a hypotensive trauma patient?" |
| Views obtained | Which standard views you achieved, and which you could not obtain |
| Image quality | Good, adequate or poor |
| Findings | Answer the clinical question in focused terms |
| Supervision | Directly supervised, scanned alone and reviewed later, or independent |
| Supervisor or mentor | Name and role of the person who watched or reviewed the scan |
| Formal imaging or outcome | What CT, departmental scan or surgery later showed |
| Reflection | What went well, what you missed, what you will do differently |
Supervision categories
Get the supervision field right, because every pathway counts it separately.
- Directly supervised. A supervisor or mentor stood beside you while you scanned. FAMUS calls these supervised scans. FUSIC calls them directly supervised scans.
- Scanned alone, reviewed later. You scanned without supervision, saved the images and a mentor reviewed them afterwards. FAMUS calls these mentored scans. FUSIC calls them unsupervised scans.
- Independent. Your own scan with no review. Useful for practice, but it does not count towards FAMUS or FUSIC accreditation.
Keeping patient data out of your logbook
This is where trainees most often get it wrong.
- Never take identifiable information out of your trust. The FAMUS curriculum packs state this directly. Your logbook travels with you, so it holds no names, hospital or NHS numbers, dates of birth or addresses.
- Link the entry to the images with a code. FAMUS recommends labelling the report T1, T2, T3 and saving the images on the machine under the same label, so you and your supervisor review them together without identifiers.
- Label training scans with a training reference. FUSIC recommends labelling training scans stored on or exported from machines with a training reference, not patient details.
- Remove burnt-in data before exporting. Most machines print the patient's name and ID along the top of each image. Crop or mask it. Follow your trust's policy on removable media before you put a USB drive in a scanner.
- Check your trust's policy on photos. Many trusts prohibit photographing screens on personal phones. Ask your information governance team before you start.
RCEM points to the Royal College of Radiologists' guidance on using patient images for teaching and training. The BMUS and RCR 2023 joint document "Recommendations for specialists practising ultrasound independently of radiology departments" covers storage, reporting and governance for scans done outside radiology.
Training scans and the clinical record
Pathways differ on whether a training scan goes in the patient's notes.
- FAMUS and FUSIC say training scans must not go in the clinical record or PACS, and must not drive clinical decisions, until an accredited practitioner has verified the findings.
- RCEM recommends reporting every diagnostic scan as per local ED guidelines, stating your entrustment level in the report.
Your department's PoCUS policy decides which applies to you. If it is unclear, ask your PoCUS lead before you scan.
Counting rules each pathway applies
Your logbook only counts if it meets the rules of the pathway you are working towards.
| Rule | RCEM | FAMUS | FUSIC |
|---|---|---|---|
| Scan numbers | Indicative only, across the whole training programme | Minimum supervised scans, then indicative mentored scans, per module | Minimum totals and minimum directly supervised scans, per module |
| Time window | Through training, with sign-off expected by the end of ST5 | Thoracic pack: finish within 2 years of the first supervised scan | Logbook within 12 months, first to last scan, and accreditation within 24 months |
| Normal and volunteer scans | Not specified | Normal scans encouraged as part of the logbook | No more than 10% on healthy volunteers |
| Simulation | DOPS on simulated patients accepted | Up to 5 simulator scans, supervised and showing pathology only, never for the final assessment | Not addressed as counting scans |
| Scans on a course | Count as learning evidence | First supervised scans may take place on a course | No longer accepted as directly supervised scans |
| Reflections | 5 reflective notes per modality | Optional reflection on each report sheet | Not specified as a number |
| Who signs | Supervisor through workplace assessments and entrustment | Supervisor or mentor countersigns each report sheet | Mentor or trainer reviews and signs off the logbook |
Two rules catch people out most often:
- FUSIC's 12-month window runs from your first logbook scan, not from registration. Plan your first scan for when you have regular access to patients and a mentor. Extensions are granted only in exceptional circumstances, and you need to ask the Intensive Care Society at least four weeks before the window closes.
- FAMUS and FUSIC count supervised scans separately. Fifty scans with only six directly supervised does not meet FUSIC Heart's minimum of ten.
Writing a reflection that counts
A reflection earns its place when it shows change. Four short lines are enough:
- What happened. "Hypotensive patient, subxiphoid view poor because of abdominal distension."
- What I did. "Switched to parasternal long axis and found a small effusion without RV collapse."
- What I learned. "The subxiphoid view is not the only route to the pericardium."
- What I will do next time. "Go to parasternal early when the abdomen is distended."
Reflect on the scans that went wrong. A missed finding later picked up on CT teaches more than ten normal scans, and supervisors value honest reflection on errors.
Compare with formal imaging
Follow up your scans. Check the CT report, the departmental scan or the operation note and record the result. FUSIC's packs call comparing your images with chest X-ray and CT "an invaluable part of the training process". Over time you build evidence of your own accuracy, which supports your sign-off and your appraisal.
After accreditation
Keep logging. Pathways expect it:
- RCEM recommends an up-to-date logbook and reflection as part of continuing professional development after entrustment level 4.
- FAMUS accreditation lasts three years. To keep it, you confirm ongoing regular scanning. The thoracic pack sets a minimum average of 20 thoracic scans a year, performed or supervised, and SAM provides an anonymised logbook template.
- FUSIC asks accredited practitioners to keep up regular scanning and CPD, and to audit their studies.
A current logbook also supports your annual appraisal and any future application to become a mentor, trainer or supervisor.
Paper, spreadsheet or app
Any format works if it holds the minimum dataset and protects patient data.
- Paper works on any shift but is easy to lose and hard to summarise.
- A spreadsheet sums totals well but is clumsy on a phone at the bedside.
- The RCEM e-portfolio (risr/advance, formerly Kaizen) has a procedural log and an ultrasound case reflection form, and links to your ARCP.
- The free Wavelength app logs scans against RCEM, FAMUS and FUSIC targets, records supervisor sign-off in person or by link, keeps images on your phone and exports a PDF, Excel or CSV summary with a verification code. It is not yet connected directly to any e-portfolio, so you attach the export to your portfolio entry.
Whichever you choose, log on the day of the scan. A logbook rebuilt from memory before an assessment rarely matches the detail your supervisor expects.
Sources
Checked against these documents on 4 October 2026.
- RCEM: Ultrasound education and training, 2021 curriculum FAQ
- RCEM Point of Care Ultrasound Curriculum 2021, Appendix 3
- FAMUS curriculum pack: thoracic module (Society for Acute Medicine)
- FAMUS: how to accredit
- FUSIC Heart training pack (Intensive Care Society)
- FUSIC Lung training pack (Intensive Care Society)
- FUSIC FAQs
- BMUS and RCR: Recommendations for specialists practising ultrasound independently of radiology departments (2023)