Resident Takes Leading Role on POCUS

McLaren St. Luke’s Family Medicine Residency is ahead of the curve, thanks to third-year resident Ian Thomas, M.D., M.S., R.M.S.K., R.S.C.C., who secured a $50,000 grant from his health system’s foundation in 2021 to support the creation and implementation of a point-of-care ultrasound curriculum at the Perrysburg, Ohio, program.

Thomas has emerged a leader on the subject in the past year, serving as an instructor in six POCUS workshops in four states and Washington, D.C. He also was elected resident representative of the AAFP’s POCUS Member Interest Group and will serve as preceptor for two Global Ultrasound Institute workshops this spring, April 13-14 in San Francisco and May 6 in Cleveland.

“I never would have imagined it would spiral into something this big,” said Thomas, who was one of a dozen family medicine residents who received the AAFP’s Award for Excellence in Graduate Medical Education in 2022. (The deadline for this year’s GME awards is May 19. Winners receive a $2,000 scholarship as well as transportation, lodging and registration for the Family Medicine Experience, which is Oct. 26-29 in Chicago.)

Last year, Thomas also was one of 30 scholars in the AAFP Foundation’s Emerging Leader Institute. That year-long program provides students and residents with $1,000 scholarships to attend the AAFP’s National Conference of Family Medicine Residents and Medical Students and the Emerging Leader Institute, which both take place in late July in the Kansas City metro area. ELI scholars are paired with a family medicine mentor who provides guidance and support on a leadership project of the participant’s choice.

“The goal of the Emerging Leaders program is to develop your own leadership path and to grow as a leader,” he said, “and it’s through your project that you do that.”

Thomas chose to develop a POCUS workshop in conjunction with the Ohio AFP, despite some efforts to dissuade him from taking on a project of such scale. Success would require collaboration and assistance from numerous stakeholders, he was advised, and it could have been difficult to complete by the deadline.

The challenge, he said, was the point.

“I knew that if my project was something I could accomplish by myself, it wasn’t a big enough challenge for me,” he said. “I’ve always worked alone and done things by myself. I needed to pursue this goal to grow. In doing that, it’s led me on a wild path of things I would have never anticipated.”

Thomas attended state and national events that offered POCUS workshops and took note of what worked and what didn’t. In the negative column, Thomas found that some workshops had too few machines and/or preceptors per participant, and that some participants often were asked to play the role of patient. Those participants, he said, got less hands-on learning than they would have if the workshops had recruited people specifically for the patient roles.

Thomas collaborated with individuals, institutions and vendors to build curricula for his workshop and his residency:

• GE Healthcare provided machines for the workshop and a handheld ultrasound to raffle in a fundraiser that supported POCUS curriculum and training for the only family medicine residency in Malawi.
• The Global Ultrasound Institute coordinated the Malawi fundraiser through the Health Equity Residency Exchange program and offered a years’ worth of online POCUS training for an additional raffle winner.
• Inteleos provided ultrasound credentialing resources for workshop participants.
• Medical students from the Ohio State University and University of Toledo, as well as two Bowling Green State University graduates applying to medical school, were recruited to act as patients so workshop participants could focus on learning.
• Thomas’ ELI mentor — Grant Family Medicine Residency faculty and former Ohio AFP Board member Sarah Sams, M.D. — connected him with state chapter staff who lent their expertise on the logistics of putting a workshop together.

“Without the help of Dr. Sams, OAFP staff Erin Jech and Caitlin Laudeman, and my co-residents — and the support of my faculty and faculty from other institutions — I wouldn’t have been able to achieve this,” he said. “I’m proud of what we were able to accomplish together. Now I have a playbook of the things I’ll need to create workshops in the future.” 

Thomas is working on a couple of actual books, too.

He wrote an 80-page pocket guide on musculoskeletal ultrasound for the Global Ultrasound Institute this winter. It will soon be available online and in print.

Thomas, a former competitive gymnast, is a program director for a gymnastics academy in Toledo and coached throughout medical school and residency. He is a contributing writer for the second edition of the American College of Sports Medicine’s Sports Medicine: A Comprehensive Review.

Thomas was reading the first edition, which was published in 2012, when he noticed that a significant amount of the content regarding gymnastics was outdated. The resident reached out to the book’s author and senior editor, Francis O’Connor, M.D., M.P.H., medical director of the Uniformed Services University Consortium for Health and Military Performance at the Uniformed Services University of the Health Sciences, to politely point out that the chapter needed updating.

Within a few hours, O’Connor responded: “Would you like to be part of editing this chapter?”

 “I was like, ‘Absolutely!’” Thomas said. “I pinch myself all the time. I keep finding myself in these very lucky positions.”

Thomas is in good company. His co-editors are Ellen Casey, M.D., and Marcy Faustin, M.D., team physicians for the USA Gymnastics National Women’s Team, and former All-American gymnast and current Ohio State medical student Joey Bonnano. The book is expected to be published later this year.

“I emailed Dr. O’Connor, not expecting anything back,” Thomas said, “and I literally got an email back that same day. The whole ultrasound grant started the same way, with a random email of an idea I had, and that led to a $50,000 grant. I’ve gotten really good at writing emails.”

Thomas will graduate in June before starting a sports medicine fellowship this summer at Harvard Boston Children’s Hospital. He hopes to continue coaching and eventually build a multi-disciplinary gym that brings together sports medicine physicians, sports psychiatrists, conditioning coaches, athletic trainers and physical therapists.

His mother, Allison Thomas, M.D., of Battle Creek, Mich., also is a family physician, and Thomas rotated in her practice. But it was Thomas’ own health issues that attracted his early interest in medicine. He was diagnosed with Hodgkin lymphoma at age 11 and underwent treatment for a year and a half.

“I grew up around medicine,” he said, “but I wanted to understand my diagnosis and what it meant — what cancer is, what death is. It’s not something you’d typically consider at 11, but it definitely sparked my interest in medicine.”

The experience also shaped how he cares for patients.

“I tell my new patients about my pathway through medicine and how I felt uninvolved in my care during cancer treatment,” he said. “We may talk about all the most evidence-based treatments for their conditions because my job is to be an educator and inform them how to best care for themselves. But ultimately, I am the navigator and they are the captains of the ship, moving away from a paternalistic style medicine and toward a more patient-entered style of care.”