Salary, protected time, and operational trends among emergency ultrasound programs: Results from the Society of Clinical Ultrasound Fellowships benchmark surveys.

BACKGROUND: Many emergency ultrasound (EUS) physicians and leaders depend on benchmarking data to gauge compensation, protected time, and operational metrics, yet available data are limited. We summarize four cycles of a national EUS benchmarking survey to characterize trends in salary, non-clinical protected time, demographics, operations, and billing for academic EUS divisions. METHODS: We performed a repeated cross-sectional analysis of Society of Clinical Ultrasound Fellowships surveys fielded in 2017, 2019, 2021, and 2023, reported in accordance with STROBE. Continuous variables are presented as medians with interquartile ranges. Director total salary was normalized to March 2026 dollars, and a multivariable linear regression was performed to identify factors associated with director buydown hours. RESULTS: Between 65 and 105 programs responded per cycle, with an average response rate of 65%. Median director total salary rose from $290,000 in 2017 to $340,000 in 2023, but inflation-adjusted buying power fell from roughly $394,000 to $375,000. EUS director protected time declined from 29.8% in 2019 to 21.4% in 2023. Western programs and larger departments had fewer director buydown hours, whereas director hours spent on EUS activities predicted more buydown (p < 0.001). EUS directors were predominantly male and white; fellowship directors were more junior and more often female than EUS directors. Billing rose from 88.6% to 94.9% of programs, with a widening range of billed examinations. CONCLUSIONS: While nominal compensation rose, inflation-adjusted compensation and protected time for EUS leaders declined even as programs and billing expanded. This provides important data for individual and program benchmarking.