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Implementation of a point of care ultrasound curricula is valuable, but optimal integration for internal medicine residency is unclear. The purpose of this study was to evaluate if a structured ultrasound curriculum vs. structured ultrasound curriculum plus supervised thoracic ultrasounds would improve internal medicine residents' skill and retention 6 and 12 months from baseline. We conducted a randomized controlled study evaluating internal medical residents' skill retention of thoracic ultrasound using a structured curriculum (control,