Insonation, or the use of ultrasound, has been proposed to be included in the medical school curriculumboth for education and bedside physical examination. It is important to consider what impact insonatioshould have on medical student education. Increasingly students are exposed to ultrasound use on clinicarotations, but to what extent should ultrasound be an integrated part of the preclinical curriculum in the United States? Ultrasound can serve to augment an existing curriculum in anatomy, physiologyphysical examination, and disease assessment and treatment. In addition, the actual performance aninterpretation of the insonation component of physical examination in real time may be an emerging skiset to be expected of medical students. Here we describe the utility and challenges of incorporating aultrasound curriculum into undergraduate medical education, including examples from institutions thahave pioneered this innovative curricular change.