Competence in Point-of-Care Ultrasound (PoCUS) is widely recommended by several critical care societies. Despite numerous introductory short-courses, very few doctors attain PoCUS competence, due to the challenges in establishing longitudinal competence programs.To evaluate the methodological quality of the literature on basic PoCUS competence processes in critical care.and Methods: A systematic review to identify manuscripts meeting predefined inclusion criteria was performed using three medical databases (PubMed, OVID Embase, Web of Science), extra references from original articles, review articles and expert panel guidelines, and directly contacting authors for further information if required. The objectives, domains, and inclusion and exclusion criteria of the review were determined during discussions between experienced PoCUS educators. Data extraction and analyses were performed independently by 3 reviewers.Of the 5408 abstracts extracted, 42 met the inclusion criteria for longitudinal PoCUS competence. Each study was described along four broad categories: general information, study design and trainee characteristics; description of introductory course; description of longitudinal competence program; grading of overall methodological quality on a 4-point Likert scale. Thirty-nine studies (92.9%) were from a single center. Most studies lacked important details on study methodology such as prior ultrasound experience, pre-and post-course tests, models for hands-on sessions, ratio of instructor to trainee, competence assessment criteria, number of scans performed by individual trainees, and formative and summative assessments. The studies were rated as follows: Poor = 19 (45.2%), Average = 15 (35.7%), Good = 4 (9.5%) and Excellent = 4 (9.5%).There is very little high-quality evidence on PoCUS competence. To help frame policy guidelines to improve PoCUS education, there is a need for well-designed longitudinal studies on PoCUS competence.