How to Become an Ultrasound Tech

Diane Luwe BS, RDMS, is an experienced sonography instructor and clinical coordinator in the Department of Diagnostic Ultrasound at Seattle University. She earned both her Bachelor of Science in biological science and her secondary education degree in biological science at Colorado State University. She worked as a high school biology teacher until 1978, when she entered the field of sonography.

That same year, Diane completed her postgraduate study in biological science at Portland State University and went on to study sonography at Portland Adventist Medical Center in Portland, Oregon. She first worked as a hospital-based diagnostic medical sonographer, and in 1984 she began teaching sonography at Seattle University. For the past 18 years, Diane has also been a clinical coordinator, scheduling clinical rotations and advising senior students during their clinical internships.

What is the study of sonography?

Diagnostic medical sonography is a field of medical imaging that uses high frequency sound waves to visualize normal body structures, identify pathology, and diagnose abnormalities. The study of sonography includes both didactic coursework and a clinical internship to prepare a student for a career as a sonographer, a professional who operates an ultrasound machine.

A sonographer performs ultrasound examinations on patients. During an ultrasound examination, sound waves, or ultrasound, are emitted from an ultrasound machine and enter the body from a wand called a transducer, which is placed on the skin. Each sound wave bounces off internal structures and returns to the transducer as an echo, which is recorded as an image that reveals the shape of the internal organs being examined. Sonograms, the images resulting from the returning ultrasound echoes, are useful for evaluating organs of the abdomen (liver, kidneys, pancreas, spleen, gall bladder), pelvis (bladder, ovary, uterus), thyroid, breast, brain, muscular-skeletal system, heart, and vascular system. Sonograms are also used to evaluate pregnant patients and the fetus.

What do you find most interesting about sonography?

The most interesting part of sonography is the way that a sonographer gets to be a patient care provider, biologist, physicist, computer scientist and detective all in one. Each examination provides the opportunity to make a positive impact on the care and overall health of the patient. Education in anatomy, physiology, and biochemistry give the understanding of the normal and abnormal organ structure found in each unique patient. Knowledge of physics and computer technology allow one to operate the ultrasound equipment to produce the best images for each patient exam. It is the combination of working with all these parts -- patients' signs and symptoms, anatomical information found during the examination, and the implementation of physics and instrumentation -- that makes a sonographer a detective who can help solve the patient's health questions.

What is your least favorite aspect of sonography?

My least favorite aspect of working as a sonographer is the potential for irregular hours. Working in a hospital setting can mandate being part of an "on-call" system, which requires the sonographer to return after regular work hours to perform additional duties. Although being on-call can increase a sonographer's income, the loss of sleep and disruption to a family schedule are difficult.

What careers do students commonly pursue with a degree in sonography?

There are four subfields of sonography. A sonographer can become a Registered Diagnostic Medical Sonographer, a Registered Diagnostic Cardiac Sonographer, a Registered Vascular Technologist or a Registered Physician in Vascular Interpretation. In order to practice sonography in one of these areas of specialty, a student must first complete a sonography program and internship, then earn board certification.

A Bachelor of Science is the terminal degree in sonography. Not all school programs offer a BS degree, and of those who do, not all are accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP). CAAHEP establishes and maintains the standards and practices of quality for education in the diagnostic medical sonography profession.

Graduates of CAAHEP-accredited programs are eligible to take the national board certification, which is the standard of practice in ultrasound. The purpose of the certification is to provide assurance that ultrasound professionals have completed the specific didactic courses and clinical internship experience necessary to deliver high-quality patient care. The national board certification is offered by the American Registry for Diagnostic Medical Sonography (ARDMS) and awards credentials in each of the four areas of specialization.

What personality traits do you think a student should have in order to be successful in a sonography program?

In order to be successful in a sonography program or in a sonography career, students should possess self-motivation and self-responsibility for learning, as well as independent judgment and the ability to integrate and synthesize course work into a clinical setting with patient care. Students must be problem solvers who can think critically to analyze the images obtained and form correct answers to diagnostic questions. Sonographers must also have the ability to communicate effectively with patients, recognize and adapt an exam to the patient's needs, cope with emergency situations, and maintain ethical working relationships with patients and staff.

What electives would you recommend that a student in a sonography program take?

In addition to the anatomy, physiology, and pathophysiology classes that should be a requirement for any program, I would also recommend that students take courses in embryology and congenital abnormalities. Courses on medical ethics and law, as well as communication classes in speech and writing, will add to a student's professional skills. I also suggest that students take a CNA (Certified Nursing Assistant) class, which will provide a base knowledge of patient care skills.

Besides sonography courses, I recommend that potential sonography students have a thorough understanding of physics, math, and biology, because ultrasound is a science-based field. A strong background in medical terminology is also helpful for learning didactic material and working in the clinical setting.

What study tips would you give to a student to help him or her succeed in a sonography program?

As with all college coursework, consistent attendance and participation in class are crucial for success. Working in study groups to actively discuss case studies and review didactic material is also helpful.

Do you think sonography is a subject that can be studied online, or is a traditional class environment ideal?

Although some ultrasound courses are often available online, I would recommend a traditional classroom setting for studying sonography. Basic ultrasound didactic classes may be studied online, but do not provide the student an opportunity to "verbalize" medical terminology, or describe sonographic information during case studies. A huge part of a sonographer's daily responsibility is the ability to accurately articulate and communicate the information obtained on an ultrasound examination; this is a responsibility that needs to be learned and practiced in a traditional classroom setting.

In addition to classroom study, an internship in a clinical site is necessary to become a sonographer. This training cannot be accomplished online.

What pieces of advice, or caution, would you offer to a prospective student of sonography?

If you are considering studying sonography, I advise you to thoroughly research any potential sonography program before applying for admission. Not all programs will guarantee a clinical internship assignment as part of their program. It is important to look for CAAHEP-accredited programs that meet the standards and practices for a quality education in the diagnostic medical sonography profession.

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