Diagnostic imaging embraces several procedures that aid in diagnosing ailments. The most familiar procedures are the x ray and magnetic resonance imaging; however, not all imaging technologies use ionizing, radiation, or radio waves. Sonography, or ultrasonography, is the use of sound waves to generate an image for the assessment and diagnosis of various medical conditions. Sonography is commonly associated with obstetrics and the use of ultrasound imaging during pregnancy, but this technology has many other applications in the diagnosis and treatment of medical conditions throughout the body.
Diagnostic medical sonographers use special equipment to direct high frequency sound waves into areas of the patient's body. Sonographers operate the equipment, which collects reflected echoes and forms an image that may be videotaped, transmitted, or photographed for interpretation and diagnosis by a physician.
Sonographers begin by explaining the procedure to the patient and recording any medical history that may be relevant to the condition being viewed. They then select appropriate equipment settings and direct the patient to move into positions that will provide the best view. To perform the exam, sonographers use a transducer, which transmits sound waves in a cone-shaped or rectangle-shaped beam. Although techniques vary by the area being examined, sonographers usually spread a special gel on the skin to aid the transmission of sound waves.
Viewing the screen during the scan, sonographers look for subtle visual cues that contrast healthy areas with unhealthy ones. They decide whether the images are satisfactory for diagnostic purposes and select which ones to store and show to the physician. Sonographers take measurements, calculate values, and analyze the results in preliminary findings for the physicians.
In addition to working directly with patients, diagnostic medical sonographers keep patient records and adjust and maintain equipment. They also may prepare work schedules, evaluate equipment purchases, or manage a sonography or diagnostic imaging department.
Diagnostic medical sonographers may specialize in obstetric and gynecologic sonography (images of the female reproductive system), abdominal sonography (images of the liver, kidneys, gallbladder, spleen, and pancreas), neurosonography (images of the brain and other parts of the nervous system), or breast sonography. In addition, sonographers may specialize in vascular sonography or cardiac sonography. (Vascular sonographers and cardiac sonographers are covered in the Handbook statement on cardiovascular technologists and technicians.)
Obstetric and gynecologic sonographers specialize in the imaging of the female reproductive system. Included in the discipline is one of the more well-known uses of sonography: examining the fetus of a pregnant woman to track the baby's growth and health.
Abdominal sonographers inspect a patient's abdominal cavity to help diagnose and treat conditions primarily involving the gallbladder, bile ducts, kidneys, liver, pancreas, spleen, and male reproductive system. Abdominal sonographers also are able to scan parts of the chest, although studies of the heart using sonography usually are done by echocardiographers.
Neurosonographers focus on the nervous system, including the brain. In neonatal care, neurosonographers study and diagnose neurological and nervous system disorders in premature infants. Like other sonographers, neurosonographers operate transducers to perform the sonogram, but they use frequencies and beam shapes different from those used by obstetric and abdominal sonographers.
Breast sonographers use sonography to study diseases of the breasts. Sonography aids mammography in the detection of breast cancer. Breast sonography also is used to track tumors, monitor blood supply conditions, and assist in the accurate biopsy of breast tissue. Breast sonographers use high-frequency transducers made exclusively to study breast tissue.
Work environment. Sonographers typically work in healthcare facilities that are clean. They usually work at diagnostic imaging machines in darkened rooms, but they also may perform procedures at patients' bedsides. Sonographers may be on their feet for long periods of time and may have to lift or turn disabled patients.
Some sonographers work as contract employees and may travel to several healthcare facilities in an area. Similarly, some sonographers work with mobile imaging service providers and travel to patients and use mobile diagnostic imaging equipment to provide service in areas that otherwise would not have access to such services.
Most full-time sonographers work about 40 hours a week. Some sonographers work overtime. Also, sonographers may have evening and weekend hours when they are on call and must be ready to report to work on short notice.
Diagnostic medical sonographers usually use diagnostic imaging machines in dark rooms, but may also perform procedures at a patient's bedside.
Diagnostic medical sonography is an occupation to which there are multiple paths of entry. Formal education in sonography, training, or a combination of these are accepted by employers. Employers do prefer sonographers who have received education from an accredited program or completed training in an accredited practice, and who are registered.
Education and training. There are several avenues for entry into the field of diagnostic medical sonography. Sonographers may train in hospitals, vocational-technical institutions, colleges or universities, or the Armed Forces. Some training programs prefer applicants with experience in other healthcare professions or high school graduates with courses in mathematics, health, and science.
Colleges and universities offer formal training in both 2-year and 4-year programs, resulting in either an associate or a bachelor's degree. Two-year programs are the most prevalent. Coursework includes classes in anatomy, physiology, instrumentation, basic physics, patient care, and medical ethics. In 2008, the Commission on Accreditation of Allied Health Education Programs (CAAHEP) accredited over 150 training programs. Accredited programs are offered by colleges and universities. Some hospital programs are accredited as well.
A few 1-year programs that typically result in a vocational certificate also are accepted as proper education by employers. These programs are useful usually only for workers already employed in a healthcare occupation who seek to increase their marketability by training in sonography. One-year vocational-certificate programs are not accredited by the CAAHEP.
Certification and other qualifications. No States require licensure in diagnostic medical sonography. However, sonographers may become credentialed by one of the professional certifying bodies. Most employers prefer to hire registered sonographers because registration provides an objective measure of an individual's professional standing. To become registered, one must first become eligible to take the examination by completing the proper education, training, or work experience. The exam typically includes a physics and instrumentation exam in a sonography specialty. Typically, sonographers must complete a required number of continuing-education hours to maintain registration. For specific details on credentialing, contact the certifying organization.
The American Registry for Diagnostic Medical Sonography (ARDMS) certifies each person who passes the exam as a Registered Diagnostic Medical Sonographer (RDMS). This credential can be obtained for several different specialty areas like the abdomen, breast, or nervous system. The ARDMS also credentials cardiac and vascular sonographers. The American Registry of Radiologic Technologist offers credentials in breast and vascular sonography. The Cardiovascular Credentialing International credentials cardiac sonographers. (Vascular sonographers and cardiac sonographers are covered in the Handbook statement on cardiovascular technologists and technicians.)
Sonographers should have good communication and interpersonal skills, because they must be able to explain technical procedures and results to their patients, some of whom may be nervous. Good hand-eye coordination is particularly important to obtaining quality images. It is very important that sonographers enjoy lifelong learning, because continuing education is crucial to workers in the ever-changing field of diagnostic medicine.
Advancement. Sonographers can seek advancement by obtaining competency in more than one specialty. For example, obstetric sonographers might seek training in abdominal sonography to broaden their opportunities and increase their marketability. Sonographers also may seek multiple credentials—for example, being both a registered diagnostic medical sonographer and a registered diagnostic cardiac sonographer.
Sonographers may advance by taking supervisory, managerial, or administrative positions.
Diagnostic medical sonographers held about 50,300 jobs in 2008. About 59 percent of all sonographer jobs were in public and private hospitals. The remaining jobs were typically in offices of physicians, medical and diagnostic laboratories, and outpatient care centers.
Employment change. Employment of diagnostic medical sonographers is expected to increase by about 18 percent through 2018—faster than the average for all occupations. As the population continues to age, there will be an increasing demand for diagnostic imaging. Additional job growth is expected as healthcare providers increasingly utilize ultrasound imaging as a safer and more cost-effective alternative to radiological procedures. Ultrasound imaging technology is expected to evolve rapidly and spawn many new sonography procedures, enabling sonographers to scan and image areas of the body where ultrasound has not traditionally been used.
Hospitals will remain the principal employer of diagnostic medical sonographers. However, employment is expected to grow more rapidly in offices of physicians and in medical and diagnostic laboratories. Health care facilities such as these are expected to increase in number because of the strong shift toward outpatient care, encouraged by third-party payers and made possible by technological advances and less expensive ultrasound equipment that permit more procedures to be performed outside of hospitals.
Job prospects. Job opportunities should be favorable. In addition to job openings from growth, some openings will arise from the need to replace sonographers who retire or leave the occupation permanently. However, job opportunities will vary by geographic area. Sonographers willing to relocate will have the best job opportunities. Sonographers with multiple specialties or multiple credentials also will have good prospects.
The median annual wage of diagnostic medical sonographers was $61,980 in May 2008. The middle 50 percent of sonographers earned wages between $52,570 and $73,680 a year. The lowest 10 percent earned less than $43,600, and the highest 10 percent earned more than $83,950. Median annual wages of diagnostic medical sonographers in May 2008 were $62,340 in offices of physicians and $61,870 in general medical and surgical hospitals.
Suggested citation:
Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2010-11 Edition,
Diagnostic Medical Sonographers, on the Internet at http://www.bls.gov/oco/ocos273.htm
(visited February 09, 2010).
