Q: How can I become a sonographer?
A: We recommend a well-rounded cardiac sonography program that meets both didactic and clinical instruction and is accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP), through the Joint Review Committee in Cardiovascular Technology (JRC-CVT) and the Joint Review Committee in Diagnostic Medical Sonography (JRC-DMS). Echocardiography or Cardiac Sonography is covered through two allied health care disciplines which are Diagnostic Medical Sonography and Cardiovascular Technology.
These programs can be found by visiting the education section of our Website where you can review programs that are accredited by CAAHEP or by visiting their site at www.caahep.org. There is also information on schools under the "Sonographers" link on our Website. By attending a program accredited by CAAHEP, you will be eligible to apply to take the national certification examinations offered by the ARDMS and/ or CCI upon graduation from the program. By successfully completing the certification exams, you will be awarded a credential of 'registered' in that field. Increasingly, employers require their sonographers to become registered or hire only registered sonographers.
Q: How do I become a registered sonographer?
A: There are several types of registry organizations and the type of training you choose can affect what you need to do to be able to take the certification examinations.
ARDMS (American Registry of Diagnostic Medical Sonographers) administers examinations and awards credentials including the areas of diagnostic medical sonography, diagnostic cardiac sonography and vascular technology. Contact the American Registry of Diagnostic Medical Sonographers (ARDMS) at http://www.ardms.org or 1-800-541-9754. ARDMS offers four different credentials:
- RDMS® Registered Diagnostic Medical Sonographer®
- RDCS® Registered Diagnostic Cardiac Sonographer®
- RVT® Registered Vascular Technologist®
- RPVI® Registered Physicians Vascular Interpretation®
The Cardiovascular Credentialing International (CCI) administers examinations and awards credentials in the field of cardiovascular technology, including the areas of vascular technology and diagnostic cardiac sonography. Contact CCI at http://www.cci-online.org or (800) 326-0268. They offer the following credentials:
- RCIS: Registered Cardiovascular Invasive Specialist
- RCS: Registered Cardiac Sonographer
- RVS: Registered Vascular Specialist
- CCT: Certified Cardiographic Technician
Q: Need Career Presentation Materials for Students?
A: If you are asked to talk about your Sonography career at a school, college or club, ASE can provide you with free “Careers in Non-Invasive Cardiovascular Sonography” guides to hand out to your audience. These informative flyers contain information on the profession, nature of the work, opportunities for jobs, training and salary ranges. Contact ASE’s Marketing Director at jfactor@asecho.org for more information or to order.
Q: What is the Scope of Practice for Sonographers?
A: Click here to view the Scope of Practice for Sonographers as endorsed by
- Society of Diagnostic Medical Sonography
- American Institute of Ultrasound Medicine
- American Society of Echocardiography
- Canadian Society of Diagnostic Medical Sonographers
- Society for Vascular Sonography
Q: What is ASE's position on preliminary reporting by sonographers?
A: A cardiac sonographer must be skilled in interacting with patients, which involves explaining the procedure to the patient but not discussing the clinical findings of the examination. We have two documents that address this issue: "Guidelines for Cardiac Sonographer Education" and "Interpretation of Echocardiographic Data: Are Physicians and Sonographers Violating the Law?".
Q: Can you give me information on sonographer salaries?
A: The median salary for sonographers in the United States in 2004 was reported to be $50,000- $80,000 (depending on geographic location). The field is also seeing an increase in signing bonuses. Many employers are also offering tuition assistance and loan forgiveness to graduating students in exchange for employment agreements with those students. Beyond the financial rewards, there are many other attractions of this dynamic field. Flexibility and mobility are key benefits of this career. So are hands-on patient interactions and opportunities to work with leading-edge technologies. Sonographers also have the opportunity to specialize --- to migrate to the area of ultrasound that most intrigues them. Sonographers can work with all stages of life- fetal, children, adults and the elderly. Opportunities to cross-train, to advance into supervisory or management roles, and to teach or do research are also within reach in this exciting field.
Q: Are there licensure requirements for sonographers?
A: Regulation of echocardiography is coming. Two states, Oregon and New Mexico, now require licensure for sonographers and more states are expected to follow their lead. In general, credentialing by CCI or ARDMS is a requirement for sonographers wishing to be licensed. Medicare requires that studies be performed by a registered technologist or under direct supervision of a registered technologist in vascular labs. Echocardiography registry requirements are also needed in several states for performing stress echoes.
Q: What is the job market like?
A: The current job market is robust for Cardiac Sonography. Many opportunities exist in clinics, mobile health services, physician’s offices, and hospitals. Many areas of the country are now experiencing shortages as the rate of heart disease and the patient load continues to rise in the U.S. Careers in ultrasound are also evolving into a variety of pathways including endeavors such as education, independent business operations, management, and research.
Q: Where can I find employment?
A: Visit ASE's Marketplace to post jobs and resumes and find employments.
Q: Are there standards of case loads for cardiac sonographers?
A: There have been a few surveys over the past few years which gathered data on the average number of cases sonographers would perform in a day. The data from the 2002 ASE survey showed the most common average of studies per day by one sonographer was 8-10. Other surveys we have come across also validate the ASE survey results. The only true "standard" which exists is the ICAEL lab accreditation standards. The ASE, as a sponsoring organization, supports those standards as good practice to maintain quality. These standards suggest allowing a minimum of 45-60 minutes for an uncomplicated transthoracic case, and possibly another 15 - 30 minutes for a complicated case. This standard would fall into line with the benchmark data survey results of the most common number of studies per day at 8-10. The other issue to not leave out of any discussion of number of cases per day is the physical effects of scanning too many patients per day. Many well known speakers on the subject of musculoskeletal injury in scanning recently quote statistics of a dramatic increase in the incidence of injury when sonographers perform more than 10 studies per day. One other suggestion to make in comparing case volumes, is to look to other neighboring or regional labs to see what they are doing. This benchmark data can offer a lot of relevant information.
Q: Is there a state specific scope of practice or by-laws for Cardiac Sonographers?
A: The ACC/AHA have scope of practice for physicians involved in echo. The ASE has written documents on scope of practice for sonographers over the years. ASE has just published a minimum standards document for the cardiac sonographer which addresses many of these issues (click here to download a pdf of this document). Historically, sonographers were once designated as technicians or “one who is a specialist in the practical knowledge and technical details of ultrasound” and often received only on-the-job training. This traditional career pathway for sonographers has now evolved today into a requirement of training through a formal cardiac ultrasound program, obtaining a recognized credential through a certification examination, association with professional societies, and continued medical education by attendance at local/regional or national meetings. There are also legal restraints on the practice of medicine without a license and the practice of cardiac sonography must take these in consideration.
Q: Does ASE have a policy regarding degradation of echo images and the possible conversion of echo video images?
A: The ASE does not have an official policy on videotape enhancement, or have any specific vendors that it would recommend for either of these 2 processes. Unfortunately, videotape images degrade over a number of years and often very quickly the more the image has been played. It may be legally dangerous to use methods to enhance those images. Check with your own medical records department before changing anything about the image. Often in legal cases the attorneys for both parties want the "original" video, so a copy or a reproduced enhanced copy which has been enhanced may not be appropriate. Certainly there are vendors and solutions that will improve the quality of older videotape. The legal and law enforcement industries perform video enhancement so there is a possibility that healthcare may do the same. As for taking your previously recorded videotaped echo images and converting them to a digital storage file, there are echo labs that looked for help in this from the ultrasound manufacturers and the digital echo reporting vendors. Many labs work with digital echo vendors (i.e. GE, Philips, Siemens, Heartlab, Digisonics, etc) to work on retrospective image conversion. This is a very labor intensive task and consequently has some significant costs. Again it may be legally dangerous to take originally captured medical images and converting them. There aren't a lot of vendors that recommend this because labs still need to maintain the original copy, and the possibility of being able to simultaneously display a converted image within a new digital storage system is often not possible.
Q: How long should an echocardiographic study take ?
A: The CQI document from 1995 recommends 45 to 60 minutes from patient encounter to departure for a good-quality, uncomplicated exam. Here is a link to the document
