A
Career in Sonography
 If
you're thinking about a career in ultrasound, these pages might
help you get a more detailed understanding of what the field is
really like. We polled current students to find out what they most
wanted to know when they were deciding whether to apply to the
DMS program at Montgomery College. Here are some of our results:
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What
do sonographers do?
THE
JOB
Diagnostic
Medical Sonography (DMS),
also known as “ultrasound” by many, is a relatively
young mode of diagnostic medical imaging that utilizes
ultrasound energy (sound frequencies much higher
than are audible by humans or animals). A transducer,
held by the sonographer, is somewhat like a flashlight/camera
in that it assists in production of real-time images,
on a computer monitor, as though one were “seeing” inside
the body. These images are then conveyed to an interpreting
physician for diagnosis.
Sonographers
capture real-time images that show the anatomy of internal
organs -- especially the kidneys, liver, spleen, pancreas
and gallbladder. The structure and motion of the heart
can be recorded in an echocardiogram and used to analyze
cardiac function. Blocked arteries, blood clots and
congenital malformations can be detected through a
Doppler ultrasound technique that examines blood flow.
Songraphers
have extensive, direct patient contact that may include
performing some invasive procedures. Ultrasound is
used to guide needles for breast, kidney and liver
biopsies, as well as to drain cysts and ascites (free
fluids). Sonographers must also be knowledgeable
about and able to limit the risk from possible exposure
to blood and body fluids.
Some examples where ultrasound can be used are in detecting and determining the
cause of:
- Female
pelvic pain, abnormal bleeding or other menstrual
related problems, such as cysts and fibroid growths,
as well as ovarian and uterine cancers
- Male
prostate abnormalities
- Pelvic
tumors and other disorders of the urinary bladder
- Pregnancy
outside the uterus
- Blood
clots
- Aortic
aneurysms
- Suspicious
lumps or nodules in breast tissue
Furthermore, ultrasound allows the unborn child to be viewed safely – to
indicate position, evaluate the placenta, determine
if multiple pregnancies exist, diagnose congenital
abnormalities and establish fetal age.
The professional
responsibilities include, but are not limited, to:
- Obtaining
and recording an accurate patient history
- Performing
diagnostic procedures and obtaining diagnostic images
- Analyzing
technical information
- Using
independent judgement in recognizing the need to
extend the scope of the procedure according to the
diagnostic findings
- Providing
an oral or written summary of the technical findings
to the physician for medical diagnosis
- Providing
quality patient care
- Collaborating
with physicians and other members of the health care
team.
The ability
to interact compassionately and effectively with people
who range from healthy to critically ill is a must
for the sonographer.
Many sonographers also assist in electronic and clerical scheduling, record
keeping, and computerized image archiving. Sonographers may also have managerial
or supervisory responsibilities.
Sonographers
generally specialize in one of several areas: General
Ultrasound (Abdominal, Obstetrics, Gynecological,
Breast), Vascular Ultrasound or Adult and Pediatric
Cardiac Ultrasound. To
view information on each specialty track, visit their
individual pages at DMS
Specialty Tracks.
Ultrasound
is a very "hands on" modality. More than
other radiology methods ultrasound images depend on
the technique of the person doing the study. Learning
proper technique requires many hours spent scanning
in class, in open scan sessions and during clinical
hours.
Sonography
is a relatively safe, mostly non-invasive diagnostic
tool used in tandem with other familiar imaging modalities
including X-ray, CT, and MRI…each playing indispensably
specific roles, along with DMS (as an increasingly
versatile and valuable mode) in our highly technological
world of medicine today.
What
are the career opportunities?
Sonography is a dynamic profession that
has grown significantly over the past 20 years. With rapidly developing
new technologies and increased use of diagnostic ultrasound procedures,
growth is projected to continue in the future with employment opportunities
for qualified sonographers in both urban and rural areas nationwide. Sonographers
and vascular technologists can choose to work in clinics, hospitals, private
practice physician offices, public health facilities, laboratories, and
other medical settings performing examinations in their areas of specialization.
Career advancement opportunities exist in education, administration, research,
and in commercial companies as education/application specialists, sales
representatives, technical advisors, etc.
More
information about a career in Sonography can be found
at Society
of Diagnostic Medical Sonography
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Earnings
Potential for Sonographers
 As
sonography students, we come into contact with a variety
of working sonographers and sometimes we get street-level
information about what people are making. Unfortunately,
this information seems to be pretty unreliable in terms
of what any given individual can expect to earn. The
reason is that there is a big range in compensation
within the field of sonography, depending on geographic
area, level of experience, the individual institution
where one works and the specifics of the work relationship
(employed vs. freelance, for example).
We've heard
of new grads earning as much as $36 an hour on their
first job. We've also heard of people making $25 an
hour even with three years of experience. There are
also stories of experienced freelancers making $45
an hour while working on a per-need basis (these are
called "PRN" workers within the allied health
world).
 Each
of these situations might have its own advantages and
disadvantages. The person making $25 an hour might
be working at the area's most prestigious hospital
for their specialty and "paying their dues" in
the short term in hopes of achieving a more profitable
or interesting career in the long term.
In contrast,
the person working on a PRN basis probably doesn't
get benefits and never knows when they will suddenly
be out of work. In general, the job outlook for sonographers
in all specialty tracks is currently considered to
be good in the DC metropolitan area. This is not expected
to change for the foreseeable future.
 The US
Department of Labor provides national
statistics on salaries within the field of sonography.
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Various
Work Environments
Sonographers
usually find work in one of three places: hospitals,
outpatient clinics and doctor's offices. There is also
some work at educational institutions, research facilities
and equipment manufacturers. However, since most sonographic
work is in clinical settings, we thought we would offer
some input as to what these environments are like.
Hospitals:
Working in a hospital can feel a little like joining
the Army. The level of commitment that is expected
of hospital workers is quite high. The overall attitude
is that patients' needs come first. This is especially
true in emergency situations. If a patient comes in
to the emergency room at three in the morning needing
a sonographic exam, you might very well get a call
in the middle of the night.
Even without
emergency situations, hospitals have high personnel
needs because they're open all the time. As a result,
they have to "cover" certain posts for many
more hours a week than would be necessary in another
type of facility. This can mean a variety of things.
To deal with snowstorms, for example, hospitals typically
recruit teams of volunteers to drive employees to work
in 4-wheel drive vehicles. In another type of job,
you might get a free day off, but not if you work at
a hospital! In more extreme circumstances, it is not
unheard of for workers to actually sleep at the hospital.
So, why
would anybody do it? For one thing, hospital work is
a great way to get a really broad base of experience.
Also, people are compensated for being on call, and
on days when they're not called in, they get extra
compensation without doing extra work. On a less tangible
note, there can be a strong sense of communal mission
in a hospital, and many people seem to thrive on it.
For others, especially those with major family commitments,
it might be overwhelming.
Outpatient
Clinics and Doctor's Offices: We've lumped
these together because an outpatient clinic is basically
just a big doctor's office.
Compared
to the hospital setting, outpatient clinics offer much
more of a 9 to 5 work situation. Patients are scheduled
to come in during regular daytime hours and, if the
weather gets bad, everybody just stays home. As for
on-call issues, if a patient gets into trouble in the
middle of the night, they call the hospital, not you.
Patients
who come to clinics are generally much healthier than
hospitalized patients. For one thing, they are able
to walk or get around in a wheelchair. In contrast,
hospital patients are often very ill and are confined
to a hospital bed or stretcher.
So, why
would anybody not choose to work in an outpatient clinic?
There are several reasons. For one thing, some people
might find that a clinic is too quiet or boring compared
to a hospital. Clinics are less likely to have that "ER" sense
of action or excitement.
Another
potential problem with clinical settings is that, because
of the relatively small personnel groups, individual
workers are much more dependent on having good coworker
relations. In a hospital, you can always switch to
the graveyard shift or find some other way to escape
a dreaded coworker. In a clinic, you might feel more
compelled to find a new job if you don't fit in.
Conclusion:
Each work setting offers its own advantages and disadvantages.
If you enter the program at Montgomery College, you
will experience a variety of work environments as part
of your clinical training. By the time you finish,
you will know what your individual preferences are.
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The
Physical Aspects of Sonography
One thing
you might not realize about sonography is that it is
quite physically demanding. In fact, there are specific
physical standards that you must be able to fulfill
in order to do the work. For example, your vision must
be adequate to distinguish fine shades of gray on a
computer screen. You also have to be physically strong
in order to help people move around if they are not
fully mobile on their own. Read the Technical
Standards of physical fitness published
by Montgomery College for more information about physical
requirements.
Because
of the demanding physical nature of sonography, work-related
injuries are actually a very significant problem among
sonographers. In fact, these injuries are the number
one reason why people eventually leave the field. Fortunately,
equipment manufacturers are starting to realize the
importance of ergonomic design, and there are some
exercises that can help. Take a look at the Society
of Diagnostic Medical Sonography's web pages on ergonomic
issues and exercises.
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Legal
Aspects of Being a Sonographer
 You've
probably heard stories about the legal troubles faced
by doctors as a result of malpractice lawsuits. What
you probably haven't heard is that sonographers occasionally
get sued too. Although the incidence of lawsuits brought
against sonographers is relatively low, it is a risk
that you should be aware of.
A sonographer
who makes a mistake can potentially cause serious harm
to a patient. But, while this is a scary thought, there
is a positive way of looking at it. You could regard
this risk as merely the flip side of the fact that
sonography is a highly skilled profession. Most job
functions that require particular expertise include
a certain inherent risk of harm if a mistake is made.
This is true even for those who work outside of the
health field. This is just part of being in a responsible
position.
 The
good news is that sonographers can reduce the risk
of lawsuits by maintaining good standards of practice
and keeping up their level of training. The other good
news is that malpractice insurance is readily available
for sonographers and is relatively inexpensive (a few
hundred dollars a year). Find out more about liability
insurance at the SDMS website.
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