Choosing a career in 2017 in the health industry is challenging because there are so many options. One of the choices is sonography, also called ultrasound technology or Diagnostic Medical Sonography. As millions of uninsured people join the ranks of the insured in 2017 due to implementation of a national health insurance program, there will be a great need for credentialed Diagnostic Medical Sonographers. However, before deciding to become a sonographer, there are some things to keep in mind because this is not the right profession for everyone.
1. A person does not like working with people and prefers a set schedule.
During a normal shift, a sonographer will interact with up to 12 patients and a number of physicians and other hospital personnel. Sonographers must greet the patient and explain the process in a way that is professional but reassuring. They are hands-on health professionals who prep patients for the image-taking session and position them during the procedure. Sonographers also work with doctors, nurses, office staff, families and other people.
It is frequently necessary to adjust the planned work schedule to provide critical services to patients on an unexpected or emergency basis. The sonographer must be able to maintain composure while managing stressful situations and be willing to work additional hours to provide quality patient care.
In fact, working sonographers frequently point out that their positions require being on call for the equivalent of one week a month. They may have to rotate shifts, and some people find that difficult to manage. These scheduling requirements will interfere with social activities and require additional family planning. Anyone unwilling to assume this type of schedule should choose another professional field.
2. Someone does not like technology or regularly upgrading knowledge and skills as technology advances.
Sonographers are responsible for preparing, using, and then recalibrating sophisticated equipment. They must be able to recognize when the ultrasound machine is not working properly, and that requires in-depth knowledge and experience and frequent information upgrades. Ultrasound technologists use a variety of medical radiological positioning aids; ultrasound, Doppler, or echo monitors; 3D sonography equipment; pulse echo or echography units; cardioscopes; computers; medical software; and much more.
New ultrasound technologies are being developed all the time, requiring sonography professionals to invest time and effort in learning how to use new equipment and techniques. Just recently the National Institute of Biomedical Imaging and Bioengineering developed a handheld ultrasound imaging device, and there will surely be more new equipment introduced in the future. To maintain currency, sonographers must regularly learn how to use the new ultrasound machine technologies.
Sonographers completing their educational program requirements should sit for the ARDMS exams to earn credentials. The ARDMS registered Diagnostic Medical Sonographer has to earn a minimum of 30 continuing medical education requirements (CMEs) during a designated three-year period to maintain the credential. After the three years, there is a 10-year recertification period. Professionals interested in maintaining quality standards and advancing their careers will go beyond minimum requirements and regularly attend informative workshops, seminars and/or classes offering CME credits.
3. There is little interest in maintaining detailed patient records or working within bureaucratic systems with strict rules.
If a personal vision of being a sonographer includes only working with patients and then passing off the maintenance of records to others, the vision needs correcting. Sonographers manage a mix of input to electronic patient health records and filling out paperwork. They establish accurate records of information by documenting the number and type of images taken and the content of each image. The healthcare professionals might be responsible for scheduling exams, obtaining consent forms, and completing safety reports.
How much manual paperwork is required depends on where the sonographer is employed. A large hospital may have installed a sophisticated computer system that is integrated with the medical equipment, and procedure results are automatically recorded and paperwork requirements are minimized. However, if the sonographer works for a small, rural outpatient center, there may be significant paperwork processing required.
In any medical office or business there will be daily routines, minimum job requirements, a need to comply with detailed government regulations, extensive record-keeping, and ranking of staff. The sonographer must answer to radiologists, doctors and supervisors. The job can get quite complicated at times. For this reason, sonographers must be flexible and able to work within an established system.
4. It is important to get a lot of recognition and regular accolades for job performance.
Sonographers are “quiet” health professionals. They are usually not seen dramatically running down hospital halls to respond to emergency calls or attending award ceremonies held in their honor. Sonographers choose their careers because they want to help people and make a difference in their lives by providing quality healthcare services.
For anyone needing a lot of pats-on-the-back to remain motivated, Diagnostic Medical Sonography is not a good career choice.
5. The ideal job is one with routine work that does not require critical thinking, active listening, problem-solving, or decision-making.
Sonographers are key players in the delivery of healthcare services. They do not just prep patients and take images. They must analyze the images to determine if they are usable or need to be redone. The professional must make decisions about equipment adjustments and the best way to adjust patient positions to get accurate images. They must decide which images to keep and which to discard. The trained professionals also determine the scope of the exam as images are taken.
The Diagnostic Medical Sonographer is responsible for ensuring the image is complete enough for its intended purpose, which might be assessing internal organs, locating neural abnormalities, pinpointing disease of the breast, or determining if a fetus is developing normally.
Conclusion
Unsung Heroes with One Purpose: Help Patients
Sonographers can rightly be called unsung heroes because they play such an important role in delivering non-invasive diagnostic medical services. The patient may talk about a great doctor or wonderful hospital, but it is unlikely anyone will hear him or her talking about the stunning images of heart disease or a brain tumor. When expectant parents show off fetus images to family and friends, they will talk about plans for the baby or the excitement of knowing it is a boy or girl. They may remember the “nice person who took the pictures.” However, the likelihood is that they will not be overheard discussing the sonographer skills that produced the images.
People choose to become a sonographer because they want to help people and are attracted to the medical field, but they do not want to be doctor or nurses. The rest becomes unimportant. It is really that simple.
I am an MRT and registered sonographer with sonography Canada. I too applaud the regulation of this profession. Some of my concerns or comments are as follows:
1. Remove MRT from the suggested abbreviation as a prefix to DMS. Not only is this confusing, but as an MRT who is proud of my credential, I don’t feel a sonographer should be entitled to use it.
2. Grandfathering. I see the details are still being discussed, but to ptotect the competency and integrity of qualified registered technologists currently employed, I strongly support upholding current requirements and exams in place with sonography Canada. Simply “working in the field”, or having a supervisor write a note stating competency is far too lenient.
3. As so many comments previously, subspecialities need to be recognized. Employers take advantage of general sonographers often tasking them with different areas (echo, breast, msk, vascular) with little training or support in the clinical setting. Without the CMRTO recognizing the vast differences in skills for certain exams, how can we expect an employer to understand? Not to mention sonographers with added specialities should be compensated financially for their extra skill sets. This could be better argued through the collective bargaining process if additional credentials were recognized.
Thank you for the opportunity to share my comments!Friday, 29 September 2017 02:43Sonographer
It is about time that sonographers become Regulated. We still have people coming into the sonography profession and taking short cuts around education. Many educated people can, and have written the ARDMS exams, and pass and hold credentials from the ARDMS. That does not make them compentent sonographers. An ARDMS credential shows they are compentent in exam writing. Having a credential doesn’t prove competence in scanning. Sonography is the most operator dependent of all the imaging modalities. I personally know many sonographers that hold multiple ARDMS credentials, as I do. When I wrote my ARDMS exams it was common for most sonographers to write the echocardiography exam. Some of these sonographers have never performed echocardiography in over 20 years. Does having a credential make someone competent? If you haven’t performed an echocardiography exam in >20 years do you have the knowledge, skills and judgement to do an echo examination now? I wouldn’t want that sonographer doing my echo exam. Please don’t get hung up on a credential. It is important, but I don’t think it is that important. Being in a Regulated College, will ensure that we are all self reflecting, and saying do I have the knowlege, skills and judgement to do this examination. If we don’t have the knowledge, skills and judgement we shouldn’t be doing that examination. Sonography Canada’s credentials are the credentials most employees are looking for now; and Sonography Canada should be applauded for all the work they have done in ensuring competence in scanning is involved in passing their examinations, but remember not too long ago Sonography Canada grandfathered in ARDMS registrants as well. If you take the time to study the history of the Regulated Health Colleges you will find that all of the Regulated Colleges initially grandfathered practioners in. You have to start somewhere, and the CMRTO will ensure they will know everyones background. It is the duty of the Regulated Health Colleges to protect the public. As a health professional I will be honoured to be in a Regulated College; knowing that the entire Regulated sonography community is bound to protect the public and uphold to the highest standards, and ensure safety to all people having ultrasound examinations. Our current un-regulated environment allows the incompentent practioner to work and to tell patients they are sonographers. Regulation will ensure only Regulated Sonographers can hold the title. (What ever that title may be). Regulation also means that if someone is fired because they are incompetent, that there will be mandatory reporting of this person to the CMRTO, and that individual will not be able to work again, until they have proven their competence. Isn’t this what you want if you are a professional? Don’t we want the incompetent to be Regulated out? It is called Self Regulation for a reason, we the professionals are funding it; and Regulation ensures patient protection. Thanks CMRTO for ensuring that all sonographers are striving to continously learn, and improve, and protect the public. Friday, 29 September 2017 04:08MRT
I am an MRT(R) who does mammography and am registered with the ARDMS as an RDMS in the specialty of breast ultrasound. My training for breast ultrasound involved taking the Burwin Sonography Principles and Instrumentation and Breast Ultrasound courses, 1 year clinical training under the supervision of a radiologist, and the ARDMS registry exam. Will this new regulation require MRT’s who practice mammography to complete a full sonography program as listed in Schedule 1.3 to be able to be trained and perform breast ultrasound? Will the CMRTO accept the education and exam as prescribed by the ARDMS to practice breast ultrasound as an MRT in Ontario? Friday, 29 September 2017 13:24Sonographer
The grandfathering practice should be simply proof of registration with ARDMS and/or Sonography Canada. As a paying member of both these organizations currently, I should not have to again prove myself capable of performing my job that I have done for over 13 years. We have educational requirements with both these governing bodies that require CME submissions every three years. and the three year dates for a lot of techs do not fall exactly the same. So it is a lot of course juggling to make sure your CMEs are beneficial to both organizations. and now a third organization to add to this? Seems like a lot of red tape to perform our profession. this would be very discouraging for future techs. And I am also an x-ray tech. So I seem to pay endless dues for my profession, and this will add another fee. I feel this does not benefit patients or the community. Sounds unfair and unnecessaryFriday, 29 September 2017 14:21Sonographer
I have been a registered Sonographer for nearly 20 years, working only in Ontario. I applaud that the field of Ultrasound will be recognized and regulated in this province.
What is a bit unclear to me at this point is what will be expected from a fee responsibility. What specifically will our fees be to become registered with CMRTO and is our registration still required to be upheld with Sonography Canada and ARDMS?
And, I have a specific question related to my current professional situation. I have been seconded to another project within the hospital for a minimum of 2 years and am currently not practicing in ultrasound. What will this mean for me personally during this process?Monday, 02 October 2017 02:02MRT
Last year I paid $531.10 to the CMRTO for my MRT registration. Will Sonographer’s be paying the same CMRTO dues as MRT’s?Monday, 02 October 2017 14:30CMRTO
CMRTO response: Yes, members in all specialties will be paying the same fees.
The annual fee for registration with the CMRTO is set out in the by-laws of the College. Each member is required to pay an annual fee of $470.00 + HST ($531.10). There is only one annual fee regardless of how many specialties a member is authorized to practise.
When someone applies to be registered in a new specialty, they are required to pay a one-time application fee of $100.00 + HST ($113.00).Tuesday, 03 October 2017 02:34Sonographer
I have a question regarding grandfathering and required hours worked. I have had three children in the last five years, and therefore do not meet the required hours for grandfathering. Are there any provisions in place for this type of circumstance?Tuesday, 03 October 2017 14:48MRT
A question for CMRTO regarding CME’s.
As both an MRT(R) and a sonographer, I’d like to know what the yearly educational requirements will be for technologists who hold both certifications. Tuesday, 03 October 2017 16:19Sonographer
As a sonographer, I already perform other delegated tasks approved by my employer (institution) such as IV insertion and injection of contrast media. As some of my colleagues have either hid behind the excuse that they wouldn’t be ‘covered’ in the event something went wrong and they were to get sued, or not allowed to perform such tasks due to union involvement from competing professions, is there somewhere in the ‘scope of practice’ with this regulation that states sonographers are allowed and encouraged to perform these tasks many are already doing anyways, and will in fact be protected by the CMRTO should an adverse event occur?
Thanks in advance for your response.Tuesday, 03 October 2017 16:25CMRTO
CMRTO response: You can find out about the controlled acts that MRTs are authorized to perform in the CMRTO Standards of Practice on www.cmrto.org.Tuesday, 03 October 2017 17:51Sonographer
My suggestion to CMRTO is that , once we registered with CMRTO , than this should be a governing body for sonographer NOT ARDMS or sonography canada moreover the employer in ontario , before hiring they have to ask for only CMRTO registration .In this way we don’t have to pay , multiple dues .Tuesday, 03 October 2017 17:56Sonographer
CMRTO should be flexible for existing sonographer , during grandfather period. Their judgement should be fair . The reason Iam saying this is that , 90 % of the sonographer is ontario are international medical graduate , and in their o wn country only doctor is allowed to do ultrasound , It means the sonographer who were doctor in their home country are way more experienced .Tuesday, 03 October 2017 18:19MRT
may I suggest the a name for the college: Medical Imaging college of Ontario MICO)
The college of medical imaging of Ontario (CMI) to satisfy all modalities.
It is an excellent move on part of the college to house all imaging modalities under one umbrella and one set of guidelines and rulesTuesday, 03 October 2017 19:45Sonographer
“Applicants must meet all of the requirements for registration in the same area of practice within diagnostic medical sonography (general sonography, cardiac sonography or vascular sonography each being considered an area of practice) in order to be registered in the specialty of diagnostic medical sonography.” – this means that we will have to pass a licence( board exam ) to be register in the speciality we work? In my case I hold ARDMS for adult echo- is this gone be enough to be register for “cardiac sonography”?. I also have a membership with Sonography canada in good standing but without any credentials just because Sonography was never recognized before by the ministry of health to be on charge of Sonographers. I work for the last 15 years in a teaching hospital and my ARDMS was good enough to teach many Cardiology residents. I am asking you in the name of a group of experienced Sonographers to get a straight answer regarding this. Will be ARDMS credential enough or we will have to go and pass Sonography exam? Tuesday, 03 October 2017 19:50CMRTO
CMRTO response: The requirement that an applicant must meet all requirements for registration in the same area of practice within diagnostic medical sonography is an element of the on-going registration requirements that apply to all individuals wishing to practise diagnostic medical sonography in Ontario after the grandparenting period.
Initially, there will be a one-year grandparenting period starting in January 2018 to permit those individuals working competently in diagnostic medical sonography currently or within the last three years to apply for registration as a DMS. These individuals may not have completed an approved educational program or approved examination.
You can find out more about the grandparenting period on the CMRTO website at www.cmrto.org. We will send out regular ‘DMS Updates’ as the regulations proceed.Wednesday, 04 October 2017 14:12Sonographer
Hello, I am currently a practicing MRT(R), CRGS & RVT.
My concerns moving forward with licensing under CMRTO is in regard to echocardiography and vascular technology. Currently all I have read is to do with just general ultrasound and does not go into details for echo and vascular. Currently, if we hold a certification from an accredited general ultrasound school we have the ability to train on the job and work towards our echo and vascular certification. This is essential in rural Ontario, especially in the North, as it is very difficult to recruit echo technologists to the region as there is already such a shortage of echo techs. I feel the quality of the scanning is still very high, especially now that sonographers have to go test at cardiac centres after completing their Sonography Canada licensing exam to ensure they are scanning at the highest quality. I hope that moving forward with CMRTO they take into consideration the need for on the job training of accredited ultrasound technologists to ensure we continue to be able to serve our rural communities in all aspects of ultrasound.
Thank youWednesday, 04 October 2017 17:40Sonographer
!.We can not be under CMRTO it will confuse patient .We are doing ultrasound not any test related to radiation.
2. All credentials should be recognized RVT,RDSC etc
3.It will not improve any patient care
4.It should be up to Employer to make sure all sonographers are register
5. .Ministry should only paying for test done by register sonographers
6.It is insulting for sonographer to pay exrta money to CMRTO to be accepted to their organization. Thursday, 05 October 2017 14:29Sonographer
hi
I have a question from CMRTO . Once we are regulated by them. is there will be criteria for pay scale because there are many employer , who are just using sonographers and give them lower salary . when we ask for raised they said ” this is what you can have and you should be thankfull that you are working ”
please make a strict rule for these kind of employer .who are abusing sonographer . and make pay scale according to the level of seniority .
thanks Friday, 06 October 2017 19:22Sonographer
I’m sorry but it is an absolute joke that individuals will be able to perform sonography who have not completed a proper training course under the “Grandparenting” policy. If I thought I was handy with electrical work from watching youtube videos it doesn’t mean I should be allowed to wire a house.
I have worked steadily in the ultrasound field for over 20 years, initially in a busy downtown hospital and then in private diagnostic imaging centres. Recently I decided to change my place of employ and had visited various clinics to interview. I looked at everything when I was considering a job because I really care about what I do. I was fortunate to be credentialed in many specialties and to possess a lot of clinical experience but it took time for me to find a good place to work. It was far from easy.
It surprised me to see some equipment in clinics with such poor quality images. Endovaginal ultrasound transducers were being soaked in the ultrasound room with the patient and sonographer present , where there was lack of ventilation . Fixed Examination tables were being used instead of Stretchers that could be raised or lowered for the ease of the patient. The fixed tables also required the sonographer to stand with their arm in an awkward position for a long period of time. One such clinic had just passed an inspection by the CPSO ( College of Physicians and Surgeons of Ontario) . I was a little shocked.
The most disturbing trend in most clinics is the short booking times for all examinations. Exams are being booked in some places for various specialties in 15 -20 min booking slots . The pressure to be faster and produce more volume is a requirement for the sonographer hired in most places to offset the reduction in the service fees outlined by the Ministry of Health
The fact is: Shortened examination times result in many cases with pathology being missed. This in NO way protects the public and in fact puts sonographers in a high risk situation. Who is ultimately responsible if a sonographer misses something when there is inadequate time given for the examination??? or Subpar equipment?? A sonographer is required to bring the patient into the room, take a history, perform the examination, write up a technical report and review and document prior imaging measurements of pathology for the radiologist if the patient is here for followup. The Sonographer today is sometimes required to add billing and scan all technical reports for the radiologist. The Sonographer today is required to teach in the clinical setting but given inadequate time to do a thorough job with inadequate or no extra pay .There can also be subtle adverse employment actions that make it difficult to remain at your job if you voice your opinion therefore for a lot of sonographers it is better not to voice your opinion at all.
Jobs are scarce therefore sonographers have to make due with what is out there but there is little in place to protect a sonographer when an injury occurs due to repetitive strain . The cause in most cases is due to the pressure to perform. Be faster , Complete more cases in your allotted shorter booking times. The use of of Improper chairs. Improper tables. I have had many colleagues and friends in this profession that have eventually had to leave our field because of repetitive strain injuries.
Financially sonographers also have to survive too. We have bills to pay. Cost of living increases but the pay of the sonographer decreases to offset the service fee cut backs . How fair is that ? I am making less pay now than when I worked in the hospital over 10 years ago. Short booking times for certain examinations is very unfair to the sonographer and extremely unfair to the patient. A life can be lost . A malignant lesion missed when there is time for treatment . Fetal loss because something was missed on a biophysical profile obstetrical examination. These are devastating outcomes.
There must be a system in place to regulate the times for examinations. Knowledgeable people with the credentials and clinical experience need to evaluate clinics and hospitals to take a deeper look at what is really going on.
I hope the CMRTO becomes the voice of the sonographer. In the end , we strive to do the best we can for the patient and the Mandate of the CMRTO is to protect the public. We need to also protect the sonographer in the workplace and by doing so this will also protect the public. These two go hand in hand.