FAQ – Ultrasound!

I am so excited to share today’s post because besides it being my job, it is something I am truly SO passionate about and absolutely love sharing with people. Ever since I started pursuing sonography, I have had tonssss of questions from people about the field of sonography, the schooling, what sonographers do & what sonography really IS.  I have easily had 20 + people reach out to me with so many great questions and a lot of people who had a genuine interest to get into the field! It’s a length and complex process that is difficult to summarize in a short conversation. I would constantly think how nice it would be if I blogged it to make it a little more broken down and easier to understand – so here we are 🙂

WHAT IS ULTRASOUND?  Ultrasound, sonography, or diagnostic medical sonography is a type of imaging modality that uses ultrasonic sound waves to image both superficial and deep tissues / organs. There is no radiation, so no risk of harmful exposure (a big reason why it has become such a preferred method of imaging). People typically associate ultrasound with obstetrics (pregnancy), which is correct, but only a fraction of what ultrasound is used for. I personally have between 13-16 patients a day, and usually 1, maaaaaaybe 2 is an OB. They really are just a small part of the picture.  Other types of ultrasound exams are usually broken up into the following categories to evaluate the associated areas:

• Abdomen – imaging of the aorta, inferior vena cava, pancreas, liver, gallbladder, common bile duct, right & left kidneys, spleen & more
• Vascular – Aorta / IVC, upper & lower extremity veins, upper & lower extremity arteries, carotid arteries, transplanted kidneys, transplanted liver, vascularity of liver & deep abdomen, bypass grafts, stents, aneurysms, etc.
• Gynecology –Uterus/endometrium, ovaries, adnexas, cervix & vagina
• Small Parts – thyroid, breast, testicular ( yeeeeep, scrotal exams are apart of this field!) hernias, lymph nodes, superficial masses, etc.
• Obstetrics – evaluation of  fetal anatomy – including but not limited
  • Intracranial: thalamus, lateral ventricles, choroid plexus, caves septum pelucidum, cerebellum, cisterna magna, third ventricle, falx cerebri
  • Face: orbits, nose/lips/palate
  • Abdomen & pelvis: stomach, diaphragm, kidneys, bladder, cord insertion, 3 vessel cord, umbilical vein & more
  • Heart:  4 Chamber heart, evaluation of atria & ventricles, right ventricular outflow tract, left ventricular out flow tract, any intracardiac foci, BPM
  • Misc: Amniotic fluid, placenta, cervical length, fetal position, spine, fetal profile, 2 upper extremities, 2 hands, 10 fingers,  2 lower extremities, 2 feet, 10 toes, evaluate for clubfeet, rocker bottom feet, etc.

Can you see why the gender of the baby is the VERY least of medical concern and the LAST thing on my mind?😂😂😂  Ultrasound can be used for SOOO much, its literally hard to believe. It seems like new purposes are constantly being found for ultrasound and it is rising in popularity amongst doctors and patients.

THE SCHOOLING:   Finding a school that offers a diagnostic medical sonography (DMS) program can be challenging. I honestly can’t even think of any 4-year university in my area that offers DMS. You usually have 2 options for ultrasound:

1. Community College Programs : Some community colleges offer DMS programs. Cypress College and Orange Coast College are known for having 2 of the best ultrasound programs in the state of California. However, the waitlist for these programs are usually anywhere between 3-5 years (last I heard), OR operate by a lottery system in which sometimes less than 20 people (out of hundreds that are on the waitlist) are randomly selected and offered a spot in the program.  Crazy, right? I personally could not live my life in waiting like this. So I chose to do my pre-requisites for the DMS program at a city college for 2 years, then I transferred to a private school for an ultrasound program, which brings us to option # 2.
2. Private College : IF you are like me and  you are not in a position where you can or want to wait the 5 years on a waitlist, a private school program may be your best option. The program I was in was almost 2 years. Full disclosure – the catch with private schools is  the $$$. Private schools, once you’re accepted into their program, are tuition-based. Usually they cost you a pretty penny, and a lot of private schools can be a scam. As in, they aren’t an accredited school, have no employment rates amongst their graduates, and are just out for your money. LOOK OUT for these programs and steer clear of them. Make sure your program has a CAAHEP accreditation, ARDMS accreditation and if not, keep moving.  This is a super complex topic with much more detail involved,  so feel free to reach out to me if you have questions on this issue 🙂

DEGREE: The degree is not what matters most in tihs field. It’s the licenses you obtain after graduating. I graduated with an Associates degree. You do not need a bachelors for ultrasound if you are graduating from an accredited program.  The only thing a bachelor’s degree will allow you to do in this field is make you eligible of administrative positions in a hospital, like a supervisor / manager of the ultrasound department.

CONTINUING EDUCATION:  This is the important part.  It doesn’t matter if you have an Associates or Bachelor’s degree – everyone has to take their registry exams. There is one for each category of exams: the Abdomen board, OBGYN, Vascular, etc. The boards you obtain, combined with the # of years you’ve been in the field, is what will give you a leg-up in this competitive field. Boards can be TOUGH. They take months of prep to be ready for, the study materials/books can be pricey, and the hours spent studying can drive you crazy. But once you get that white piece of paper that reads ‘PASS’, you will literally breathe the biggest sigh of relief and the amount of doors it will open will make every last second you spent studying worth it.

WHAT DOES A SONOGRAPHER DO?  How it works –  Say you go to your doctor and complain of abdominal pain. After running a few different tests, your doctor may order an ultrasound to get a better look and determine if there is anything pathological causing your symptoms – gallstones, pancreatitis, etc. You then come in for your ultrasound -💃🏻 cue me. 💃🏻 Once we’ve done your exam, I write up a worksheet and summarize my findings from the images I took. I then submit the images + my worksheet to a radiologist, the doctor who specializes in reading ultrasounds ( & CT, MRI, X-ray, & more). They will review all the information I submitted to them, and in turn send a report to YOUR doctor summarizing the results of your ultrasound. Because the radiologist can only report on what the sonographer images, it is vital that as a tech, you are alert and aware of any possible abnormalities of what you’re scanning. If you don’t image something, the radiologist most likely won’t see it. It’s a lot of responsibility — you are quite literally what could be the reason a mass or abnormality is caught, or missed.

Think of it like this: Say  I took a bunch of pictures of my house, but none of the pool in the backyard. If I showed you all  the pictures I took, how would you know there wasn’t a pool if I didn’t show you there was one? You most likely wouldn’t. Thats exactly how it works for ultrasound. It is so vital that you know what you’re imaging and that you image it well because the radiologist needs to know whats there.

PROS & CONS OF BEING A SONOGRAPHER:   This job is not for the faint of heart. The hours can be long, early and late. The cases and patients you have can stick with you and break your heart. Doctors are not always appreciative. The field itself is under-appreciated because generally people are undereducated about the capabilities of ultrasound. The job can be physically taxing; since you use your right arm to scan for 8-10 hours a day, its very easy to develop chronic wrist, arm, & shoulder pain/conditions (it takes a lot of proper ergonomics to keep this from happening). You deal with a LOT of unhappy, unpleasant, sick people. You truly see people at their worst.

Despite these things, there is no other job I’d rather have. I get to combine anatomy, physics & physiology. I am ALWAYS learning new things. I get to interact with people and help aide in figuring out a diagnosis to make them healthy again. Because of what I find on their ultrasound, a doctor may be able to create a better treatment plan. Though sometimes patients can be difficult, there are those few every now and then that make you realize why you do what you do. Whether it’s the sweet elderly man who is inquisitive and appreciative of your job and wants to know all about it, the patient who comes back and thanks you for finding the abnormality on his ultrasound last year, or the first time mother you get to show a little beating heart to. There are so, so, so many moments that warm your heart and humble you to your core. It is a tremendous responsibility to be in the medical field but also the greatest privilege.

If you or someone you know is interested in the field of ultrasound, share this post with them! As always, if you ever wanna chat more about specifics, I am always available 🙂

xo,

Toni