How to Become a Diagnostic Medical Sonographer

Does the idea of working with some of the most advanced technology in the medical field interest you? Would you like to play an important role in helping doctors diagnosis illness? As a diagnostic medical sonographer (formerly referred to as “ultrasound technologist”) you will use sonographic (sound wave) equipment to obtain internal images of a patient’s body for evaluation by physicians.

Career Overview

Sonography is the use of sound waves to create internal images of the body for use in diagnosing various medical conditions. Although commonly used and widely known for its application in obstetrics, sonography is used to diagnose and guide treatment for a variety of ailments throughout the body.

Diagnostic medical sonographers (a.k.a. sonographers) use sonographic equipment that carries sound waves into select areas of the body. The equipment captures the reflected echoes of body structures and creates and image that can be videotaped or photographed for evaluation and diagnosis by physicians.

Duties of a Diagnostic Medical Sonographer

  1. The process begins when the sonographer explains the procedure to the patient and records his or her medical history, especially as it relates to the condition being evaluated.
  2. The sonographer then adjusts the equipment to appropriate settings and guides the patient into different positions to obtain the best view.
  3. The sonographer prepares the patient’s body by spreading a special gel on the area to be examined and then scans the patient’s body using a transducer which emits sound waves in a cone- or rectangular-shaped beam.
  4. When viewing the image, sonographers search for subtle clues to the underlying medical condition.  They then capture images to show physicians for further evaluation. As per Professor Charlotte Henningsen, President of the Society of Diagnostic Medical Sonographers, “because of the real-time nature of sonography exams, it is one of the more operator-dependent medical imaging modalities.”
  5. Aside from imaging, sonographers also update and store patient records and maintain equipment.

Diagnostic Medical Sonographers may specialize in such areas as obstetrics and gynecology, abdominal sonography (kidneys, liver, spleen, and pancreas), neurosonography (images of the brain and other parts of the nervous system), vascular sonography, cardiac sonography, and breast sonography.

Career Outlook

According to the U.S. Bureau of Labor Statistics, employment of diagnostic medical sonographers is expected to increase by about 18 percent through 2018—a rate that is faster than the average for all other occupations. This growth can be attributed to the continuing aging of the population with an increased demand for diagnostic imaging services. Growth in the field also arises from the realization by healthcare providers that the use of ultrasound equipment to diagnose illness is a safer and more cost-effective method than is the case with radiological procedures. The field is expected to evolve even further with the introduction of new sonographic equipment, enabling sonographers to scan areas of the body that have until this point not be examined.

Education and Training to become a Sonographer

According to Professor Charlotte Henningsen, President of the Society of Diagnostic Medical Sonographers (SDMS), the majority of states (Texas included) have no licensing or certification requirements for diagnostic medical sonographers and it is possible to enter the field with a high school diploma. There are several pathways for entering the field of sonography; however, Professor Henningsen does acknowledge that graduation from an accredited training program along with registration through the American Registry for Diagnostic Medical Sonography (ARDMS), Cardiovascular Credentialing International (CCI), or American Registry for Radiologic Technologists (ARRT) is highly recommended to enhance your marketability to potential employers. As per Professor Henningsen, all of the sonography-related professional associations embrace the idea of sonographers certification as the community standard-of-care. Accredited programs also provide preparation for certification examinations that you will need to pass in order to obtain sonographer certification.

The Commission on Accreditation of Allied Health Education Programs (CAAHEP) accredits over 190 educational programs offered by vocational schools, community colleges, and universities. Several hospital-based programs have received accreditation as well.

Colleges and universities are where the majority of accredited programs are found. Coursework will include anatomy and physiology, medical instrumentation, basic physics, patient care, and medical ethics combined with extensive clinical education.

There are also shorter educational programs that are acceptable to most employers. However, these programs are most appropriate for those who are already employed within a healthcare career seeking to transition into the field of sonography.


Certification Requirements

As per Professor Henningsen of the SDMS, there are currently limited certification requirements to work as a diagnostic medical sonographer. However, those who wish to enter this field are strongly encouraged to seek accredited sonography programs and obtain sonographer credentials. Most employers prefer to hire registered sonographers since this provides objective evidence of a candidate’s knowledge and professional standing.  The profession is also seeking to establish stricter standards for entry as the field of sonography continues to evolve with the introduction of new technology.

Diagnostic Medical Sonographers may become registered by passing two examinations administered by the American Registry for Diagnostic Medical Sonography (ARDMS): 1) the Sonography Principles and Instrumentation (SPI) examination; 2) an additional exam chosen from such specialties as vascular, cardiac, breast, abdominal, and neurosonography.

Upon passing both exams you will certified as a Registered Diagnostic Medical Sonographer (RDMS) by ARDMS. According to Professor Henningsen, there are currently 70,000 Diagnostic Medical Sonographers registered through this agency which is the organization that credentials the large majority of sonographers; however, CCI and ARRT also provide sonography certification examinations.

Eligibility to sit for the exams:

  1. You may sit for the SPI exam upon successfully completion of ultrasound physics and instrumentation courses.
  2. You will not be eligible to sit for one of the specialty exams until you have graduated from a training program.

Overview of Application Process for the SPI and specialty exams:

  1. You must first register with ARDMS before having access to the online application. When completing the application be sure to use your full legal name. You may pay the application processing fee of $200. online but must mail all supporting documents to ARDMS.
  2. Supporting documentation to sit for the SPI includes a transcript showing proof that you have passed two ultrasound physics courses, along with non-expired government issued photo identification.
  3. For graduates of accredited two year programs (60 semester credits) located in the U.S or Canada applying to take one of the specialty exams, supporting documentation includes:
    1. Copy of your school diploma or an official transcript and
    2. Original letter signed by program/medical director attesting to date of graduation and successful completion of the program and
    3. An original signed and completed clinical verification (CV) form for each specialty area, if applicable, must be submitted. The CV form is not required if the application is submitted and received by ARDMS within one year of program graduation and
    4. Photocopy of non-expired government issued Identification with your signature. The name on the ID card must match exactly the name you indicate on your test application form.

For those who did not graduate from an accredited two year program or who have additional professional experience, visit and complete the online questionnaire to determine your documentation requirements.

  1. ARDMS will review your documentation and compare your education and clinical experience to one of the published examination prerequisites and/or requirements.
  2. ARDMS will send eligible applicants an Examination Confirmation Letter within two to four weeks following submission of your application and all supporting documents to the ARDMS office. The letter will indicate the exam you are approved to take and notify you of the 90 day period during which the exam must be scheduled at an approved testing site.
  3. A Web site address and toll-free number will be provided so you may schedule an appointment to test. All examinations are administered online using Pearson VUE test centers located throughout the United States.  New users will need to create a new web account with Pearson VUE.  Once your web account is created, the username and password will be used to schedule all future examinations.
  4. You will be notified of your preliminary examination score immediately upon completing the exam. ARDMS will also be sent the score electronically. The results are subject to review and acceptance by ARDMS.
  5. Upon passing the exam ARDMS will grant the Registered Diagnostic Medical Sonographer (RDMS), Registered Diagnostic Cardiac Sonographer (RCDS), and/or the Registered Vascular Technologist (RVT) credential and you will receive a certification packet with temporary ARDMS Identification (ID) card and an official letter within six weeks. Your name will be printed on the certificate exactly as you recorded it on your application. The official ARDMS ID card is sent at a later date.
  6. Once you pass both exams, you will then be listed in the ARDMS online directory with your two letter state code so that potential employers can verify your credential.

Additional information on ARDMS exams may be found at

For comprehensive information on the ARDMS exams and application process, refer to the Application Booklet which can be found at

For details regarding certification requirements through CCI, visit

For details regarding certification requirements through ARRT visit,

Career Advancement

Diagnostic Medical Sonographers can seek advancement by obtaining multiple credentials. For example, cardiac sonographers might seek certification in the area of neurosonogrpahy to broaden their career options and enhance their marketability to potential employers.  Sonographers may also advance into management roles supervising the role of other sonographers.

Related Resources:

Becoming an Ultrasound Technologist in California