Inside Medicine: Sonographer

There is a national shortage of sonographers

In a series focusing on medical specialties, the BBC News website meets sonographer Mark Russell.

Sonographers provide a diagnostic service by using an imaging test, called ultrasound, which sends vibrations to a part of the body and receives them back again.

Most people are aware of its use in pregnancy to provide images of babies in the womb, but ultrasound imaging is also widely used in other hospital departments.

Mark Russell's CV

WHAT IS YOUR JOB?

I am a sonographer at Homerton University Hospital in Hackney.

As part of a team of sonographers, I am responsible for doing and reporting on a wide range of ultrasound examinations. I work closely with clinicians and other teams in the hospital to provide an effective diagnostic service.

Areas we cover include obstetrics, gynaecology, urology, neonatal (newborns), vascular and general abdominal.

WHAT IS THE MOST COMMON CONDITION?

One of the most common uses of ultrasound in our hospital is in obstetrics to date and monitor a pregnancy, and to screen the baby for any obvious structural or chromosomal abnormalities.

Women are scanned during pregnancy

Ultrasound is also used extensively in gynaecology. The most common condition we see in our local population, which includes a high proportion of Afro-Caribbean women, would have to be fibroids - benign growths in the womb.

Abdominal ultrasound is also performed to diagnose common conditions such as gallstones, and we use testicular ultrasound to diagnose testicular cancer.

WHAT IS THE MOST COMMON PROCEDURE?

This is an obstetric scan.

Patients are routinely offered two scans during their pregnancy (at around 12 and 20 weeks).

The hardest thing about the job is breaking bad news when an abnormality is found with the baby or the baby has stopped growing Mark Russell

Ultrasound can be used from the very early stages of pregnancy where it can pick up problems such as ectopic pregnancy, which is a potentially life threatening condition where the pregnancy is not growing in the correct place.

Ultrasound can be used to screen for Down's syndrome at around 12 weeks (Nuchal Translucency scan) and throughout pregnancy it can be used to detect abnormalities and growth problems - which is especially important in twins.

WHAT IS THE HARDEST THING ABOUT YOUR JOB?

Again, related to obstetric ultrasound, the hardest thing about the job is breaking bad news when an abnormality is found with the baby or the baby has stopped growing.

There is no easy way to tell the parents, and despite some training at college and counselling courses which many of us have attended, it never really gets any easier.

WHAT IS YOUR MOST SATISFYING CASE?

It's really difficult to pinpoint any one specific case since every abnormality or cancer that you pick up early stands a better chance of survival.

WHY DID YOU CHOOSE THIS SPECIALITY?

I first trained as a radiographer but was attracted to ultrasound because it gave me more autonomy at that time.

When I qualified in radiography it was quite rare for radiographers to do more than produce the x-ray images, which the radiologist would report on.

Although this was a great skill in itself I felt that I wanted more involvement.

Ultrasound allowed me to both perform the scan and independently report on it. I have the responsibility of making the diagnosis and liaising with clinicians to discuss my findings.

But radiography has changed a great deal since I qualified and radiographers now report in many areas.

IF YOU HAD YOUR TIME AGAIN WOULD YOU CHANGE YOUR SPECIALTY?

No, I am really glad I chose the specialty of ultrasound.

The workload is really varied and I work with a really great team.

There is a national shortage of sonographers so there is never any shortage of work. It can be stressful at times, but it is always satisfying.

There are always new things to learn and experience.

WHICH SPECIALTY WOULD YOU HAVE GONE INTO IF NOT YOUR OWN?

I used to really enjoy CT (computed tomography), which is the scanner with a hole in the middle which the patient passes through.

CT scans are used to create a cross sectional and 3D image of the head or body.

CT can help diagnose many abnormalities such as strokes, brain haemorrhages and cancer.

The pace is always fast and you get to see lots of pathology and trauma.

HOW DO YOU SEE YOUR ROLE DEVELOPING IN THE FUTURE?

Many other healthcare professionals are beginning to use ultrasound in many areas of the hospital and in the community.

I think it's important that as sonographers we make sure they have adequate training in their specialist area and practise safely.

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CV - Mark Russell

1995: Qualified in Radiography BSc (hons) City University

1998: Qualified in Ultrasound (PgDip) South Bank University and became sonographer, Homerton University Hospital

2004: Obtained MSc in medical ultrasound, South Bank University

2007: Clinical lead sonographer, Homerton University Hospital