Sonographer Education in the U.S. & Hungary

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Terry DuBose: "This is Terry DuBose at the 9th Congress of Ultrasound in Obstetrics and Gynecology. I'm with Carolyn Schellenberg and Susan Sipos who have two poster presentations, one about American education and one about education in Hungary. They both work in Hungary now. I'm going to turn the microphone over to them and let them discuss their experiences with education in the U.S. and in Hungary and how sonography is practiced as with sonographers and sonologists. Carolyn and Susan?"

Carolyn Schellenberg: "In the U.S., sonographers have been around for a long time. In America, the ARDMS was established back in 1975, ultrasound started before that and certification was in our distant past. In the United States, sonographers basically work independently, and they are given a lot of responsibility. In the area of obstetrics, the doctor will check a case only if the sonographer sees something that is not right, so that's placing a lot of responsibility on the sonographer."

Susan Sipos: "Yes, it's almost the same case in Hungary. There have been working sonographers for ten or fifteen years, and since the formation of the Hungarian Society for Ultrasound and Obstetrics, they get official guidelines to do their profession. They can work alone, but if they find any pathological findings, they have to show them to the doctors. It's the physician's responsibility to screen the patient, look at the findings or picture, or just do an oral interview."

Carolyn Schellenberg: "I think one of the big differences between sonographers in the U.S. and in Hungary is the training. Sonography is older in the U.S. It's been used longer, so there are good training programs around. There is already a very detailed certification system with prerequisites so you can take your certification exams. These things are just being developed in Hungary right now. There are doctors working on the education there, but because of some differences that we'll discuss in a little bit, official education is just beginning in Hungary."

Terry DuBose:: "What environment do you two work in, and do you work together?"

Susan Sipos: "Yes."

Carolyn Schellenberg: "Yes, we work together, and we work at the Semmelweis University Medical School in Budapest. It's now a center for training sonographers. It's a small center, and we have two machines. It is important to consider the differences between the U.S. healthcare system and a former Eastern Europe healthcare system-the big difference is money. The sonographers are very skilled, but the big difference is money. Our machines are fairly old, and the way the whole health system is set up, there's very little reimbursement for each patient. You don't spend much time with patients-only three to five minutes per patient scanned. We do have a computer program to type things in on, but it's really rushed, and even for those patients we only get a few cents reimbursement for doing them. So you have to do a hundred patients in a day with those two ultrasound machines to get any reimbursement whatsoever, and that's a real big problem with ultrasound in Hungary."

Susan Sipos: "And if somebody's over his or her fiftieth examination on that day... well, God bless the patient, I think."

Terry DuBose: "I can imagine. I think we may be the only three sonographers at this conference."

Carolyn Schellenberg: "There's one other."

Terry DuBose: "There is one other?"

Carolyn Schellenberg: "Yes, I think there's one other from China."

Susan Sipos: "China or Korea."

Carolyn Schellenberg: "Yes."

Susan Sipos: "She had a presentation from... China? Korea? Hong Kong? I don't know."

Carolyn Schellenberg: "She's a nurse and maybe also a sonographer, but she's a nurse who does ultrasounds, at least."

Terry DuBose: "So there are probably four sonographers here. It's interesting that you two presented studies on contrasted education in Hungary and the U.S., and they were accepted for presentation. I'm really glad."

Carolyn Schellenberg: "Yes, I think it's good that we were accepted for presentation because I think the rest of the world needs to know how sonographers are trained, that training is suggested in Hungary, and it is beginning. For the training that's already in place in the U.S. for registered sonographers, you're registry eligible. I want to make that clear, but this training is much more than that which the doctors receive. I guess being in Europe, I hear so many times, 'I need a doctor to do it.' Or I hear other people who aren't from our clinic say, 'are you a doctor?,' or 'how do you do ultrasounds if you're not a doctor?,' and 'isn't a doctor better at that?' My answer would be no, not looking at the training that we have and the training that the doctors have in ultrasound-training for a year with hands-on experience for twenty-four hours a week, and then thirty-two hours a week for an entire year makes you much better prepared to do ultrasound than watching someone for a month."

Susan Sipos: "And sometimes we are told if we make a mistake, it's because we are not experienced. Yet if the mistake is made by a doctor, it's a diagnostic mistake."

Terry DuBose: "Yes, I understand. Yes, we deal with that in the U.S., also. Thank you both very much and good luck."