How to become an ultrasound tech: the specialties, the program, the ARDMS or ARRT credential, your state and a first job

How to become an ultrasound tech (diagnostic medical sonographer) in 2026: the specialties, the programs, the ARDMS and ARRT credentials and their exams, the few states that license sonographers, what sonographers are paid, and how to land a first job.

A sonographer makes the ultrasound images a physician reads: a baby in the womb, a gallbladder, a heart, the blood flow in a leg. Unlike X-ray and CT, ultrasound uses no radiation, and in most states the credential employers ask for is a national one rather than a state license. This guide takes the steps in order from the credentialing bodies' own requirements, and every job figure in it opens the live list it comes from on CareJobs.Now, where 30,423 radiology and imaging jobs are open today, each read from the employer's own job board.

Contents

1. What sonographers do, and the specialties
2. The program
3. The credential: ARDMS or ARRT
4. Your state
5. What sonographers are paid
6. Getting hired
7. What to ask a program
8. A checklist

1. What sonographers do, and the specialties

A sonographer prepares the patient, chooses the probe and settings, takes the images and measurements the exam calls for, and passes a preliminary report to the physician who reads it. Most work in hospitals, imaging centers, physicians' offices and obstetric and cardiology practices; hospital sonographers often take call for emergencies.

The work divides by what is scanned, and so do the job titles:

• General sonography: the abdomen, pelvis, obstetrics and gynecology, small parts and breast ( sonographer jobs).
• Cardiac sonography (echocardiography): the heart, in adults, children or before birth ( cardiac sonographer jobs).
• Vascular sonography: arteries and veins ( vascular sonographer jobs).
• Musculoskeletal sonography: joints, tendons and muscles.

Many sonographers hold more than one specialty, and a second one widens the jobs open to you.

2. The program

Most sonographers finish a sonography program that combines coursework with scanning practice in hospitals and clinics. Programs come in several lengths: some are associate or bachelor's degrees, and some are shorter certificate programs for people who already hold a degree or a credential in a patient care field. The credentialing bodies set which education and how much clinical experience qualify you for their exams, so check a program against them before you enroll.

3. The credential: ARDMS or ARRT

Two bodies certify sonographers, and employers accept either for general sonography; job postings usually name the one they want.

ARDMS (the American Registry for Diagnostic Medical Sonography, part of Inteleos) awards the Registered Diagnostic Medical Sonographer (RDMS) credential. In its own words, "RDMS® certification requires the SPI exam and your choice of specialty exam(s)": the Sonography Principles and Instrumentation (SPI) exam on the physics of ultrasound, plus a specialty exam such as abdomen, obstetrics and gynecology, breast, pediatric sonography or fetal echocardiography. ARDMS also awards the Registered Diagnostic Cardiac Sonographer (RDCS) credential for echocardiography and the Registered Vascular Technologist (RVT) credential for vascular work. Each has prerequisites, pathways that combine education and clinical experience, which ARDMS's prerequisite charts set out.

ARRT (the American Registry of Radiologic Technologists) certifies sonography and vascular sonography through its primary pathway, which, in ARRT's words, "includes completing an ARRT-approved educational program", along with an associate degree or higher and its ethics and exam requirements. Rad techs who move into ultrasound often take this route; our rad tech guide sets out ARRT's requirements.

4. Your state

Most states do not license sonographers on their own. By the American Society of Radiologic Technologists' list of the states that regulate each modality, a handful do: New Hampshire, New Mexico, North Dakota, Oregon and the District of Columbia. Our rad tech license requirements by state show the ultrasound column beside every state's rule. Elsewhere, the employer asks for the ARDMS or ARRT credential, and many hire new graduates who will sit for it within a set time.

5. What sonographers are paid

Nationally, BLS measured a median of $46.44 an hour for diagnostic medical sonographers in May 2025. Open jobs post their own rates: our sonographer pay page and cardiac sonographer pay page show what open jobs post by state and by employer. Many imaging postings state a sign-on bonus; the imaging job statistics give today's share for sonographers and the median bonus.

6. Getting hired

Clinical sites often hire the students who rotate through them, so a program's clinical sites matter as much as its classroom. Our new grad healthcare jobs list the imaging jobs whose titles name a new graduate, and many sonographer postings accept a graduate who is "registry eligible", able to sit for the credential, and set a deadline to earn it. PRN jobs and call shifts are a common first step at a hospital.

What the work asks of you. Scanning is physical: you hold the probe with steady pressure for much of a shift and reach across patients and the machine, so ask an employer how many exams a sonographer scans a shift and what it does about ergonomics (adjustable tables and chairs, support cables, time between exams). You also spend more time alone with each patient than most imaging staff do, and you see the images first while the physician gives the result, so the job asks for calm and discretion as much as technique.

7. What to ask a program

• Does finishing the program qualify me for the ARDMS exams I want (or ARRT's), and for which specialties?
• How many graduates pass the SPI and specialty exams on the first attempt, and how many work as sonographers within a year?
• Where are the clinical rotations, and how many scanning hours will I get in each specialty?
• What does the whole program cost, with books, exam fees and travel to clinical sites?

8. A checklist

1. Choose a specialty, or two, and a program that qualifies you for its exams.
2. Pass ARDMS's SPI and a specialty exam (or ARRT's sonography exam).
3. Check whether your state licenses sonographers: the ultrasound column by state.
4. Apply where you rotated, and to registry-eligible new grad jobs: sonographer jobs.
5. Add a second specialty once you are working, to widen the jobs open to you.