THE SONOGRAPHER'S CME PRIMER

Continuing medical education (CME) is an essential part of the sonographer's tool kit. CME is part of your equipment, like the basic training you received when you learned to perform ultrasound; CME also helps define your competence and professionalism as a sonographer. Read on, and you will be able to benefit from finding out about the varied CME options that are available to you, how they can help your career and creative ways to manage the costs and opportunities afforded you by the existing CME options.

Why should you obtain CME? Our surveys indicate that most sonographers enroll in programs to obtain credits so that they can meet their Registry requirements. With 30 hours required every three years by ARDMS a registered sonographer has to plan carefully to avoid coming up short. And financial preparation often has to accompany making room in your schedule. (More about the financial story later.) But there are other reasons to continue your education as a sonographer. Many physician specialty organizations are beginning to recognize that the lifelong learning process is essential and the American Medical Association has even stopped using the term CME, replacing it with CPD, or Continuing Professional Development, instead. Education as a continual process is no less true for the sonographer. In whatever area you work, the rapidly evolving technology of diagnostic ultrasound is requiring that you keep up with how equipment works and how to use it clinically. Most of you probably never had to make the transition from A-mode and bistable B-scanning to grey-scale and real time. But most of you have had to learn how to apply power Doppler, harmonic imaging and sophisticated new optimization packages. The same developments that are making your home computer cheaper and more powerful will eventually change the way you scan today. Are you ready to adapt? Without extending the learning process you wont be! Continuing education fills other needs too. It allows you to be more confident in your work as you hear how others tackle everyday problems. For many conference attendees, knowing that their protocols and approaches are the same as those used in major teaching centers brings a great measure of assurance. Finally, CME gives you the opportunity to enhance your skills and thereby strengthen your standing in the job market.

What about the various types of CME credits? If you are among the many sonographers seeking to maintain your Registry status you should know about the types of credits offered and which ones will satisfy the ARDMS requirement. There are many options. The ARDMS web site lists "Acceptable CME Credits" at http://www.ardms.org/registrants/reg_frameset.html but this list is somewhat confusing since it mixes credit types with names of organizations. Here's the key, in brief. You may use credits earned at any ultrasound course that issues SDMS, SVT, AMA Category 1 or AOA Category 1 credits. (Another type, called ACOG cognates, is also acceptable but is only issued to members of ACOG, the American College of Obstetricians and Gynecologists.) I wondered why ASRT credits were not on the list and a quick email to Dale Cyr, Executive Director of ARDMS, confirmed that, for now at least, they are not accepted. Credits that are approved by the SDMS and SVT are easiest for the educational provider to offer, as they require a relatively simple application and a filing fee. AMA Category 1 credits (Category 2 credits are being phased out) can only be issued by educational providers accredited by the Accreditation Council for Continuing Medical Education (ACCME). ACCME accredited providers must follow a stringent set of guidelines that ensure the educational value and integrity of their programs. For more information on ACCME and its accredited providers go to http://www.accme.org. The guidelines for CME approval by SDMS are at http://www.sdms.org/pdf/cme01.pdf (Acrobat reader required).

Let's take a moment to look at the various CME options available to you. One way of breaking them down is to distinguish between live programs and distance learning. Live courses can range from annual society conventions (Society of Diagnostic Sonographers, American Institute for Ultrasound in Medicine, Society of Vascular Technologists, American Society of Echocardiography) to small local meetings, like those held by your local SDMS chapter. (Tip: If you work in a teaching hospital you may be able to earn free credits from the hospital's CME Office for attending Grand Rounds on relevant subjects.) In between is a large range of regional conferences offered by associations (e.g., Los Angeles Radiologic Society), universities (e.g., Thomas Jefferson University) or other providers (e.g., Institute for Advanced Medical Education). These conferences tend to offer greater depth on specific topics than the large conventions can. Distance learning includes online CME and CME offered through videotapes, audiotapes, journals and correspondence courses. Which one is best for you? The answer is based on what you need to learn, how you learn best, how much time you can take out and how much money you can spend. So if family obligations prevent you from traveling, a form of distance learning is likely to be your best solution. If you learn best by reading, journal based CME may be best for you. Barring these two cases, however, a live conference is probably the best way to go for most sonographers. No online course can take the place of a live authoritative presentation; no videotape can replace the opportunity to interact with faculty and colleagues. It's about more than just sitting in on a lecture. Live conferences are an opportunity to see and hear and reach out. Most people who attend a conference return to work invigorated and refreshed, with renewed enthusiasm and new ideas. Sonographers need feedback from faculty, other sonographers and even exhibitors.

But this brings us to the big question ofS money! Unless you live in a small town chances are that a conference will come your way eventually (if you live in Orlando, New York, Chicago and certain other cities there are conferences happening all the time.) That knocks out the travel costs. Otherwise, it can cost up to $1-2,000 to attend an out of town conference when you include tuition, airfare, lodging and meals. Can you afford that? Well one can argue that you cannot afford NOT to do this, at least periodically.

Here are some alternative ways to manage this expense if your employer does not currently have a reimbursement program.

Equipment Purchases: Most ultrasound manufacturers can offer CME assistance as part of an equipment purchase. If your lab is currently negotiating a purchase this item should definitely be on the table.

Scholarships: The SDMS Foundation offers scholarships to sonographers whose employers do not reimburse their CME. This is an excellent way to get help and is surprisingly easy. For more information, go to: http://www.sdms.org/foundation/CMEgrants.asp .

New Job: Are you applying for a new job? Do you realize how much in demand sonographers are right now? With competition for qualified applicants nearing fever pitch in many regions, you are well positioned to make annual conference attendance part of your negotiation.

And finally, Save up for it. You are a professional. Part of being a professional is investing in your career by participating in these types of events. Just because you don't make as much money as a physician doesn't mean you can't afford it. Lots of professionals earn less than sonographers yet still manage to participate in professional seminars. Besides, professional seminars are largely tax deductable. So, like the docs, you can let Uncle Sam subsidize your trip, legally. And, also like the docs, you can extend your trip into that much needed vacation.

So how do you find about the CME opportunities that are available to you? Whether you are expanding your knowledge base or just earning credits you should never be in the position of not being able to find a program that suits your needs. (The Web is the best single place to look, though a detailed discussion on how to best use the Web for finding and taking CME would fill up a whole other article). Good listings appear at the sites of AIUM, Radiological Society of North America and the Ultrasound Insider metasite. Another excellent resource is the CME page of journals dealing with ultrasound and specialties related to ultrasound (ie, radiology, OB-GYN, cardiology, etc.). The Journal of Ultrasound in Medicine, AIUM's monthly journal, lists upcoming courses; the SDMS publication, Journal of Diagnostic Medical Sonography had such a listing but discontinued it at the beginning of 2001. Listings of online CME programs in sonography are easily found at web sites such as that of the ARDMS.

Sonography is a profession that always challenges you to know more and perform better. Hopefully you will be challenged to take advantage of the wide range of CME opportunities that are available to you. I welcome your feedback and personal experiences and will be happy to share them with readers in a future article. You can write to me at mailto:ik@IAME.com .

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