Q & A With Radiologist – Dr. Joe Antony

Pursuing an education in order to become an ultrasound technician is a great career choice, but also one that shouldn’t be taken lightly. In this interview, Dr. Joe Antony, who has significant experience in the field of sonography, offers a professional perspective for students who are considering entering the field. Dr. Antony also shares his knowledge at his Ultrasound Imaging Blog.

  1. When you were looking for schools to study medicine, what factors did you consider to be most important?
  2. Looking back on your studies, what college course has helped you the most in your current profession? Why?
  3. How did you get your start in ultrasound imaging (sonography)?
  4. What are some of the biggest challenges you face day-to-day as an ultrasound technician?
  5. What do you enjoy most about your career as an ultrasound technician?
  6. What skills do you feel are most essential for someone to have success in sonography or ultrasound imaging?
  7. Technology in medicine is constantly changing: what new ultrasound technologies are affecting the profession most?
  8. What is one piece of advice you would give to someone who is starting a career as an ultrasound technician?
  9. After earning a medical degree, how should graduates find organizations in need of skilled ultrasound technologists?
  10. Do you feel demand for skilled sonographers is rising? Where do you see the industry being in ten years?

1. When you were looking for schools to study medicine, what factors did you consider to be most important?

Perhaps the most important factor to consider before selecting a medical school would be the quality of medical education available there. What is the programs reputation? Other factors include the distance that needs to be traveled from home, and the cost of attendance. The resources available and educational facilities also affected my decision. I did not have the option of online medical education during my college days (in the 1980s).

2. Looking back on your studies, what college course has helped you the most in your current profession? Why?

The most interesting course I took was during my undergrad, where I was exposed to a radiology professor reading x-ray films during class. We had a short term course in radiology back then. The scene was very different from the hectic hours spent during medical and surgical clinical terms. Radiology (conventional x-rays at first, and later, ultrasonography), offered a lower-stress option compared to the pressure of surgery and clinical medicine. Later when I took radiology (radiodiangnosis) as my medical postgraduate course, I fell in love with ultrasonography. I liked that I could diagnose a patient’s illness, or see the fetus in real time using ultrasound imaging. With the advent of modern computers and new technologies, the job prospects in sonography were plentiful.

3. How did you get your start in ultrasound imaging (sonography)?

I had my first exposure to sonography during my second year as a resident in post-graduate training. My interest in anatomy and knowledge of this subject helped me significantly in my ultrasound imaging studies. It was during the later half of my second year radiology residency course, that I was able to actually scan patients myself. Often the senior residents would be busy with other work, and would put me in charge of the ultrasound machine, where I would pick up renal calculi, but not the fetal ultrasound cases.

4. What are some of the biggest challenges you face day-to-day as an ultrasound technician?

Perhaps the biggest challenge the sonologist or ultrasound technician faces, is the proliferation of private ultrasound clinics that have gynecologists proficient in ultrasound imaging. Often, I have heard of surgeons and physicians joining the fray, trying their hand at sonography. In South Asian countries, sonography is sometimes misused for identifying fetal gender and aiding in female feticide. Hence, governments here invoke draconian laws to curb this problem. This results in absurd situations where ultrasound imaging is considered synonymous with feticide. Another problem is the high expectations patients have about ultrasonography. This technique of imaging is at best an aid to the clinical and lab investigations. Patients often do not understand the significance of clinical and lab data and the importance of correlating ultrasound findings with the other findings. An example is ectopic pregnancy- often one cannot be 100 % sure about the diagnosis, unless the sonologist has other lab and clinical data. A tumor detected on ultrasound can only be identified as such – one cannot give a pathological diagnosis based on ultrasound alone.

5. What do you enjoy most about your career as an ultrasound technician?

The best part of being an ultrasound imaging professional is that this field offers the best of radiology – both the efficiency of diagnosis and the cost of investigation. Also, the high dependence on user experience means that, with the passage of time the more experienced sonographer or sonologist has a distinct advantage over the newcomer in this field. Also, the sonographer is in close contact with the patient and has a semi-clinical role, something envied by the CT scan or MR imaging technician. The ease of setting up and starting a private ultrasound scan practice is much more than with MR or CT scan centers, where machines require huge sums of investments. A single trained sonologist and a nurse is all it takes to open an ultrasound imaging clinic, whilst an entire team of professionals is needed for almost every other (CT or MT) imaging center.

6. What skills do you feel are most essential for someone to have success in sonography or ultrasound imaging?

The most important skill in the field of sonography is the ability to visualize a 3-dimensional anatomy of the human body. This 3-D understanding of the human internal architecture has to be almost second nature to the sonographer or sonologist. The professional must be able to seamlessly scan the abdomen or any other part of the body/fetus, and simultaneously correlate what he or she sees on the ultrasound monitor with both the pathological knowledge of the part and the appearances of that part in normal patients/fetuses. Being a relatively inexpensive imaging method, the sonographer would be expected to scan a number of patients a day to meet expenses. Hence, reports need to be prepared quickly, a task that efficient assistants can make more manageable. Often, patients will want to know a little about the report from the sonologist, and this is an added responsibility that must be handled carefully.

7. Technology in medicine is constantly changing. What new ultrasound technologies are affecting the profession most?

Perhaps no other technology in the field of ultrasound imaging has had as significant impact as the advent of 3-Dimensional and 4-D ultrasound. 3-D and real time 4-D ultrasound technology have made the sonologist and the ultrasound technician seem like super docs who show the real face and limbs of the fetus in the womb. This has resulted in a demand for the newer imaging methods, especially in developed countries. Some time back, it was Color Doppler that won the fancy of the medical world. But it only created a few ripples outside the medical fraternity. 3-D and 4-D ultrasound have created more “waves” among expectant mothers than among the doctors and clinicians. In the coming years, the technology may evolve further as the pregnant mother may soon be wearing 3-D goggles like those used in the movie Avatar to view holographic projections of their baby in the uterus.

8. What is one piece of advice you would give to someone who is starting a career as an ultrasound technician?

Since the whole technology involved in ultrasound imaging is still evolving from its early days as static B-mode to real-time and now 4-D imaging, much cutting edge research is being done as newer applications are found for the latest improvements in ultrasonography. Hence, I feel that the budding ultrasound technician should read daily- both from the newest ultrasound books, as well as browse the internet, to update his or her knowledge on an almost daily basis. What I do is this: the moment I see a new/confounding case during my day’s sonographic work, I immediately turn to the internet to find the available medical literature on the topic or case I have seen. It is very rare that I can’t find a medical site or information that is related to the topic I wish to learn about. Another useful point is that one can join many online ultrasound and medical discussion groups/ forums, specifically for sonography, where help is available, within minutes after asking a query. Images can be posted to such forums and diagnosis obtained from professional friends as well as web based discussion groups.

9. After earning a medical degree, how should graduates find organizations in need of skilled ultrasound technologists?

The internet and online medical websites/online medical job directories today offer the best opportunity to learn about potential jobs and options to start a new medical ultrasound job. This does not mean that medical magazines and the news media are to be ignored. On the contrary, the (older) print media can compliment the internet in finding a suitable career for the budding ultrasound technician. Whilst selecting a career, salary, working conditions, and the potential for growth using the newer technologies (including 4-D imaging and use of interventional ultrasound methods), should be considered.

10. Do you feel demand for skilled sonographers is rising? Where do you see the industry being in ten years?

Yes. The need for skilled sonographers is increasing due to the frequent use of this safe method of investigation. Almost every physician, gynecologist, or surgeon (to name a few) find it difficult to manage cases as simple as an abdominal colic or more ominous cases such as ectopic pregnancy to fetal anomalies, without first having an ultrasound scan done on the patient. Thus, what the x-ray was 20 years ago, is now replaced to a larger extent, by the burgeoning need for ultrasonography. Therefore, there has been a boom in the demand for the skilled ultrasound professional or sonographer. Ultrasound technology is still evolving, with machine resolution jumping ahead in whole quantum leaps. This further increases the need for the experienced and well trained ultrasound professionals. Besides this, the experienced sonographer is in much demand even today, due to the whole method of ultrasound imaging being highly user dependent. In the future, with technology changing rapidly, it may be possible for lay persons, even in remote areas to transmit ultrasound images or ultrasound videos, live from their location, to skilled sonographers/ sonologists to obtain an instant diagnosis.

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