The Sonographer Workforce

The sonographer workforce remains one of the key policy and advocacy priorities at the ASA. In this article, we take a closer look at some of the current challenges and work the ASA is doing towards developing solutions.

Key features of the sonography workforce

When considering the current workforce challenges, it’s helpful to begin by identifying the key features of the sonography profession.

Three-quarters of sonographers work in the private sector, including private clinics in a hospital setting, and one-quarter in a public hospital or department. It is common for sonographers to work in multiple locations, with around 60% doing so either for the same employer or for a different employer. A significant proportion of sonographers work in part-time, casual or locum positions, particularly in Australia (62%). In New Zealand, 45% do so. Overall, 80% of sonographers are female (90% in New Zealand).

In Australia, there are currently 19 accredited sonography courses delivered by seven education providers. Most sonographers are domestically trained, with only a small number of overseas-trained sonographers approved each year to work in Australia. In New Zealand, there are currently two accredited courses offered by one provider. New Zealand relies heavily on overseas-trained sonographers to meet demand, with two-thirds of new registrants each year coming from overseas – many of whom are required to complete a period of supervision and familiarise themselves with local protocols and culture.

The most significant workforce challenge is the workforce shortage, which has been ongoing for two decades and is expected to continue

Based on age and years of experience, the ASA estimates one-quarter of sonographers will reach retirement age in the next decade. The ASA 2024 Sonographer Employment and Salary Survey suggests that more than 35% intend to leave the profession in the next ten years.

With 7,820 accredited sonographers in Australia and 747 in New Zealand, there is currently one sonographer per 3,470 residents in Australia, and one per 7,150 residents in New Zealand (equivalent to 29 and 14 sonographers per 100,000 head of population, respectively).

Current workforce challenges

The most significant workforce challenge is the workforce shortage, which has been ongoing for two decades and is expected to continue.

In an ASA survey of major employers undertaken in early 2024, respondents estimated a 20–30% undersupply, most acute among experienced sonographers, clinical supervisors, and managers. Employers indicated that almost half the positions advertised were not filled.

The shortage has implications for patients, sonographers and employers.

Employers report having to close exam rooms and delay appointments; increased stress and injury for sonographers; higher costs associated with attracting, retaining or upskilling staff; and an increased reliance on locums to cover gaps. The ASA 2024 Workforce Health and Safety Survey indicates that many sonographers are working additional hours, missing scheduled breaks, and experiencing work-related pain, anxiety and exhaustion. Left unaddressed, these issues may cause sonographers to leave the workforce earlier than planned.

In addition to impacting patients, employers and current sonographers, the shortage also has a compounding effect on the future workforce. Training sonography students requires time and resources, both of which are in short supply, particularly in the private sector, where most clinical training placements occur. As a result, there is currently a significant shortage of placement positions and clinical supervisors.

Most students undertaking a post-graduate accredited sonography course are required to find their clinical training placements to complete the recommended minimum of three days per week over two years. For those who do not have existing connections to an imaging department or practice, it can be particularly challenging. This is significant given the increasing number of sonography students coming from nonradiography backgrounds.

Many of the workforce challenges facing sonographers are multifaceted and complex. Overcoming the challenges will require sector-wide collaboration and commitment

Employers who advertise clinical placements are often inundated with applicants. While arrangements vary, it’s not uncommon for students to undertake an unpaid placement, at a location away from their usual residence, placing many students under financial and general stress. In Australia, there is the added challenge that while many stakeholders are involved – including educators, employers, and sector bodies such as ASAR and ASA –there is no single entity providing central oversight of clinical placements and no central framework in place outside of the course and sonographer accreditation. This means there is a wide variety of arrangements that exist – which can be challenging for students, educators and employers alike.

In New Zealand, where sonographers are regulated under the MRTB and where only one university currently provides sonographer training, there is greater oversight and support for students. It’s also more common for students to receive financial support from their employers. In some regions, there are local initiatives in place where public and private sector employers collaborate to share students.

In the workforce, many sonographers also face limited career progression opportunities and lack recognition for specialist or leadership roles including clinical supervision, which can impact their retention. Finally, while workforce statistics continue to improve with time and resources, further work is needed to ensure detailed, up-to-date sector information is available to support policy development, ideally in a format that aligns with other allied health professions and the wider imaging profession to support national and regional workforce strategies.

What is the ASA doing to help overcome the workforce challenges?

With the demand for ultrasound services expected to continue, the workforce challenges must be addressed to ensure an ongoing sustainable sonographer workforce. As the peak body for sonographers, the ASA continues to support and advocate for the profession in a number of ways, as outlined below.

• Clarifying and quantifying key issues by seeking member input through surveys such as the Sonographer Employment and Salary Survey; engagement with ASA Committees and Special Interest Groups; and working with stakeholders to gather and share industry information.

• Raising awareness and encouraging discussion through our member publications, website and marketing activities; disseminating survey and project findings; and through our annual international conference.

• Developing clinical and professional development guidance and resources - in collaboration and consultation with key stakeholders. This includes work on career development, clinical supervision, scope of practice, code of conduct and investigating scan times.

• Developing policy guidance and resources through relevant government and industry consultations, professional membership bodies and sector forums, and meeting with government, industry stakeholders and decision makers. We also prepare position statements, articles and guidelines on key topics, highlighting issues and recommendations to advance the profession.

Many of the workforce challenges facing sonographers are multifaceted and complex. Overcoming the challenges will require sector-wide collaboration and commitment. The ASA will continue to engage with members and work with stakeholders to develop and deliver solutions to support a sustainable sonographer workforce into the future.