Liz Torrey
Echocardiograms, which use sound waves to create images of the heart, are a common procedure in American healthcare.
The videos produced by echocardiography allow doctors to see how a patient’s heart is pumping blood, which can be invaluable in evaluating symptoms, diagnosing heart disease, or simply preparing for surgery or other procedures.
An echocardiogram is a type of ultrasound test that uses no radiation, is painless, and has few side effects, so there is little reason for your doctor not to order an “echo” test.
There’s just one problem: There aren’t enough people trained to perform echocardiograms, both nationally and in Virginia.
There is a growing need for this role in healthcare, with the U.S. Bureau of Labor Statistics predicting that the total number of cardiac sonographer jobs will grow 10% nationwide by 2032. VCU Medical Center in Richmond currently has openings for this role.
“Of the 2 million patient interactions at the hospital annually, one-third are for cardiovascular disease symptoms, and echocardiography is necessary to deliver a wide range of cardiovascular care,” said Greg Hundley, M.D., director of the VCU Health Pauley Heart Center. “Our echocardiography program is outstanding, with team members working around the clock to serve the needs of the hospital’s inpatient and outpatient patients, not to mention the cardiac sonographers at Pauley Health Center clinics across the state.”
As administrators of VCU Health’s echo team, Pauley Heart Center staff are acutely aware of this workforce shortage and are taking major steps to address it through an educational partnership that invests in a new generation of healthcare workers.
Partnering to advance educational opportunities and patient care
With funding from the Virginia General Assembly, Pauley Heart Center partnered with Rappahannock Community College (RCC) to establish a new two-year associate degree program in echocardiography in 2022. While two-year diagnostic medical sonography degree programs are also offered at several other community colleges in Virginia, only one school in Northern Virginia offers a cardiac sonography degree program.
While Hundley acknowledged the underlying deficiency in the echo technician shortage at VCU Health, he also recognized the need to add more cardiac ultrasound training programs and make them more accessible across Virginia.
“Dr. Hundley came to us and basically said, ‘As a cardiologist, I know what the future holds,'” says Ellen Koehler, dean of health sciences at Rappahannock Community College. “He explained that echo positions would grow exponentially over the next few years, but that Virginia did not have enough programs that could train students fast enough to meet the growing demand. He thought community colleges would be best placed to provide the education and training to put people into the workforce to fill some of the demand he predicted.”
Hundley became familiar with RCC through his service on the board of directors of VCU Health Tappahannock Hospital, which works closely with many of the community college’s medical residency programs.
“[RCC’s Warsaw and Glenns] “The campus serves students in the Middle Peninsula and Northern Neck, some of the areas in Virginia most in need of workforce development programs and economic opportunity,” Handley said. “Inter-institutional collaboration seemed like an obvious solution to the challenges we all face.”
Funds allocated by the Virginia General Assembly allowed RCC to invest in ultrasound equipment and other technology needed to launch the program. Healthcare professionals at the Pauley Heart Center then supported Koehler and his team in designing the program’s five-semester curriculum and degree courses, and arranging clinical site agreements so students in the program could do their clinical training at VCU Health. VCU Health also helped RCC hire a program coordinator and instructors.
Finally, the program welcomed its first group of eight students in fall 2023 after receiving approval from RCC’s accrediting body, the Southern Association of Colleges and Schools Commission on Colleges (SACSOC).
Practical learning that students can apply to “real life” situations
Nature Cox, 22, of Westmoreland County, is one of the first students enrolled in RCC’s ultrasound program. She had been pursuing a radiology degree until she heard that RCC was offering a new cardiac sonographer program.
“I’ve always been interested in the inner workings of the human body, but when I started having heart problems myself I became obsessed with learning about the heart. I have an implantable loop recorder. [Going through that process] “It was my first time seeing an echo and I thought, ‘Wow, this is pretty interesting,'” she said.
Cox said her first semester was tough, but she was able to stick with it because what she was learning was interesting.
“I already have an associate’s degree, but it’s not in the medical field, so that was an adjustment in itself. This program requires a lot of study hours, but I don’t find it difficult because the content I’m learning is so interesting and has real-life applications,” Cox said.
An echocardiogram is a test that allows medical professionals to see images of a patient’s heart. Rappahannock Community College students are learning how to take these pictures as part of a two-year degree program. (Rappahannock Community College)
Students ultimately earn an associate of applied science degree, which means taking classes in English, math, anatomy and physics in addition to echo training coursework.
“Ultrasound is all about sound waves, so we learn the physics as a foundation to learn how the machine works,” says Harsha Sharma, RDCS, RDMS, director of the program. “Once we understand that, we can operate the machine and get great imaging.”
“The facilities we have at RCC are really great,” said Virginia Rinehart, 19, who is in her second semester in the program. “I feel like they put a lot of thought into it, and Mr. Sharma, and the whole school, does everything they can to make sure we’re successful.”
For their clinical placements, students travel to various locations in central and eastern Virginia, including VCU Health hospitals in Richmond and Tappahannock. RCC also provides students with a small stipend to help cover gas and parking costs. Koehler said the program was designed in collaboration with Virginia McGee, MSN, RN, CEN, nurse manager for Pauley’s noninvasive cardiology program, and aims to provide hands-on experience for students who “spend less and less time in the classroom and more and more time in the clinical setting” as the semester progresses.
“We have students from all over our service area, and even though our service area is large, some of our students have to travel far to get to their clinical placements,” Koehler said.
Reinhardt is currently in his clinical residency at VCU Medical Center in Richmond, while Cox completed his first clinical residency at VCU Health Tappahannock.
“So far, I’m really enjoying the fast-paced environment,” Reinhardt said. “I like seeing a variety of patients, age groups, and medical conditions. When I do my inpatient rotations doing portable ultrasounds, I really enjoy going around the different floors of the hospital and learning about the different levels of care. I also get to practice the scans I’ve learned in class.”
While managing coursework and clinical placements may sound daunting, Cox encourages others to seek out unique educational partnerships like the RCC and Pauley Heart Center.
“To anyone who is hesitant to join the program because they think it’s too much work, I would say it’s not that hard! I work full time and help care for my family. My father has a disability and we manage it!” she added.
RCC has purchased enough equipment to enroll 20 students in the program each year and is working on short-term and long-term plans to ensure the program’s continued success. First, hiring a clinical coordinator. Koehler and Sharma said they expect to have more than 100 students in the program by January 2024.
“The people we serve are working people who are trying to make their lives better,” Koehler said. “This degree is like a big winning lottery ticket. If students are interested and complete the program, they’re on their way to making a pretty decent living in our rural service area.”
In the United States, the average salary for a cardiac sonographer is $78,210. Salary expectations for new graduates from the RCC program range from a base salary of $65,000 to $75,000, with up to $90,000 including overtime and on-call work. Cox and Reinhard plan to seek positions as cardiac sonographers in hospitals after graduation.
Koehler hopes the program will provide more opportunities for graduates to continue investing in their communities, especially rural areas.
“If we can keep some of our students in these jobs in the Northern Neck, it will help the community,” Koehler said, “so families won’t have to travel all the way to Richmond to get the cardiovascular care they need.”
For the same reasons, Hundley would like to expand Pauley’s partnerships with Virginia’s community colleges to create more workforce development programs in cardiac ultrasound and other cardiovascular care.
“There are so many Virginians who could benefit from this and other cardiac technology training programs, both on the provider side and the patient side,” he said. “I’m excited to see what the future holds.”
