A shortage of sonographers is causing long wait lists and extended travel times for expectant women in Ontario. The average wait time for an ultrasound is roughly 4 weeks, according to a report from the Fraser Institute.

“In the Ottawa region, we’re struggling to get imaging done for all sorts of women’s health issues, including obstetrics and gynecology. The reasons for this include challenges in recruiting and maintaining sonographers, as well as having an adequate number of clinics operating in this subspecialized area,” Sony Singh, MD, chair of obstetrics and gynecology at the University of Ottawa, told Medscape News Canada.

Ontario had a 20% sonographer vacancy rate in 2024, and Canada faces a staffing crisis, according to Sonography Canada. A survey commissioned by the organization reported that in 2024, 51% of diagnostic medical sonographers had considered quitting their jobs in the previous 2 years.

“We’re deeply concerned by these findings,” said Susan Clarke, executive director of Sonography Canada, in a statement. “Respondents cited increased workload, a lack of investment in sufficient staffing, the risk for injury, and scheduling overload as reasons for this. Also, limited mental health supports are taking their toll on our profession,” she added.

High Rates of Burnout

Fourteen percent of respondents indicated that they’ll be leaving the workforce within 4 years, and they aren’t being replaced with enough new personnel. Following the onset of the COVID pandemic, many sonographers didn’t return to work. The deficit in sonographers has resulted in overwork and burnout among the remaining staff, said Clarke.

The high-volume, repetitive nature of the work places a physical strain on sonographers and leads to high burnout, Singh noted. “Can you imagine having your shoulder up on a belly or a probe in the vagina every day at a large volume? It’s physically daunting. People say, ‘Just reduce the volumes to take care of the staff.’ But the problem in our healthcare system is that volume is what drives the income to cover the expenses of hiring the sonographer, in addition to covering the costs of purchasing the equipment in a clinic setting. The reimbursement is not that much. Hospitals, which have a slightly different funding model, employ a lot more sonographers than clinics. However, the procedure volumes aren’t that great because obviously hospital staff is better protected,” he added.

“It’s not about hiring more sonographers,” said Singh. “Where there are jobs available, we’re looking for sonographers who have an interest in and a skill set for women’s health specifically, so that may be hard to find. Second, how many imaging clinics do we have that are going to be able to do this work and turn a profit, incentivizing them to invest in this?”

Delays Affecting Quality of Care

Expectant patients are having to travel long distances for ultrasound appointments, particularly in rural areas where towns are spread farther apart, Greg Toffner, president and CEO of the Ontario Association of Medical Radiation Sciences, told Medscape News Canada. “Sonography shortages can be geographically patchy, and patients move around to access services faster. Ontario Health created a centralized repository for monitoring and tracking wait times by region and acuity level for some diagnostic imaging services such as MRI, CT, and mammography, but ultrasound is not included in the repository. Many regional facilities such as in southwestern Ontario have created their own centralized booking system to manage referrals and workload throughout the region,” Toffner explained.

The problems with ultrasound access are causing clinically meaningful delays. Most facilities use an internal triage system to schedule patients in priority sequence by level of acuity. Some regions have centralized systems to identify priority levels. “More acute patients should get their scan sooner, and less acute patients would wait longer,” said Toffner. “If the system is working, a patient in need of a priority scan should get their scan in a reasonable timeframe. The system can be heavily procedural, however, in terms of what constitutes a priority level, and people can get missed. Patients need to advocate for themselves, especially while the system is under such strain. They need to ask questions to their care providers, follow up on getting their appointments booked, push for services, or move to different centers if needed to ensure they get the care they need.”

Alleviating the Shortage

The Ontario government is adopting measures to alleviate the strain by hiring sonographers from abroad through the “As of Right” framework. This allows eligible applicants certified in another province or territory, and select US health professionals, to be deemed certified in Ontario for up to 6 months while completing their full provincial registration. These healthcare workers can be fast-tracked to receive certification within 10 business days of their application.

“Our delivery numbers at Ottawa Hospital are the highest they’ve ever been in the history of our organization, so we’re partnering with community ultrasound centers and working with them to take on the volume,” said Singh.

“The quality of obstetrics and gynecology imaging, Canadawide, on average, is quite poor, and that’s a reflection of how poorly we’ve treated women and their diagnosis overall,” he added. “Obstetrics and gynecology imaging should be prioritized because that is where birth happens.”

Toffner and Singh reported having no relevant financial relationships. 

Evra Taylor is a widely published freelance medical writer and reporter with 20 years of experience covering a broad range of therapeutic sectors, including family health, cardiology, psychiatry, ophthalmology, and dermatology.