Working in the UK – one Aussie’s perspective

Each year many sonographers travel abroad for work. For some, this is an opportunity to further develop their skills, for others it is simply a means to travel and see the world. I regularly receive emails asking my advice for working overseas. For today’s post I have asked Tim Eller to provide some insight on his experience working as a sonographer in the UK. Tim was responsible for a lot of my echo training, many years ago, before heading to the UK. Tim has since returned to Australia providing locum echo services throughout Queensland.

I lived and worked in the UK for close to 6 years and worked as a locum through an agency, as a self-employed locum and worked for the NHS as manager of a cardiac department in a large tertiary hospital. From this experience, I’ve seen both sides of the fence. My past and present colleagues will attest to the fact that I certainly don’t know everything, so the following tips are simply what I consider to be helpful if you’re thinking of heading to the UK for a locum stint.bigben_Vichaya Kiatying-Angsulee

Follow my 8 pieces of advice to help make your UK journey a smooth one.

1. Don’t screw your current employer over 

Give your current employer plenty of notice of your intentions to leave, especially if you plan on boarding a plane as soon as your DMU or Uni results are back. Cardiology is a small world! At some point you will come home and you don’t want your future employment prospects hindered because of past, unethical decisions you’ve made. Typically, your employer has invested time and money into your training… do the right thing and give as much notice of intent to leave as possible. Don’t burn your bridges!

2. Go with a locum agency first

That seems obvious seeing as this post is about locum work, however you could try and approach hospitals directly as a locum, or apply for a permanent job within the NHS. It is far easier to get in contact with a locum agency to find your first job in the UK. They will do most of the leg work and let you know exactly what they need to get you set up (visa, resume, qualifications check, police check etc). They will also give you information on setting up bank accounts and ways of receiving your pay. There are plenty to choose from and all do pretty much the same thing (although they’ll tell you different). So just search online for cardiac locum agencies in the UK. It is important to remember that once an agency has found you a position, particularly your first, most of their work is done and they will then receive commission for every hour you work. If you’re not happy with them, make it known, or simply go with another agency (just check with your department manager first, sometimes contracts may limit when you can change agencies).

3. Become a member

BSE.fwBecome a member of the British Society of Echocardiography (BSE). By becoming a member of the BSE you are supporting the society that represents you and your rights as a cardiac sonographer in the UK. It also gives you access to educational content on the BSE website, which is excellent by the way. Click here to sign up and become a member. I would also strongly encourage you attain BSE Adult Transthoracic accreditation. It’s not mandatory as our Australian qualifications are recognised in the UK, but I think if you’re going to work there, get the UK accreditation.

4. Get covered

Make sure you have professional indemnity insurance. I believe this should apply to you even in Australia, regardless of where you work (public, private or self employed). If you have it already in Australia, make sure it covers you for work overseas.

5. Go with the flow

No matter how frustrating it may be when you turn up for your first day, to find the echo department does things differently to the way you’re used to, don’t say “Well back home we do it like……..” or “In Australia……..”. Go with the flow, most labs in the UK will follow the British Society of Echo (BSE) guidelines, some will have BSE departmental accreditation and all will want you to follow their policies and procedures. That’s not to say that departments will not listen to you or get you actively involved in departmental improvements, just not in your first week. The BSE website has an excellent standard transthoracic echo protocol which I suggest you take a look at. See the BSE protocol here. By looking at the protocol, you’ll see what is recommended by the national body. There are also a number of other excellent protocols in the education section.

6. It’s all up to you

The sonographer is responsible for scanning and reporting in the UK, your report is the final report. If you don’t do a provisional report in your current practice, and I’m talking about a comprehensive textual report, not just ticking a few boxes and scribbling down a few notes, start to become familiar with how to report. Some departments will have brief reporting templates, others very comprehensive, regardless of that, your report is final, you will need to get used to taking on that responsibility.
The American Society of Echo published a document in 2002 (it’s old but a good place to start), which outlined how to report and what to include in a report. Check it out here. 
The BSE also published a document in 2006 which is very similar and based on the 2002 ASE document. Have a look at the BSE document here.
It should be pointed out that most labs will have good support structures if you need help or are unsure of how to report something. This is usually in the form of the senior sonographer or imaging cardiologist. If you’re unsure, ask!!!

7. Try not to be the odd one out

Don’t be surprised if you come up against some animosity, not directly at you, but simply because you are a locum. Locum pay is very good, I think too good and you could potentially be paid twice what an equivalent NHS employed sonographer is. Don’t sit on your backside if it’s quiet, be proactive, if something needs to be done, do it.

8. Get out of the city

This is my personal note and others would disagree with me entirely. London is a great city and definitely go for a stint there if that floats your boat. However, getting hammered at the local Walkabout with a bunch of Aussies every weekend can be done in Australia. Do something different and get out of the M25 ring and work in a regional hospital. There is so much more to the UK than London.

Working overseas was a rewarding experience I would highly recommend. We are lucky to have our profession to support us around the globe. Enjoy it, but take your professionalism with you. It may be a working holiday, but you are still working.


Worked in the UK? Share your experiences in the comments below.

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Image courtesy of Vlado and Vichaya Kiatying-Angsulee at

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  • Reply MARIA MERCEDES ALVAREZ VELLAZ April 16, 2016 at 4:55 pm

    Tim’s article is one of the most interesting and useful I have found.
    But I still have a lot of questions
    How can I get an UK BSE Adult Transthoracic accreditation? When I enter to the BSE page, I find the information about departmental accreditation, bou not about individual accreditation.
    I am living in Belfast
    I am European National
    My Doctor and my Cardiologist titles where obtained in Venezuela
    The Cardiology post grade medical residence in Venezuela includes an intensive training as echocardiographer. During the second and third years of medical residence, we have to perform about 600 echocardiograms each year. Those echocardiograms where supervised and reviewed (the digital loops and pictures, or the tape record, according the method of storage) by the tutor. I did my Cardiology residence at Vargas Public Hospital, and I am recognised as Cardiologist for the Hospital and for the DF Medical College. Since them I have kept working as clinical cardiologist and as echocardiographer obtaining the images, performing the measures and elaborating the final report.
    My plans are not to apply for a Medical accreditation in UK
    I want to obtain an accreditation as echocardiographer in UK
    I would be very happy if I receive some advice from you
    Best regards
    Maria Mercedes

    • Reply echoguru April 16, 2016 at 10:42 pm

      Hi Maria. Thanks for your email. I will check with my UK contacts and let you know as soon as I know more.

  • Reply Debra Herring October 31, 2017 at 7:08 pm

    Great article Tim, with very relevant tips for those wanting to go to the UK and work.
    I can only highly recommend this experience as I too was a locum in the UK for 2 years and enjoyed every moment of it. Unlike Tim I didn’t work in London, but did a lot of work in NHS hospitals in the countryside – Bath, Bristol, Cheltenham, Worthing and Kirkcaldy. Getting a good agency is a great help and to be willing to travel and try new things will be very rewarding. I had the joy of driving to work through the Cotswolds to get to work in Cheltenham, as I lived in Bath., and also lived for a short time in Edinburgh, where I had the wonderful scenic train ride along the coast to Kirkcaldy to get to work. The pay is very good and will give you the opportunity to explore the UK and Europe, with the added bonus of short and inexpensive trips to places you have always wanted to visit.
    The BSE has a very good echo conference every year and has great educational material – I am still a member after 12 years. The requirements to become a qualified cardiac sonographer is very similar to what is required here. I found the cardiac sonographers I worked with were very keen to learn, and enjoyed having an Aussie colleague. Having a cardiologist not check my echo reports took some getting used to, but as you rightly pointed out “go with the flow”.
    More than anything I think it really makes you appreciate the health service we have in Australia.
    Again, well done, and maybe we can entice some UK cardiac sonographers to have similar experiences in Australia.

    Debra Herring,
    Clinical Echo Educator, Alfred Heart Centre

    • Reply echoguru November 1, 2017 at 2:12 am

      Hi Debra, You raise the excellent point that there are many very different UK working experiences and not everyone is on the same journey! I have visited a lot of that countryside too (a LONG time ago) and it must have been amazing to live/work there and have such a picturesque commute. We are very lucky to have endless options available to us, and to work in a profession that can truly take us anywhere.
      I will need to highlight the options for working in Aust, particularly for our local sonographers who think that the UK pilgrimage is the only pathway…
      Thanks for sharing your experience, I would LOVE to read other sonographers experience of their working adventures.

      • Reply D December 13, 2017 at 1:29 pm

        On the other hand coming from the UK to Oz its very difficult to strip back and forget everything that we’re taught in the UK (full comprehensive report) to tick a box or simply right “normal” for everything and to ket a cardiologist have final say on your work when sometimes theyre wrong!!!
        Again go with the flow and enjoy the sunshine !!!

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