Sonography Principles & Instrumentation (SPI)

Effective November 10, 2020, you can now take the SPI examination online via online proctoring. Learn more! Physicians, you will still apply for the SPI examination via your MY APCA account. 

The Sonography Principles & Instrumentation (S​PI) examination tests the requisite physical principles and instrumentation knowledge, skills and abilities essential to sonography professionals and students.

As a physician, you are eligible to take many of the examinations offered by the APCA companion council, ARDMS. While ARDMS manages the SPI examination, APCA, created exclusively to serve physicians, will be your destination to apply, prepare for, schedule and maintain all your certifications. You will log into MY APCA for information regarding the examination and to apply online.

To earn an RDMS, RDCS, and RVT certification, you must pass the SPI examination and a corresponding specialty examination within five years. After passing the SPI examination, you can earn additional certifications without having to retake the SPI examination, provided you maintain active status.

​You must wait 60 days before you can retake ​the SPI examination if you do not pass it however, you are welcome to reapply after 3 days

The SPI examination assesses the knowledge, skills and abilities in the areas of clinical safety, physical principles, pulsed echo instrumentation, and quality assurance. The examination meets the fundamental physical principles and instrumentation requirements for the RDMS, RDCS, and RVT certifications.

We periodically conduct an SPI Job Task Analysis (JTA) and update the SPI examination to reflect the frequency and importance of SPI tasks being performed by Sonography Professionals.

Click here to view the 2022 SPI Practice Analysis. Prior to 2022, a practice analysis was called a job task analysis (JTA). View the 2015 SPI JTA results.

All questions on the Sonography Principles & Instrumentation (SPI) examination will fall under the domains and subdomains listed in the SPI content outline. It is essential that you review the SPI content outline to understand what will be covered in the examination. Effective September 1, 2023, there will be a new SPI content outline.

​The SPI examination for the RDMS, RDCS, RMSKS and RVT certifications is two hours long, including a five-minute survey, and contains approximately 110 multiple-choice and Semi-I​nteractive Console (SIC) questions​​.

In order to earn the RDMS, RDCS, RMSKS and RVT certifications, the SPI examination must be taken and passed in conjunction with the corresponding specialty examination within five years​. For more information on specialty examination that we offer, please visit ​Certifications and Examinations​​.​​​

ARDMS functions under policies intended to demonstrate impartiality, high ethical standards and validity of its certification assessments.

ARDMS does not restrict Applicants, Candidates or becoming a Registrant/Certificant based on limiting conditions, such as membership of an association or professional society of any organization. ARDMS will not unfairly impede or inhibit access to its certification to Applicants, Candidates or Registrants/Certificants who meet our stated policies regarding qualification requirements, renewal requirements and/or passing ARDMS’ psychometrically sound certification assessments.  ​​​

Candidates must pass the Sonography Principles & Instrumentation (SPI) examination and the corresponding specialty examination within five years, regardless of sequence. Candidates who do not complete both examinations within five years must retake the examination previously passed.

Note: The five-year rule does not apply to Registrants seeking additional specialties under a certification already earned. For example, if you have the RDMS certfication with AB, the five-year rule is not applicable if you want to add another RDMS specialty (OB/GYN, BR, FE, PS). There is no time limit to add additional specialties to a certification already earned, provided you maintain Active status.

However, if you earned the RDMS with the old UPI physics examination and AB (or any other RDMS specialty), and then passed the SPI examination, you would need to pass one of the RDCS, RVT or RMSKS specialties to meet the five-year rule requirement for the SPI examination. In this situation, adding an additional RDMS specialty after passing the SPI examination (or vice versa) would not meet the five-year rule requirement since you would be adding a specialty to a certification already earned.

The five-year rule is based on the calendar year (January 1 through December 31). The five-year period begins the day the first examination is passed, and it includes any time that remains in that year plus the next five years. For example, a candidate who passed the first ARDMS examination on June 6, 2011, is required to pass the second examination by December 31, 2016.

You will be considered a re-applicant for the SPI examination if you have previously been approved to sit for an ARDMS examination, excluding PVI and MSK examinations.

To sit for the SPI examination as a re-applicant, submit the application and payment; your application will automatically be approved.​

To sit for the SPI examination, First-Time physician applicants must meet the education/licensure and clinical requirement of the physician prerequisite

If you are not a physician or do not meet the requirements of the physician prerequisite, please visit the SPI specialty page on the ARDMS website to review the SPI Requirement and General Prerequisites chart. The prerequisites vary based on education and clinical experience.

Click to view the SPI Requirement and General Prerequisites​​.

To earn an ARDMS credential, Applicants must choose and meet the requirements of a prerequisite. Review the Prerequisite Prep tool to help guide you through the prerequisite selection process and to select a prerequisite that best meets your education and clinical ultrasound experience.

Re-Applicant – A re-applicant is a Candidate or Registrant who has previously applied and been approved by ARDMS to take or has taken an ARDMS examination and who is applying to take another examination; this does not include an individual who has only been approved for MSKS, MW examinations and approval of the Sonography Principles & Instrumentation (SPI) examination under the SPI Examination Requirement Pathway. Re-applicants should apply as such and thus this guide isn’t necessary for you.

You will be considered a Re-applicant for the SPI examination:

1. If you were previously approved to sit for any of the following Sonographer-level specialty examinations:

  • Abdomen (AB)
  • Adult Echocardiography (AE)
  • Breast (BR)
  • Fetal Echocardiography (FE)
  • Obstetrics and Gynecology (OB/GYN)
  • Pediatric Echocardiography (PE)
  • Pediatric Sonography (PS)
  • Vascular Technology (VT)

2. If you were previously approved to sit for the SPI examination.​

Applying as a Re-applicant:

To sit for the SPI examination as a Re-applicant, submit the application and payment. Your application will automatically be approved and you will be able to schedule within a day.

You must wait 60 days before you can retake the SPI examination if you do not pass it however, you are welcome to reapply after 3 days.

The SPI examination fee is $250 USD, which includes a $100 USD non-refundable processing fee. If you take an ARDMS examination at an international test center (outside the U.S., Canada and Mexico), you will be charged an additional non-refundable $50 USD fee when you schedule your examination. This fee is subject to change without notice.​​

Reimbursement Information for U.S. Armed Forces Veterans: 

Learn more about the GI Reimbursement Program for United States Armed Forces Veterans. ​

As a physician, once you are ready to apply for an ARDMS examination, follow the steps below:

  • Log in to MY APCA​ and choose the “Apply Online” option.
  • Complete the online application form and submit payment. If you are a first-time applicant, you are required to choose a prerequisite under which to apply.
  • Gather your supporting documentation and submit at time of application
  • To upload your documentation to your MY APCA account, click the “My Resources” tab, then “Upload Documents”. For “File Type” select “Application Documents”.

For more details, please visit the RDMS, RDCS and RVT How to Apply Guide​​​.

Once we have reviewed your information, we will email you with either an Examination Confirmation Letter (ECL) or a request for additional documentation. When you receive the ECL, you may contact Pearson VUE to schedule an examination appointment during your eligibility period.

If you are found ineligible to take the examination, your application will be partially refunded (less the $100 USD processing fee per examination).

Based on your prerequisite or requirement selection​​, the necessary supporting ​documentation must be received ​at the time of your online application submission.

Note: We do not retain application documentation received prior to receipt and payment of the online application. Any documentation received prior to the completed online application will be discarded.​​​

Application Letter Requirements

When applying for the SPI examination, if your prerequisite selection requires documentation of clinical experience, please note that application letter(s) must:

  • Be an official letter with the address and telephone number indicated
  • Include the current date (mm/dd/yyyy)
  • State actual dates of employment or program
  • Contain original signatures (stamped and/or computer generated signatures are not acceptable); letters cannot be signed by a relative of the applicant
  • Provide a physician’s medical license number or chief sonographer’s/technologist’s ARDMS number

Employment letters must indicate full-time or part-time training/experience AND must include the total number of paid clinical hours.

Program completion letters must include the total number of hours in the program and state individually, the number of didactic and clinical hours in the program.

Sample Letters

Provided are some sample letters that may correspond with your prerequisite requirements:

Patient Log 

For Applicants who apply under a prerequisite other than physician prerequisite – Degrees earned internationally must be evaluated prior to selecting a prerequisite. We require a course by course evaluation. Click here​ ​for complete list of Evaluation Agencies for International Degrees.

​The application checklist is a helpful, online tool that lets you track the status of your submitted application. To view it, log into MY APCA and visit the “Application Checklist” from the “Application Center” drop down menu.

Once we have reviewed your documentation, you can find out what documentation we accepted and what additional documentation we may still need by selecting “View Checklist.” If “View Checklist” is not available, it simply means we have not yet reviewed your documentation.

​If you are found eligible to take an examination, we will email you an Examination Confirmation Letter (ECL) within one to two days of application approval and you will be able to schedule your appointment at that time. The ECL will also be posted to your MY APCA account and will include your eligibility period to schedule and take your examination.

APCA provides reasonable testing accommodations in compliance with the Americans with Disabilities Act (ADA) .  Under the ADA, a disability is a physical or mental impairment that substantially limits one or more major life activities. Having a diagnosed impairment does not necessarily mean that an individual is disabled as defined by the ADA, and not all disabilities require test accommodations.

For more information regarding the ARDMS testing accommodations program, including documentation requirements, processing timelines, and types of accommodations offered, please read the APCA’s Test Accommodations page.

​Once your SPI application has been approved, an Examination Confirmation Letter (ECL) will be emailed to you to schedule an examination with Pearson VUE – ARDMS’ official testing vendor. You will have 90 days to schedule and take your examination.

If you have not done so already, visit Pearson VUE​ to:
• Create a Pearson VUE account
• Search for seat availability
• Locate a test center
• Schedule an examination
• Contact Pearson VUE Customer Service

If you are taking the examination at an international test center (outside the U.S., Canada and Mexico), a $100 USD non-refundable fee and Value Added Tax (VAT) will be charged by Pearson VUE. All international scheduling fees and associated VAT will be charged at the time the examination is scheduled. The fees and associated VAT are subject to change without notice, and they are non-refundable.

To reschedule the date and time of your examination during your eligibility period, you must contact Pearson VUE(1-877-258-9220) at least 96 hours prior to the scheduled examination date and time.

To cancel an examination appointment, you must contact
Pearson VUE (877-258-9220) and cancel the scheduled appointment no later than 96 hours prior to the scheduled examination appointment time. You will receive a cancellation email from Pearson VUE.

To request a partial refund, you must wait 24 hours after canceling the appointment with Pearson VUE and then submit a cancellation/partial refund request no later than 96 hours prior to the last date of the eligibility period.

To request an extension:

  1. Log in to your MY APCA account.
  2. Visit “My Examination/Application Status” under “Application Center.”
  3. Select the examination you wish to request a partial refund for.
  4. Complete and submit the form.

We will refund your examination fee, less the $100 USD processing fee per examination, unless we receive your request too late, you never schedule your examination or you do not keep your scheduled examination appointment. Then, the entire examination and processing fees are forfeited.​

If you need more time and cannot schedule your examination within the 90-day eligibility period, you can request a one-time 60-day extension for the examination. You must request this extension at least 96 hours prior to the last date of the eligibility period.

To request an extension:

  1. Log in to your MY APCA account.
  2. Visit “My Examination/Application Status” under “Application Center.”
  3. Select the examination you wish to extend.
  4. Complete and submit the form.

If you have a scheduled examination appointment, you must contact
Pearson VUE (1-877-258-9220) at least 96 hours prior to the scheduled examination, and notify them that you are cancelling your scheduled appointment before you complete the steps above to request an extension.

The entire examination fee is forfeited if we receive your request too late, you never schedule your examination or you do not keep your scheduled examination appointment.​

When you arrive at a test center, be prepared to:

  • Check in with a Test Center Administrator
  • Present one valid photo identification (ID); see Test Center Identification Requirements
  • Provide a digital signature
  • Have your palm vein scanned
  • Take a test-day photograph

Note: The only thing that you can bring into the testing room is you. The test centers have lockers you can use to store personal belongings. Study materials as well as food and drink are prohibited in the test center. No visitors, guests, pets or children are allowed.

Important: Review ARDMS’s Examination Admission Compliance​ policies to ensure you are not refused admission at the test center and do not conduct unauthorized examination behavior.

Test centers will provide white boards for notes during the examination upon request.

If you need special accommodations, please select “Yes” for “Special Accommodations” in the application when you apply.

Taking a practice test or two is a great way to prepare for your actual examination. We offer a Sonography Principles & Instrumentation (SPI) Practice Test that simulates the computer interface used in the actual test center environment. The SPI practice test review is comprised of 30 sample questions and is 30 minutes long.

After you complete a practice test, you will be emailed a report that shows the number of questions you answered correctly. While the report is an indication of your knowledge, the practice tests results should not be used to predict how well you will perform on the actual test at the test center.

See FAQs​ for additional information.

Each practice test costs $45 USD.

You can now register for a SPI practice test by signing into your MY APCA account and clicking the Sign Up/View Practice Test option in the Application Center tab. You can also view the computer system requirements in your MY APCA portal. For any general questions or technical problems regarding the practice tests, please call APCA at (800) 943-1709 or email

Before your session begins, you should review the test tutorial​. Please note you will not get a chance to review the test tutorial during the actual practice test, so please prepare accordingly. Once your session begins, you have 30 minutes to complete the practice test.

Register for a SPI practice test, by signing in your MY APCA account.

The SPI examination covers the following content areas. All percentages are an approximate distribution of the questions across the content areas.

SPI Content Outline (Effective September 1st, 2023)

  • Perform Ultrasound Examinations – 23%
  • Manage Ultrasound Transducers – 7%
  • Optimize Sonographic Images – 26%
  • Apply Doppler Concepts – 34%
  • Provide Clinical Safety & Quality Assurance – 10%

SPI Content Outline​​ (Current)

  • Clinical Safety – 4%
  • Physical Principles – 10%
  • Ultrasound Transducers – 7%
  • Pulsed Echo Instrumentation – 35%
  • Doppler Instrumentation and Hemodynamics – 35%
  • Quality Assurance – 4%
  • Protocols – 4%
  • New Technologies – 1%

Please note: All percentages are approximate.
Your score report will display and include performance feedback for these content areas. ​

After all of your diligent preparation and hours spent studying, here are a few valuable tips to help make your examination day a success:

  • Double check that you know where the test center is before examination day and give yourself plenty of time to get there. Remember, you MUST arrive and register at least 30 minutes before the examination begins.
  • Get a good night’s sleep before you take your examination. Being well rested and relaxed when you take your examination will help you concentrate.
  • Bring one form of current and valid identification that complies with the test center identification requirements​​.
  • Travel light. The only thing you can bring into the testing room is you. You can store your personal belongings — your car keys, watch, smartphone, purse, backpack, etc. — in lockers at the test center. The following items are not allowed in test centers: study materials, food, drink, visitors/guests, pets and children.
  • Request a white board if you plan to jot down notes during the examination. Test centers are using white boards (rather than paper) in an effort to “go green.”
  • Be advised that the use of a calculator for this examination is prohibited.  However, you may utilize the White Board provided at the test center or the digital White Board provided for online proctoring examinations for manual calculations.

Good luck!

Even though we offer practice examinations and sample questions, we do not offer study materials for our examinations – but our sister organizations do. You can find materials at:

The SPI examination features Advanced Item Types (AIT) questions, which assess and measure your practical sonography skills. They include:

  • ​Semi-interactive​ console (SIC) questions​: You will use a virtual SIC that simulates an actual ultrasound machine. The questions will display a partially-completed ultrasound image and a statement that indicates a problem. You will use a computer mouse to adjust the controls on the simulated console in a way that should correct the problem.

Visit the Semi-Interactive Console (SIC)​​ page and to learn more. ​

The SPI examination evaluates the adult echocardiography knowledge and skills you must demonstrate as a sonographer-level professional. The primary test result is a PASS or FAIL decision. In addition, you will receive a scaled score, ranging from 300 to 700. A scaled score of 555 is required to pass.

The scaled score is not a percentage of correct answers, nor is it built on a “curve” where a certain percentage of scores would pass and a certain percentage would fail. To learn more, visit Notification of Results and Scoring

You can receive a score report at the test center once you complete the examination. Additionally, your score report will be available in your Pearson VUE account. The Pass or Fail results will then be posted to your secure MY APCA account within the next week.

Candidates receiving a confirmed passing score on all required examinations and meeting all other requirements will be awarded a certification, effective the date the final examination was taken. For information on APCA’s scoring methods, visit Notification of Results and Scoring​​​.

Candidates who do not pass are invited to re-apply but must wait 60 days between attempts.

You can request a score verification for a $35 USD fee, payable by check, money order or credit card. Score verification ensures that the computer counted the correct and incorrect answers appropriately, but it does not review the questions and answers.

You must submit the completed Exam Score Verification​​​​​ ​within 30 days of having taken the examination in question. The Exam Score Verification Form will be returned if incomplete, unsigned or unpaid. ​

When deciding whether to have your score verified, please consider that ARDMS examinations are scored electronically with a high degree of accuracy, and it is unlikely that verification will alter your original score​

Below are the pass rates for the SPI examination for the past three years.  As this is a sonographer-level examination, this pass rates are reflective of all examinees (both sonographers and physicians).

First-time takers: 70%
Overall: 63%

First-time takers: 68%
Overall: 60%

First-time takers: 76%
Overall: 68%

First-time takers: 73%
Overall: 65%

First-time takers: 73%
Overall: 65%

First-time takers: 75%
Overall: 67%​​

First-time takers: 78%
Overall: 70​%​

First-time takers: ​80%
Overall: 72%

First-time takers: 79%
Overall: 71%

First-time takers: 81%
Overall: 72%

First-time takers: 77%
Overall: 70%