So I just got my SPI results back last week and I finally passed on my second attempt. Honestly was devastated after failing the first time in January, especially since I'd been in ultrasound for three years and thought my clinical experience would carry me. It did not. The registry is a completely different beast than just knowing how to scan.
What changed the second time around was actually committing to structured review instead of just flipping through my old school notes. I found an ARDMS SPI practice test that simulated the real exam format and started doing timed sections every other day for six weeks. My weak spots were patient care/safety and instrumentation — the physics-heavy stuff I'd kind of let go rusty. I'd say I put in around 60-70 hours of dedicated study this round versus maybe 20 the first time.
For anyone gearing up for SPI, don't underestimate the instrumentation and physical principles section. It's probably 40% of why people fail. A solid ARDMS SPI study guide that breaks down beam formation, transducer mechanics, and artifact recognition is worth its weight in gold. Happy to share what resources worked for me if anyone's interested.