 Next, they monitor the heart's performance while the patient is walking on a treadmill, gradually increasing the treadmill's speed to observe the effect of increased exertion.The position is generally unlicensed and skills are learned on the job; however, two- and four-year training programs to learn advanced ECG technical skills are available at junior colleges and community colleges.American Registry of Diagnostic Medical Sonographers (A.R.D.M.S.)