While in seminary, he served as Associate Pastor of the Grace United Methodist Church in Chicago, Illinois. Following seminary he became director of the Conference Council on Ministries of the Dakotas Area, a position which he held from 1978 to 1982. He was director of the Oakwood Spiritual Life Center in the North Indiana Annual Conference from 1982 to 1985), then moved to Iowa where he became the Council Director of the Iowa Annual Conference (1985–92). He was appointed Superintendent of the Cedar Rapids District of the Iowa Conference in 1992, serving until 1997. Ough's last appointment before election as a bishop was as pastor of St. Paul's United Methodist Church in Cedar Rapids (1997–