RADIOLOGIC TECHNOLOGIST
Radiographers produce x-ray films (radiographs) of parts of the human body for use in diagnosing medical problems. They prepare patients for radiologic examinations by explaining the procedure, removing articles such as jewelry, through which x-rays cannot pass, and positioning patients so that the correct parts of the body can be radiographed. To prevent unnecessary radiation exposure, technologists surround the exposed area with radiation protection devices, such as lead shields, or limit the size of the x-ray beam. Radiographers position radiographic equipment at the correct angle and height over the appropriate area of a patient's body. Using instruments similar to a measuring tape, technologists may measure the thickness of the section to be radiographed and set controls on the machine to produce radiographs of the appropriate density, detail and contrast. They place the x-ray film under the part of the patient's body to be examined and make the exposure. They then remove the film and develop it.
Experienced radiographers may perform more complex imaging tests. For fluoroscopies, radiographers prepare a solution of contrast medium for the patient to drink, allowing the radiologist, a physician who interprets x-rays, to see soft tissues in the body. Some radiographers who operate computerized tomography scanners to produce cross sectional views of patients are called CT technologists. Others operate machines that use giant magnets and radiowaves rather than radiation to create an image and are called magnetic resonance imaging (MRI) technologists.
Radiation therapy technologists, also known as radiation therapists, prepare cancer patients for treatment and administer prescribed doses of ionizing radiation to specific body parts. They operate many kinds of equipment, including high-energy linear accelerators with electron capabilities. They position patients under the equipment with absolute accuracy in order to expose affected body parts to treatment while protecting the rest of the body from radiation.
They also check the patient's reactions for radiation side effects such as nausea, hair loss and skin irritation. They give instructions and explanations to patients who are likely to be very ill. Radiation therapists, in contrast to other radiologic technologists, are likely to see the same patient a number of times during the course of treatment (see also nuclear medicine technologist).
Sonographers, also known as ultrasound technologists, direct nonionizing high frequency sound waves into areas of the patient's body; the equipment then collects reflected echoes to form an image. The image is viewed on a screen and may be recorded on videotape or photographed for interpretation and diagnosis by physicians. Sonographers explain the procedure, record additional medical history, and then position the patient for testing. Viewing the screen as the scan takes place, sonographers look for subtle differences between healthy and pathological areas, decide which images to include and judge if the images are satisfactory for diagnostic purposes. Sonographers may specialize in neurosonography (the brain), vascular (blood flows), echocardiography (the heart), abdominal (the liver, kidneys, spleen, and pancreas), obstetrics/gynecology (the female reproductive system) and ophthalmology (the eye). (See also cardiovascular technologist.)
SPECIAL WORKING CONDITIONS Most full-time radiologic technologists work about 40 hours a week; they may have evening, weekend or on-call hours.
Technologists are on their feet for long periods and may lift or turn disabled patients. They work at radiologic machines but may also do some procedures at patients' bedsides. Some radiologic technologists travel to patients in large vans equipped with sophisticated diagnostic equipment.
Radiation therapists are prone to emotional "burn out" because they treat extremely ill and dying patients on a daily basis.
Although potential radiation hazards exist in this occupation, they have been minimized by the use of lead aprons, gloves and other shielding devices, as well as by instruments that monitor radiation exposure. Technologists wear badges that measure radiation levels in the radiation area and detailed records are kept on their cumulative lifetime dose.
Radiologic technologists must follow physicians' instructions precisely and conform with regulations concerning use of radiation to ensure that they, patients and coworkers are protected from over-exposure.
Radiography programs require, at a minimum, a high school diploma or the equivalent. High school courses in mathematics, physics, chemistry, and biology are helpful. The programs provide both classroom and clinical instruction in anatomy and physiology, patient care procedures, radiation physics, radiation protection, principles of imaging, medical terminology, positioning of patients, medical ethics, radiobiology and pathology.
For training programs in radiation therapy and diagnostic medical sonography, applicants with a background in science or experience in one of the health professions are generally preferred. Some programs consider applicants with liberal arts backgrounds, however, as well as high school graduates with courses in math and science.
Preparation for this profession is offered in hospitals, colleges and universities, vocational-technical institutes and the Armed Forces. Hospitals, which employ most radiologic technologists, prefer to hire those with formal training.
Formal training is offered in radiography, radiation therapy and diagnostic medical sonography (ultrasound). Programs range in length from 1 to 4 years and lead to a certificate, associate's degree or bachelor's degree. Two-year programs are most prevalent.
Some 1-year certificate programs are for individuals from other health occupations, such as medical technologists and registered nurses, who want to change fields or experienced radiographers who want to specialize in radiation therapy technology or sonography. A bachelor's or master's degree in one of the radiologic technologies is desirable for supervisory, administrative or teaching positions.
The Joint Review Committee on Education in Radiologic Technology accredits most formal training programs for this field. They accredited 629 radiography programs and 97 radiation therapy programs in 1997. The Joint Review Committee on Education in Diagnostic Medical Sonography accredited 74 programs in sonography in 1997.
Radiographers and radiation therapists are covered by provisions of the Consumer-Patient Radiation Health and Safety Act of 1981, which aims to protect the public from the hazards of unnecessary exposure to medical and dental radiation by ensuring operators of radiologic equipment are properly trained. The act requires the Federal Government to set standards that the States, in turn, may use for accrediting training programs and certifying individuals who engage in medical or dental radiography. Because ultrasound does not use ionizing radiation, sonographers are excluded from this act.
In 1997, 36 States and Puerto Rico licensed radiologic technologists. No State requires that sonographers be licensed. Voluntary registration is offered by the American Registry of Radiologic Technologists (ARRT) in both radiography and radiation therapy. The American Registry of Diagnostic Medical Sonographers (ARDMS) certifies the competence of sonographers. To become registered, technologists must be graduates of an accredited program or meet other prerequisites and have passed an examination. Many employers prefer to hire registered technologists.
Radiographers and radiation therapists are required to fulfill 24 hours of continuing education every other year and provide documentation to prove that they are complying with these requirements. Sonographers must complete 30 hours of continuing education every 3 years.
With experience and additional training, staff technologists may become specialists, performing CT scanning, ultrasound, angiography and magnetic resonance imaging. Experienced technologists may also be promoted to supervisor, chief radiologic technologist and—ultimately—department administrator or director. Depending on the institution, courses or a master's degree in business or health administration may be necessary for the director's position. Some technologists progress by becoming instructors or directors in radiologic technology programs; others take jobs as sales representatives or instructors with equipment manufacturers.
With additional education, available at major cancer centers, radiation therapy technologists can specialize as medical radiation dosimetrists. Dosimetrists work with health physicists and oncologists (physicians who specialize in the study and treatment of tumors) to develop treatment plans.
In 1996, median weekly earnings for full-time salaried radiologic technologists were $559. Half earned between $478 and $672; 10 percent earned less than $317; and 10 percent earned more than $849.
According to a Hay Group Survey of acute care hospitals, the median annual base salary of full-time radiologic technologists was $28,800 in January 1997. The middle 50 percent earned between $26,600 and $31,800. Full-time radiation therapy technologists earned a median annual base salary of $37,300; and ultrasound technologists, $36,100.
Radiologic technologists held about 174,000 jobs in 1996. Most technologists were radiographers. Some were sonographers and radiation therapists. About 1 radiologic technologist in 4 worked part time. More than half of jobs for technologists are in hospitals. Most of the rest are in physicians' offices and clinics, including diagnostic imaging centers.
Sonographers should experience somewhat better job opportunities than other radiologic technologist occupations. Ultrasound is becoming an increasingly attractive alternative to radiologic procedures. Ultrasound technology is expected to continue to evolve rapidly and spawn many new ultrasound procedures. Furthermore, because radiation is absent from ultrasound procedures, there are no known side effects to patients.
Employment of radiologic technologists is expected to grow faster than the national average for all occupations through 2006, as the population grows and ages, increasing the demand for diagnostic imaging and therapeutic technology. For example, radiation therapy will continue to be used—alone or in combination with surgery or chemotherapy—to treat cancer. Although physicians are enthusiastic about the clinical benefits of new technologies, the extent to which they are adopted depends largely on cost and reimbursement considerations. Some promising new technologies may not come into widespread use because they are too expensive and third-party payers may not be willing to pay for their use.
Hospitals will remain the principal employer of radiologic technologists. However, employment is expected to grow most rapidly in offices and clinics of physicians, including diagnostic imaging centers. Health facilities such as these are expected to grow very rapidly through 2006 due to the strong shift toward outpatient care, encouraged by third-party payers and made possible by technological advances that permit more procedures to be performed outside the hospital. Some jobs will also come from the need to replace technologists who leave the occupation.