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X-Ray and Radiologic Tech Career Information

Without the ability to see inside the human body, doctors would find it much more difficult to diagnose and treat many different kinds of injuries and illnesses. But physicians can't just cut into patients every time they need a better view. That's why diagnostic imaging (such as medical x-ray technology) was invented. Yet, as familiar as most people are with x-rays, many don't realize just how much other non-invasive (or minimally invasive) technology exists to help medical teams understand what's happening inside patients. And many people even have deep misunderstandings about the healthcare workers who specialize in all of that radiologic technology. (Hint: so-called "x-ray technicians" represent only a small part of the field.)

What is an X-Ray Technician?

This might be the most important question on this page. A lot of people looking for a career in the healthcare field carry false assumptions about the term "x-ray technician" due to its widespread (but frequently incorrect) use. They believe the title signifies much more than it actually does. So, then, what is an x-ray technician?

An x-ray technician is:

• Someone who has a limited permit to perform only the most basic x-ray exams
• Sometimes known as a limited x-ray machine operator (LXMO)
• Sometimes known as a limited medical radiologic technologist (LMRT)
• Sometimes known as a radiologic technician or limited radiology technician
• NOT the same thing as a fully qualified radiologic technologist
• NOT the same thing as a radiologist
• Sometimes the person who fixes the x-ray equipment rather than operates it

What is the Difference Between an X-Ray Technician and a Radiologic Technologist?

These two job titles represent very different types of career opportunities. Yet, many people mistakenly use them interchangeably without understanding their error. The difference between an x-ray technician and a radiologic technologist is huge. In fact, calling a radiologic technologist an "x-ray technician" or "radiologic technician" is often considered downright insulting.

So, what are the differences between an x-ray tech and a radiologic technologist?

The main difference is simple: Radiologic technologists are fully certified to perform a wide range of x-ray or other diagnostic imaging procedures. X-ray technicians, in comparison, are more limited in their training and what they are allowed to do.

Nevertheless, many websites (and even some schools and employers) continue to use incorrect terminology when referring to the fully certified radiologic technology worker. So it is crucial that you understand the finer distinctions before choosing your path.

X-ray technicians:

• Are typically permitted (depending on the state they work in) to carry out only the kinds of routine x-ray exams (i.e., on patient chests, arms, legs, hands, or feet) that are sometimes done in outpatient doctors' offices
• Often find it difficult to get work in hospitals due to their limited abilities
• Are frequently medical assistants first and foremost who obtain limited x-ray training as part of their primary career training or as part of their continuing education
• Have less than two years of core education in radiologic technology

Radiologic technologists:

• Are licensed to perform all of the main types of radiologic exams in hospitals, including chest x-rays, fluoroscopy, and portable exams within surgical or ICU departments
• Have many more career options than just taking x-rays or working within the field of radiography
• Can obtain additional training and licenses for specialty procedures such as mammography, CT scans, angiography, MRI scans, nuclear medicine, and radiation therapy
• Have at least two years or more of core education in radiologic technology
• Usually possess a much broader and deeper understanding of diagnostic imaging technology

It should also be noted that neither x-ray technicians nor radiologic technologists are the same as radiologists. A radiologist is an actual medical doctor who specializes in radiology. Radiologic technologists are supervised by radiologists. And only radiologists can tell patients the results of their radiologic exams.

What Do X-Ray Technicians and Radiologic Technologists Do?

As noted above, the answer to this question depends a great deal on what you mean by "x-ray technician." When many people refer to x-ray technicians, they really mean to talk about radiologic technologists, unaware of the important differences.

The duties of true x-ray technicians can vary significantly since different states have different regulations and individual doctor's offices will have their own unique needs. A lot also depends on whether x-ray techs bring additional skills to the table. (Are they primarily medical office assistants? Do they have phlebotomy training? Can they help in the medical billing and coding process?) In this respect, an x-ray tech's day may be full of a lot of other tasks with only a few x-rays needed now and then.

In general, though, x-ray techs can have responsibilities that include:

• Consulting with doctors to receive the precise orders they must follow regarding the area of patient anatomy to be imaged
• Preparing patients for basic x-ray exams of injured (or potentially injured) bones
• Ensuring that the areas of patients that don't need to be imaged are safely shielded from x-ray radiation during the procedures
• Developing x-ray films or preparing digital images for use by the appropriate doctors for diagnoses and treatment plans
• Performing basic maintenance on x-ray equipment
• Maintaining detailed records
• Performing assorted office duties like cleaning, filing, and handling phone calls

In contrast to x-ray techs, radiologic technologists represent a wide range of different skill sets and career opportunities. Although most radiologic technologists are employed in the field of general radiography (taking traditional x-rays), many of them choose to specialize in very specific imaging techniques or therapies. Generally speaking, radiologic technologists work closely with radiologists and often have duties such as:

• Reviewing ordered diagnostic imaging exams with radiologists and other medical staff to ensure the correct areas of patients get examined
• Taking patient medical histories
• Responding to patient questions
• Preparing patients and imaging equipment for doctor-ordered imaging procedures
• Protecting patients and themselves from radiation exposure in the areas that aren't being imaged using things like protective lead aprons, gloves, and other shielding devices
• Placing imaging equipment and patients in the best possible positions for obtaining quality images
• Operating sensitive (and often computerized) high-tech medical equipment
• Making necessary adjustments and performing routine maintenance on diagnostic imaging equipment
• Preparing x-ray films or digital images and sending them to a radiologist to review
• Taking or retaking any additional images that are necessary as determined by a radiologist
• Monitoring their daily exposure to radiation using special instruments and wearable badges that measure radiation levels in affected areas
• Keeping detailed records about the procedures they perform as well as their cumulative lifetime doses of radiation received while on the job

Since the term "radiologic technologist" is really just a general term that refers to a number of related areas within the field of radiologic technology, more specific job duties depend on the specialty. Radiologic technologists typically work in one or more of the following areas of diagnostic imaging:

• General radiography—Using x-ray radiation, which produces black-and-white images of a patient's internal anatomy, to detect things like bone fractures, foreign objects, unusual masses, and other anomalies
• Mammography—Taking images of breast tissue using special x-ray equipment that can help detect cancerous tumors
• Computed tomography (CT)—Using a special machine that rotates x-rays around a patient in order to view the inside of his or her anatomy in a more detailed way
• Bone densitometry—Using x-ray equipment that enables the measurement of a patient's bone mineral density in order to estimate the risk of fracture or track bone loss caused by osteoporosis
• Cardiovascular-interventional radiography—Employing sophisticated equipment such as fluoroscopes to allow the viewing of moving x-ray images in real time during surgery (often minimally invasive), which helps surgeons guide catheters, stents, and other tools through a patient's body
• Magnetic resonance imaging (MRI)—Taking detailed images (without radiation) of a patient's internal anatomy using a computerized machine that applies a radiofrequency pulse to a strong magnetic field
• Nuclear medicine—Capturing functional visual information about a particular part of a patient's internal anatomy by administering trace amounts of radiopharmaceuticals (usually through a drink mixture) and then using a special camera that detects the gamma rays that are emitted by the radiopharmaceuticals

You should also know that radiologic technology isn't just about producing diagnostic images. Some highly skilled radiologic technologists specialize in helping to treat different types of cancer or other diseases. Such radiologic technologists work in one of the following fields:

• Radiation therapy—Working under the direction of a radiation oncologist to administer targeted doses of radiation to patients in order to help shrink or destroy their cancerous tumors
• Medical dosimetry—Working under the supervision of a medical physicist to calculate the appropriate dose of radiation to be delivered to a patient's tumor site while conforming to a radiation oncologist's treatment plan

Where Can X-Ray Technicians Work?

Since x-ray technicians are limited in what they are able to do, they are also frequently limited in the types of employers they can work for. X-ray technicians generally do not have the qualifications or skills to work in hospitals. Therefore, the most common workplaces for x-ray techs tend to be doctors' offices, particularly orthopedic clinics. Some chiropractic offices also employ their own x-ray techs.

Where Can Radiologic Technologists Work?

Radiologic technologists are employed in almost every type of healthcare environment. Due to their range of skills and optional specialties, radiologic technologists can be found working in urban, suburban, and rural workplaces such as:

• Hospitals (where most radiologic technologists work)
• Outpatient diagnostic imaging clinics
• Medical imaging laboratories
• Doctors' offices
• Outpatient care centers

Some experienced radiologic technologists work as traveling radiologic techs by signing up with agencies that enable them to temporarily fill positions in a variety of locations where there are shortages.

Are There Any Downsides to Being a Radiologic Technologist?

Most radiologic technologists enjoy their chosen field. But, as with any career, there can be some challenging drawbacks. So it is important that you understand what you may be getting into. The cons of being a radiologic technologist can include:

• Exposure to radiation—Even though there are good safety protocols that minimize the dangers, a little radiation exposure is still frequently unavoidable. And, over the course of many years, it can add up. Some well-experienced radiologic technologists eventually must move into different occupations when approaching their maximum allowable lifetime doses of radiation.
• Exposure to sick people—Since hospitals and medical clinics treat patients with infectious diseases, radiologic technologists are at risk of contracting contagious illnesses.
• Difficult patients—Although most patients are cooperative, others can be rude or even abusive. (Not to mention the fact that some patients smell bad or have screaming, misbehaving children.)
• Physical and psychological demands—Radiologic technologists often have to help position heavy patients and heavy equipment. Their work also involves lots of standing, walking, bending, and squatting. And because they are frequently dealing with vulnerable patients in traumatic circumstances, their days can be emotionally challenging.

What are the Upsides of Being a Radiologic Technologist?

Careers in radiologic technology can be full of many positives, which often outweigh the downsides. The best parts of being a radiologic technologist can include:

• Personal fulfillment from helping people—Radiologic technologists are vital members of medical care teams. They can feel the rewards that come from knowing that their work leads to the proper diagnosis and treatment of the patients they interact with.
• The thrill of working with cutting-edge technology—Diagnostic imaging equipment tends to incorporate some of the most advanced technology in the medical field. It can feel exciting to know that you are using the latest results of scientific progress.
• Variety of opportunities—The field of radiologic technology encompasses a large variety of different specialties. That means, with the right training and certification, you can try out different kinds of jobs while keeping your career in forward motion.
• Fun and interesting patient interactions—Some patients are a joy to be around, which can make up for the ones who are not.

What is the Typical Radiologic Technician Salary?

First, it is important to remember that asking about a "radiologic technician" salary is not the same as asking about a "radiologic technologist" salary. You need to make sure that you aren't confusing one with the other. A limited scope x-ray technician (a.k.a. radiologic technician) salary is often going to be very different from the salary of a registered radiologic technologist.

So, how much does an x-ray technician make compared to a radiologic technologist?

This is not an easy question to answer. Because so many x-ray techs work primarily as medical office assistants or in other healthcare positions in which taking basic x-rays is only a small part of their jobs, it can be difficult to know what a typical salary is for a full-time x-ray technician. It also doesn't help that many high-profile websites confuse the different terms and incorrectly lump x-ray techs in with radiologic technologists.

Perhaps the best way to look at this question is to first understand the salary range of radiologic technologists and then realize that the wages of limited scope x-ray techs will generally fall within the lowest part of that range (assuming that taking routine x-rays is their primary responsibility).

So, based on national estimates, typical annual wages for radiologic technologists break down this way: *

• The bottom 10 percent earn $36,510 or less.
• Median annual wages are $54,340.
• The top 10 percent earn $76,850 or more.

What are the X-Ray Technician Qualifications I Need to Know About?

First, you need to make sure that you are asking about the right occupation. X-ray technician qualifications are going to be very different from radiologic technologist qualifications. Either way, though, you should know about the requirements of both options so that you can make a well-informed decision that puts you on the path you actually intend to pursue.

Here are the most important points you need to understand about the qualifications necessary for becoming an x-ray technician:

• Most states require x-ray technicians to obtain a limited x-ray license before they can perform any x-ray procedures on patients. Some states, however, have no such requirement.
• In order to obtain the appropriate license, you will likely have to pass an exam that covers basic areas such as radiation protection, patient care, image production, image evaluation, equipment operation, and quality control.
• The most common way to learn what you need to know for the licensing exam is completing a post-secondary x-ray technician training program that lasts a year or less. You should note, however, that such programs only lead to a diploma or certificate of completion, NOT a degree.
• Different states use different titles when referring to licensed x-ray technicians, so don't let this fact confuse you. For example, in some states, a licensed x-ray technician is called a limited medical radiologic technologist (LMRT) or limited x-ray machine operator (LXMO). In Texas, a licensed x-ray tech is known as a non-certified technician (NCT).
• Some states choose to use the Limited Scope of Practice in Radiography exam from the American Registry of Radiologic Technologists (ARRT) for licensing purposes. But passing this exam does NOT mean you are certified by the ARRT. The ARRT does NOT grant certification or registration to x-ray technicians. (It only certifies radiologic technologists.)
• You should always make it a point to contact your state's radiation control licensure office before trying to work as an x-ray tech in order to be sure you meet all of the requirements.

Radiologic technologists, in contrast, generally must meet requirements that are much more stringent. Here are the key points to know about the qualifications necessary for becoming a radiologic technologist:

• Licensure is mandatory in most states. (Over two-thirds of states regulate radiologic technologists through licensing laws.) And states often require separate licenses for different modalities. For instance, you may need a license in general radiography to take x-rays in addition to separate licenses in whatever other specialties you choose to pursue.
• Most of the states with licensing laws require you to pass the appropriate certification exam from the American Registry of Radiologic Technologists (ARRT). Other states have their own exams but may also consider your scores on the ARRT exam (if you choose to take it voluntarily) in their licensing decisions.
• Those who successfully pass the ARRT certification exam are known as Registered Technologists (R.T.).
• In order to be considered a legitimate radiologic technologist in many states (and by many employers regardless of your location), you must obtain your certification from the ARRT.
• Staying certified with the ARRT requires an annual renewal as well as proof of required continuing education activities every two years.
• The ARRT has separate certification programs for various sub-specialties in radiologic technology (e.g., CT, mammography, MRI, etc.).
• You are only allowed to call yourself an R.T. if you are registered (in good standing) with the ARRT.
• Beginning on January 1, 2015, you must have earned at least an associate's degree in order to be eligible for the ARRT certification exam. Your degree does not need to be in the radiologic sciences, but it does have to be from a post-secondary institution that is accredited by an organization approved by the ARRT.
• To be eligible for the ARRT exam, you must also have demonstrated competence in a long list of radiologic technology coursework and clinical procedures. So, although your academic degree doesn't have to be in radiologic technology, you will still need to successfully complete a comprehensive radiologic technology program in order to meet this requirement.
• The ARRT gives qualified candidates three attempts to pass its exam within a three-year period.

Of course, you also need more than official qualifications for a career in radiologic technology. People who succeed in this field often possess characteristics such as:

• Empathy
• Patience
• A detail-oriented mind and the ability to follow precise instructions
• Physical and mental stamina
• Emotional stability
• A commitment to professionalism
• Strong interpersonal skills
• A knack for operating highly technical equipment
• Good moral character and a strong sense of ethics

Can You Tell Me How to Become an X-Ray Technician or Radiologic Technologist?

Regardless of whether you want to become an x-ray technician or a radiologic technologist, you will need to seek out quality training and possess strong determination. But before you do anything, it's a good idea to research the job market and potential employers in the location you wish to find work. Doing so will give you a realistic sense of the demand in your area and a better idea of the best path to pursue.

If you decide to become an x-ray technician, you should consider the following points:

• As stated in the section above, your state might require you to obtain an x-ray license before you can work. Therefore, you should contact your state to find out what requirements you must meet in order to apply for a license.
• You will need to find a formal training program in limited scope radiography that can allow you to learn the things you are likely to be tested on in your state's licensing exam (if your state has one).
• Even though x-ray technicians are only allowed to perform a limited range of x-ray procedures, learning the stuff you need to know will not necessarily be easy. You should expect your training to challenge you.
• In terms of job opportunities, you will have the most potential if you combine your x-ray training with formal training to become a medical assistant or other allied health professional.
• Once you are trained and licensed, it may take patience and persistence to find your first job. Focus on the kinds of employers that are most likely to hire limited x-ray techs, such as physicians' offices, orthopedic clinics, and chiropractic offices.

On the other hand, if you choose to become a radiologic technologist, you should keep the following in mind:

• Your state's radiation control licensure office is the most important place to contact first. You need to have a clear understanding of the licensing requirements in order to make the best decisions about your education.
• Choosing a formal post-secondary program in radiologic technology that is accredited by the Joint Review Committee on Education in Radiologic Technology (JRCERT) will put you on the best path to becoming certified by the ARRT and licensed in your state.
• While you are still in school, it's smart to research the places you'd like to work and try to make as many connections as you can. Your chances of landing a job after school get better with each relationship you establish with someone already in the field. (Radiologic technology can be a small world.)
• A major part of your formal training will involve hands-on clinical work at a real hospital or diagnostic imaging clinic. During this time, you should expect to have to work around 24 to 40 hours per week while continuing to attend classes full-time. You will have to balance your clinical work with homework and various project assignments.
• If you choose to enroll in a two-year associate's degree program, you should be aware that the credits you earn might not necessarily transfer to a different school or to a more advanced program. This is important to consider if you think you might want to upgrade your degree at a later time.
• As stated in the section above, you will need to obtain certification from the ARRT in order to become a Registered Technologist (R.T.). That means you'll need to do a good job in school and really digest what you learn so that you can pass the ARRT exam.
• Finding employment after school, certification, and licensure can be the most challenging test of all. In some cases, it could take several months and even relocation to find your first job in the field. But it's important to stay positive and proactive. Employers want people with both the right credentials and the right attitude.
• Hospitals are usually the target for most new radiologic technologists looking for work, but you might have better luck if you aren't so picky in the beginning. Urgent care clinics are sometimes good places to find your first job and to gain the experience that will make you more attractive to other employers. (Don't expect to land your dream job right out of school. You will probably need to make some compromises.)
• Once employed, you are likely to learn even more than you did while in school. You'll need to be prepared to learn ongoing.

How Long is Schooling for X-Ray Technician or Radiologic Technologist Careers?

The schooling for x-ray technicians is usually much shorter than the schooling for radiologic technologists. In fact, x-ray technician training generally only takes around six to 12 months and ends with a diploma or certificate of completion (not a degree).

Radiologic technologists, however, must go to school for at least two years. But you should also know the following:

• Most associate's degree programs in radiologic technology are designed to take two years to complete. However, some of those programs require a number of prerequisites before you can apply. Depending on the school and program, this can mean spending about two years completing the prerequisite coursework before even starting the radiologic technology program.
• Bachelor degree programs in radiologic technology are also available at some schools. They are designed to take about four years depending on the coursework required.
• If you choose to pursue a specialty in radiologic technology (anything other than radiography), then you will have to undergo additional formal training at some point. For instance, CT programs tend to take about six months, MRI programs usually last 12 to 18 months, and other programs range in between.

How Much Does an Education in Radiologic Technology Cost?

The cost of a radiologic technology education varies substantially depending on the type of school you choose, the length of the program, and the credential you're after. Total costs can range from as little as about $4,000 to ten times that much ($40,000 or more).

When choosing a school, keep in mind that costs are sometimes reflective of the kind of equipment students have access to during their program. Some schools do a job better than others at staying up-to-date with the latest technologies and learning materials.

Most post-secondary institutions can help you obtain financial assistance in the form of loans or grants (if you qualify).

What Can I Expect to Learn in a Radiologic Technology Program?

Radiologic technology programs that are accredited by the Joint Review Committee on Education in Radiologic Technology (JRCERT) tend to include courses in subjects such as:

• Anatomy and physiology
• Medical terminology
• Patient care
• Medical ethics
• Radiation biology
• Physics of radiography
• Radiation protection
• Radiographic pathology
• Radiologic positioning
• Radiographic exposure

In addition to coursework, most programs also include a real-world clinical component (after the first year of classes) in which students learn how to:

• Provide accurate and compassionate patient care
• Communicate with patients and other members of a medical team, which can include doctors, nurses, and experienced radiologic technologists
• Operate technologically advanced radiologic equipment
• Acquire and process diagnostic images
• Solve problems

What are the Advancement Opportunities for Radiologic Technologists?

Radiographers represent the majority of workers in the field of radiologic technology. However, many radiologic technologists do attain multiple skills so that they can work in one of the other specialties such as CT, MRI, or nuclear medicine. Still, having multiple skills does not necessarily mean that you have advanced in your career. It tends to move you horizontally rather than vertically (even if you achieve better pay).

Currently, the primary opportunities for advancement in radiologic technology exist in management, sales, consulting, or teaching. But those types of opportunities take you out of the clinical environment in which you get to treat patients.

Nevertheless, there is a relatively new movement toward establishing an additional career level in radiologic technology that would represent true advancement in the clinical area. There aren't many of them yet, but radiologist assistants (under the supervision of radiologists):

• Act as radiology "extenders"
• Support and relieve the workload of radiologists
• Assist with patient education and assessments
• Can evaluate diagnostic images
• Can order follow-up images
• Can perform select interventional procedures and routine fluoroscopic ones

Registered radiologic technologists that have lots of experience and wish to become radiologist assistants must complete a formal continuing education program for this advanced occupation and become certified as a Registered Radiologist Assistant (R.R.A.) by meeting the necessary requirements and passing the appropriate exam from the ARRT.

What is the Job Outlook for X-Ray Technicians and Radiologic Technologists?

The job outlook for x-ray technicians and radiologic technologists is promising due to the aging population, technological advancement, and growing demand for diagnostic imaging exams and other radiologic procedures. In fact, the employment of workers within the field of radiologic technology is expected to increase by 28 percent between 2010 and 2020 (faster than average).*

But although the demand for radiologic technologists is increasing, the supply of them is also increasing. This means that you can expect the competition for available jobs to be fierce in many regions. You may find that you have to move to a different location in order to more easily secure employment in this field.

Plus, the more sub-specialties you are trained and certified in, the more attractive you'll be to highly sought-after employers such as hospitals and advanced imaging centers.

How Can I Get Started?

If you are determined to pursue a career as an x-ray technician or radiologic technologist, then exploring your schooling options is a good way to begin. Check out this list of radiologic technology and x-ray technician schools to get a jump start on finding one in your area. Then get ready to start training for a career that could enable you to help people while also working with some of the most advanced technology on the planet.

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Main Sources

* Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2012-13 Edition, web site last accessed on August 7, 2012.

American Society of Radiologic Technologists (ASRT), web site last accessed on August 7, 2012.

American Registry of Radiologic Technologists (ARRT), web site last accessed on August 8, 2012.

Joint Review Committee on Education in Radiologic Technology (JRCERT), web site last accessed on August 8, 2012.