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. 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.
An x-ray technician is:
- Someone who has a limited permit to perform basic x-ray exams
- Sometimes known as a limited x-ray machine operator (LXMO), limited medical radiologic technologist (LMRT), radiologic technician, or limited radiology technician
- Different than a fully qualified radiologic technologist or a radiologist
X-Ray Technician vs. Radiologic Technologist
The main differences between these occupations are 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.
The Finer Distinctions
While exploring the field of radiologic technology, it's important to understand the finer differences.
- Are typically permitted (depending on the state they work in) to carry out only the kinds of routine exams that are sometimes done in outpatient doctors' offices (e.g., on patient chests, arms, legs, hands, or feet)
- Work mostly in doctors' offices and outpatient clinics
- Are frequently medical assistants 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
- 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 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
A Note About 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.
Duties can vary significantly since different states have different regulations and individual doctors' 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, they 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 exams of injured (or potentially injured) bones
- Ensuring that the areas of patients that don't need to be imaged are safely shielded from radiation during the procedures
- Developing 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
Although most are employed in the field of general radiography (taking traditional x-rays), many choose to specialize in very specific imaging techniques or therapies.
Generally speaking, they work closely with radiologists and often have duties such as:
Before Radiologic Exams
- 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
During Radiologic Exams
- 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
After Radiologic Exams
- 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
Throughout the Day
- 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
Radiologic Technology Specialization Options
- 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
Additional Radiologic Specialties
You should also know that radiologic technology isn't just about producing diagnostic images. Some highly skilled technologists specialize in helping to treat different types of cancer or other diseases. Those professionals 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
The most common workplaces for x-ray techs tend to be:
- Doctors' offices
- Orthopedic clinics
- Chiropractic offices
Radiologic technologists are employed in almost every type of healthcare environment. Due to their range of skills and optional specialties, they can be found working in urban, suburban, and rural workplaces such as:
- Outpatient diagnostic imaging clinics
- Medical imaging laboratories
- Doctors' offices
- Outpatient care centers
Some even 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.
According to Payscale.com, the median annual wages of limited scope x-ray technicians look like this: ***
- The median annual wage was $41,977.
- The highest-earning x-ray technicians made $56,000 or more.
Salaries in this occupation vary depending on chosen sub-specialties, work location, type of employer, and level of experience.
But based on national estimates from 2018, typical annual wages look like this: *
- Median annual wages were $59,520.
- The highest-earning 10 percent made $86,350 or more.
X-Ray Tech Qualifications
State Licensing and Exams
- It's a good idea to contact your state's radiation control licensure office to be sure you meet all of the requirements.
- Most states require a limited x-ray license before they can perform any 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.
- Different states use different titles when referring to licensed x-ray technicians. 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).
- The most common way to learn what you need to know for a licensing exam is completing a post-secondary x-ray technician training program that lasts a year or less. Such programs lead to a diploma or certificate.
Radiologic Technologist Qualifications
- 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.).
- 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.).
- The ARRT gives qualified candidates three attempts to pass its exam within a three-year period.
Schooling and Certification Eligibility
- 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 necessarily need to be in the radiologic sciences.
- To be eligible for the ARRT exam, you must also have demonstrated competence in a 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.
How to Become an X-Ray Technician or Radiologic Technologist
- It's a good idea 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).
- In terms of job opportunities, you can maximize your potential by combining your x-ray training with formal training to become a medical assistant or other allied health professional. (Learning how to become a radiological technician often involves learning about related healthcare occupations.)
- Once you are trained and licensed, patience and persistence can pay off. 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.
Finding a quality school is a good first step. Here are some other things to keep in mind:
Understand Your State's Requirements
It's a smart idea to contact your state's radiation control licensure office. That way, you'll have a clear understanding of the licensing requirements and what you'll need going forward.
Consider Program Accreditation
The Joint Review Committee on Education in Radiologic Technology (JRCERT) is one of the top accrediting organizations for post-secondary programs in radiologic technology.
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.
Get Professionally Certified and Licensed (If Necessary)
If required by your state or potential employers, you may need to obtain certification from the ARRT in order to become a Registered Technologist (R.T.).
Hospitals are a popular target for most new radiologic technologists looking for work, but you might also have luck by checking out urgent care clinics.
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.
On the other hand, radiologic technologists 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 programs may require some prerequisites before you can apply.
- Bachelor degree programs in this field 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.
- Radiologic technology programs 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
Advancement Opportunities for Radiologic Technologists
Radiographers represent the majority of workers in the field. 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.
Other opportunities for advancement exist in management, sales, consulting, or teaching.
There is also a relatively new movement toward establishing an additional career level in radiologic technology that would represent greater advancement in the clinical area. 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.
The outlook for both fields 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 13 percent between 2016 and 2026 (faster than average).**
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.
Benefits of a Career in Radiologic Technology
- Personal fulfillment from helping people—A sense of reward comes 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 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.
Exploring your schooling options is a great way to begin. Check out the schools in the list above to get a jump start on finding one in your area. Then request more information and 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.
* Bureau of Labor Statistics, U.S. Department of Labor, Occupational Employment Statistics, website last accessed on April 18, 2019.
** Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, website last accessed on October 4, 2018.
*** Payscale.com, website last accessed on June 11, 2019.
American Society of Radiologic Technologists (ASRT), website last accessed on January 23, 2018.
American Registry of Radiologic Technologists (ARRT), website last accessed on January 23, 2018.
Joint Review Committee on Education in Radiologic Technology (JRCERT), website last accessed on January 23, 2018.