The American Society of Radiologic Technologists (ASRT) is the national association for medical imaging and radiation therapy professionals with a mission to advance and elevate the profession and to enhance the quality and safety of patient care. The ASRT has a membership of more than 156,000, which includes radiation therapists and medical dosimetrists, and provides practice standards, continuing education and professional development opportunities for both professions.

Understanding the need

According to the 2022 ASRT Radiation Therapy Workplace and Staffing Survey, the overall vacancy rate for radiation therapists increased to 10.7%. The vacancy rate represents the number of positions that are open and actively being recruited. The 2022 vacancy rate for radiation therapists increased from the 7.2% rate reported in the 2020 staffing survey. The vacancy rate for medical dosimetrists increased from 9.6% to 11.3%.

The report highlighted information about workforce demographics. Although vacancy rates saw sizable increases, the average number of radiation therapists budgeted per facility rose marginally from 7.1 in 2020 to 7.3 in 2022. The number of budgeted dosimetrists fell slightly from 2.5 in 2020 to 2.4 in 2022.

The survey respondents worked in facilities that offer an average of 14.2 radiation therapy-related services, with the most common being intensity modulated radiation therapy (96.6% of responding facilities), computed tomography (CT) simulation (94.8%) and cone beam CT (93.5%).

ASRT emailed the biennial survey to 14,520 radiation therapists in June 2022. At the close of the survey in July 2022, 629 respondents from all 50 states had submitted completed questionnaires, a response rate of 4.3%.¹

To address these trends, ASRT joined forces with the American Registry of Radiologic Technologists (ARRT) and the Joint Review Committee on Education in Radiologic Technology (JRCERT) to better understand the factors impacting workforce shortages and to address needs and support medical imaging and radiation therapy professionals.

Together, the ASRT, ARRT and JRCERT created the 2023 Professional Workforce survey to initiate data-informed solutions. The ARRT, Joint Review Committee on Education in Diagnostic Medical Sonography and Joint Review Committee on Educational Programs in Nuclear Medicine Technology sent the 2023 Professional Workforce survey to 353,489 registered and credentialed medical professionals. A total of 8,701 responded to the survey yielding a 2.5% response rate. The sample size of 8,701 yields a ±1.0% margin of error at its widest for a 95% confidence level.

In the 2023 Professional Workforce survey, respondents were asked several questions around their employment status. Among those who are registered and certified but not working at all in medical imaging or radiation therapy, the most common reason by a considerable margin was that they are retired.

Most respondents had not changed jobs in the last year. The 16% who have changed jobs in the past year were asked why they left their most recent position, and a majority of those had resigned. The five most common reasons that respondents shared for resignation included that they:

• Changed jobs — a change to an equivalent position at another facility, a promotion or a relocation.
• Left due to burnout.
• Left for better pay elsewhere.
• Left due to problems with management.
• Left for more desirable hours elsewhere.

The results of the 2023 Professional Workforce survey will be included in a white paper from the Consensus Committee on the Future of Medical Imaging and Radiation Therapy published on the ASRT website in summer 2024.

The ASRT, ARRT and JRCERT hosted the Consensus Committee on the Future of Medical Imaging and Radiation Therapy, February 19-20, 2024, at the ASRT office in Albuquerque, New Mexico. Leadership from 18 organizations attended the event including, but not limited to, the American Association of Medical Dosimetrists, American Association of Physicists in Medicine, Association of Collegiate Educators in Radiologic Technology, Association of Educators in Imaging and Radiologic Sciences, AHRA-the Association for Medical Imaging Management, Medical Dosimetry Certification Board, Siemens Healthineers, Radiology Business Management Association and Society for Radiation Oncology Administrators.²

The consensus committee reviewed data from the 2023 Professional Workforce survey to work collaboratively and think critically about the future of the profession. The leadership group discussed factors contributing to current workforce shortages and solutions and career pathways in medical imaging and radiation therapy.

To address factors impacting the workforce shortage, consensus committee participants agreed on six goals to prioritize for action: Provide tools and suggestions to improve workplace satisfaction, employee engagement and recognition. Articulate career pathways.

1. Create and strengthen the workforce pipeline in collaboration with education systems.
2. Expand opportunities for education and training that will meet the emerging needs of students and the profession.
3. Raise awareness, visibility and respect of the profession.
4. Create a career ladder for advancement and mentorship.

In conjunction with the discussion on strengthening the pipeline into the profession, the interdisciplinary radiation oncology members of the consensus committee were interested in national certification and professional association support for the emerging advanced practice radiation therapy (APRT) role. To move forward with developing the APRT, a task inventory, curriculum and education program accreditation standards need to be established based on evidence-based practice.

In addition, the radiation oncology leadership at the consensus committee recommends education tailored to working professionals, including recognition of competence in emerging technologies, such as proton therapy and magnetic resonance guided radiation therapy. To support this goal, the group suggests that ongoing dialogue with industry leaders will assist in the facilitation of professional development for emerging technologies. Finally, the consensus committee recommends membership and involvement in professional associations to synthesize these aims.

In summer 2024, a white paper of the consensus committee meeting will be published on the ASRT website. As a next step, supporting organizations will continue the conversation and begin taking action to advance solutions proposed by the consensus committee.

ASRT in action

To raise awareness about the radiation therapy and medical dosimetry professions, the ASRT launched a nationwide public relations campaign, including a commercial, interviews, emails and social media content. This campaign aims to educate the public and other health professionals about these roles and is available at asrt.org/BeSeen. At the date of this article’s submission, more than 28 million Americans have engaged with the campaign, and ASRT has approval from its Board of Directors to continue this communication push in different phases for at least five years.

“Health care wouldn’t be the same without medical imaging and radiation therapy professionals, but they often fail to receive the recognition they deserve,” said ASRT CEO and Executive Director Melissa B. Pergola, EdD, RT(R)(M), FASRT, CAE. “That’s why Danny Gonzales, ASRT chair of the Board and past president, championed this campaign to raise their visibility.”³

To support workforce development, ASRT offers Radiation Therapy Student Exam Assessment Library online practice tests and radiation therapy lymphatics study modules to help students confidently prepare for the radiation therapy certification exam. To support therapists entering the profession, ASRT created the Radiation Therapy Roadmap, which navigates through six months of preparation for the radiation therapy certification exam. Each milestone along the route provides timely review materials, study resources and valuable advice to help students successfully prepare for the exam and launch their career as a registered radiation therapist.

ASRT advances the radiation therapy and medical dosimetry profession by hosting the Radiation Therapy Conference annually, offering print, digital and livestream continuing education tailored to these disciplines, which are accepted by the ARRT and Medical Dosimetrist Certification Board, and leading advocacy for the profession at the state and federal level. Radiation therapists and medical dosimetrists are active in their chapters and shape their practice standards through ASRT governance. Additionally, ASRT offers a place for therapists and dosimetrists to discuss professional issues in the ASRT Communities.

The ASRT is taking several steps to support the APRT role, including an upcoming call for submissions to a special issue of ASRT’s peer-reviewed journal Radiation Therapist that will focus on APRT. This special issue aims to explore the critical aspects of APRT practice within the contemporary landscape of radiation oncology. ASRT participates in a quarterly interdisciplinary APRT working group co-led by ASRT members. In 2024, ASRT will launch a webpage highlighting the APRT role, resources and related research.

Radiation oncology teams value each professional role for the different practice areas and skills they bring to treating patients. These workforce efforts led by the ASRT aim to support the radiation oncology interdisciplinary team and prioritize professionals and patients in cancer care.