A career in radiography

Careers information

What does a radiographer do?

Click on the radiographer’s photo below to see their individual profiles: 

Radiographers are at the heart of modern medicine. There are two sorts of radiographer: diagnostic and therapeutic.

Diagnostic radiographers employ a range of different imaging techniques and sophisticated equipment to produce high quality images of an injury or disease. Diagnostic radiographers will take the images and very often report on them so that the correct treatment can be given. They use a range of techniques including:

• X-rays – to look through tissue to examine bones, cavities and foreign objects; 
• Ultrasound – uses high frequency sound and is increasingly used due to its versatility in obstetrics, including fetal monitoring throughout pregnancy, gynaecology, abdominal, paediatrics, cardiac, vascular and musculo-skeletal; 
• Fluoroscopy – to image the digestive system providing a live motion x-ray; 
• CT (computed tomography) – which provides cross-sectional views (slices) of the body; 
• MRI (magnetic resonance imaging) – builds a 2-D or 3-D map of different tissue types within the body; 
• Nuclear medicine – this uses radioactive tracers which can be administered to examine how the body and organs function, for example the kidneys or heart. Certain radioisotopes can also be administered to treat particular cancers, eg, thyroid cancer; 
• Angiography – to investigate blood vessels. 

Therapeutic radiographers play a vital role in the treatment of cancer as the only health professionals qualified to plan and deliver radiotherapy. Radiotherapy is used either on its own or in combination with surgery and/or chemotherapy. They manage the patient pathway through the many radiotherapy processes, as outlined below, providing care and support for patients throughout their radiotherapy treatment.

Therapeutic radiographers are trained in all the many aspects of radiotherapy including:

• Simulation – using specialist x-ray fluoroscopy machines to target the area to be treated while minimising the amount of exposure to surrounding healthy tissue; 
• CT/MR simulation – producing scans to be used for the planning of a course of radiotherapy; 
• Computer planning – producing a 3-D plan of the dose distribution across the area to be treated; 
• External beam treatment – using ionising radiation, such as high-energy x-rays, the radiographer delivers accurate doses of radiation to the tumour; 
• Mould Room – radiographers in the Mould Room plan the treatment of and produce immobilisation/beam attenuation devises for those receiving radiotherapy to the head or neck; 
• Brachytherapy – the use of small radioactive sources placed on or in tumours to treat to a high dose while avoiding normal tissues; 
• On treatment review – radiographers regularly assess patients while they are undergoing radiotherapy, prescribing drugs to counteract side effects where necessary or referring them on to other health professionals if needed. 

Skills

Both diagnostic and therapeutic radiographers need a range of skills including:

• Good interpersonal skills to communicate with other members of the team and to provide support for patients who may be frightened or uncertain about what is going to happen. Therapy radiographers in particular get to know patients because they see them regularly through the course of treatment. It is important they can develop a rapport with the individual and their family; 
• Knowledge of, and an interest in, the sciences, such as biology, anatomy and physiology; 
• The confidence (after appropriate training) to work with leading-edge technology; 
• Excellent attention to detail;
• The ability to learn new skills and adapt – radiography is constantly changing; 
• To make decisions quickly and independently. 

All radiographers work to a Code of Conduct and Ethics which sets out the underpinning values and principles to promote, maintain and disseminate the highest standards of behaviour in order to enhance the good standing and reputation of the radiography profession: http://doc-lib.sor.org/code-conduct-and-ethics

Why should I want to be a radiographer? 

Both diagnostic and therapeutic radiographers provide essential services every year to millions of people. Radiography is the fulcrum around which the rest of medicine revolves.

For example, without detailed, high quality images of what is happening inside the body, diagnosis would be significantly more difficult, treatments would not be as effective and valuable time may be lost. The skills of a diagnostic radiographer are used to identify a broad range of injuries and diseases, including cancer.

Radiotherapy for cancer has also become increasingly important with six out of ten patients who receive treatment being cured. A therapy radiographer will target radiation at the site of the tumour, seeking to send the cancer into remission. The therapy radiographer is closely involved in the planning of the course of treatment, as well as the delivery. S/he gets to know the patient, explains to them what is involved and answers any concerns. Day-by-day, they monitor progress and provide support.

Radiographers are responsible for equipment that would not be out of place in an episode of Star Trek. Departments in larger hospitals can have huge capital expenditure budgets. The top of the range machines cost more than a million pounds. Promotion opportunities are excellent, with a grading structure that sees the radiographer's salary increase as s/he moves up the profession. British radiographers are recognised as being among the best in the world.

Work experience

To get a feel for what being a radiographer is really about, doing work experience in a radiography department is an excellent way.

Most welcome giving school leavers the opportunity to spend a few days shadowing a working radiographer.

One word of warning: some NHS trusts have a policy of not allowing under 18s to do work experience, particularly in radiotherapy departments. Check with your local hospital, but be prepared to look further afield if necessary.

How to become a radiographer? 

What qualifications do I need?

"The best radiography students have a balance between a good understanding of the sciences and a genuinely caring attitude," says Louise Harding, Clinical Tutor at Warrington Hospital.

"Above average science skills are important because a significant part of the degree course involves anatomy, physiology and pathology.

"Ideally, you should have an interest in science, have good GCSE grades and at least one science A–level with a total of three A–levels at grade C, but this will vary between universities. Maths skills can also be helpful but students shouldn’t be put off by the science element as this is just a small part of a radiographer's role."

Hands-on experience

A significant part of a three-year BSc degree in diagnostic or therapeutic radiography is spent working in diagnostic radiography or radiotherapy departments. There is time spent in the classroom, of course, but it is important to introduce the student into the ‘real world’ as quickly as possible.

Some universities prefer students to be placed in a handful of hospitals, giving them time to get to know the department and how they work. Others take the view that ‘variety is the spice of life’ and it is not unusual for a student to have as many as nine placements over the duration of the course. They range from busy urban hospitals to smaller community hospitals. This approach also provides students with the opportunity to sample specialist disciplines, such as paediatric radiography.

Lucy Smith, who qualified last year, warns that if a student is looking for an easy option, radiography is not it.

"You have to work hard consistently. Students on other courses only have to attend classes for eight hours a week. If you’re studying radiography, it's eight hours a day, every day," she says.

"Like all students, we loved to party but if you have patients to see the next morning, you can’t be out too late."

Everyone knows how expensive it is to be a student these days, but radiography students pay no tuition fees and they may qualify for a NHS bursary.

The money

A newly qualified radiographer does not earn big bucks, particularly when compared with the potential earnings of some other graduates. The starting pay is £21,176, while in London and parts of the south of England, there are cost of living supplements that can push pay slightly higher, but Lucy Smith has no doubt that the job has other compensations. 

"Radiography is a growing profession and job security is second to none. The number of radiographers that the National Health Service needs is steadily increasing."

How does she feel about working for the NHS?

"Don’t believe everything you read. The National Health Service has its problems, but I know that the professionals who work in it are providing an unrivalled standard of care," Lucy says.

Career progression

Promotion opportunities are excellent with a grading structure that sees the individual’s salary increase as they move up the profession. There are also management opportunities. 

Radiographers now have the opportunity to become consultant practitioners, allowing them to reach a more senior level of management, while retaining a high level of clinical practice and working with patients. There also are opportunities to move into teaching or research.

Once you’ve qualified, there is a wide choice of job opportunities. A radiography degree is a recognised vocational qualification. UK trained radiographers are recognised as being among the best in the world. 

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Click here to view a video which describes the work of a diagnostic radiographer and the different modalities involved. It was filmed at the Mater Dei Hospital in Malta.