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A career in radiography
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 delivery of radiotherapy services. They are the only healthcare professionals qualified to plan and deliver radiotherapy. They constitute over 50% of the radiotherapy workforce, working with clinical oncologists, medical physicists and engineers.
Therapeutic radiographers are responsible for the planning and delivery of accurate radiotherapy treatments using a wide range of technical equipment. The accuracy of these are critical to treat the tumour and destroy the diseased tissue, while minimising the amount of exposure to surrounding healthy tissue. Their degree qualified training solely in oncology and the care of cancer patients makes them uniquely qualified to undertake this role.
The newer treatment techniques, such as Intensity Modulated radiotherapy, Image Guided radiotherapy and adaptive radiotherapy, require decision making at the point of treatment delivery at each treatment to ensure the optimum personalised treatment plan is delivered accurately at every treatment.
Therapeutic radiographers are extensively involved at all stages of the patients' radiotherapy journey:
• Pre-diagnosis – giving health promotion advice and raising awareness of cancer.
• Patient consent – working with patients to enable them to make informed decisions about their treatment options.
• Pre- treatment preparation and planning – this includes use of sophisticated equipment, such as CT and MRI scanners, to scan patients and the use of computer planning systems to plan complex dose distributions across the required treatment area of each individual patient. As well as the preparation of any required devices individually made for each patient to ensure the accurate delivery of their treatment
• Treatment delivery – the use of a range of radiotherapy equipment to deliver accurate doses of radiation to each patient. The most commonly used machines for external radiotherapy are called linear accelerators, however, there are many other types of equipment. Therapeutic radiographers are also involved in giving internal radiotherapy treatments called brachytherapy.
• Patient management during treatment – the regular assessment of patients whilst undergoing treatment. Many radiographers qualify to prescribe drugs for patients to counteract the side effects of treatment. They are also responsible for the psychosocial well being of their patients whilst they are attending for treatments.
• Patient follow up, management and care after treatment has finished.
As Allied Healthcare Professionals, therapeutic radiographers undertake clinical practice at all levels;
• Consultant practitioner
• Radiotherapy service manager
A growing number of radiographers undertake tumour site specific roles or specialist treatment roles (at both advanced and consultant level practice), where they are responsible for their own patient load from treatment referral, through treatment to post treatment follow-up. They are part of the multi-disciplinary approach to patient management by attending and participating in MDT (multi-disciplinary team) meetings. These post holders provide continuity of care for their patients across their cancer journey with improved levels of care for their patients as well as efficiency benefits for the service.
Therapeutic radiographers are also involved in clinical research at all levels; ranging from recruitment to trials through to radiographer-led research studies to evaluate the newer technologies and techniques as part of providing evidence based practice.
They can also specialise as community liaison practitioners. These post holders provide continuity of care between all health care providers. They also support and educate staff in the primary care services to understand and manage the side effects experienced by radiotherapy patients after they have finished their course of treatment.
Radiotherapy Service Managers are professional qualified managers responsible for the strategic delivery and planning of the service along with the day-to-day operational management of radiotherapy services. Their professional training and expertise is critical to the provision of safe and efficient radiotherapy services.
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, physics, 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.
Radiographers need to be quite physically fit. They may be on their feet most of the day and there is some moving and lifting of patients and equipment involved.
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.
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 physics, anatomy, physiology and pathology."
For current entry requirements, contact the university admissions tutors.
A significant part of a programme leading to qualification 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 ‘clinical world’ as quickly as possible.
Some universities prefer students to be placed in one or two 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.
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.
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.
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.