How to Become an X-ray Tech

  • X-ray techs assess patients, position them correctly during diagnostic imaging, operate imaging equipment, and apply basic radiology skills and knowledge to reduce radiation exposure.
  • The minimum educational requirement (an associate’s or a bachelor’s degree), necessary certifications, and licenses to become an official X-ray tech are similar to a radiology technician.
  • There are ample opportunities for X-ray technicians to broaden their career paths. For example, X-ray techs may earn more credentials to specialize in other radiology-related fields such as nuclear medicine, MRI, and CT. 
  • Radiographers with certification or licensure may pursue further education in related specializations.

What Is an X-ray Tech?

An X-ray tech is a healthcare practitioner who uses specialized imaging equipment such as an X-ray machine for diagnostic purposes.
X-ray technicians assist physicians and other medical personnel with patient care. Technicians are also frequently in charge of correctly positioning patients for x-rays and ensuring the highest quality images.
The Bureau of Labor Statistics (BLS) online occupational handbook considers medical X-ray imaging as a specialization in radiologic technology(1).
However,  “X-ray tech” and  “X-ray technologist” may refer to the same profession and are often interchangeable(2). Another similar title for the position is “X-ray technician(3).” 

Radiologic Technologists and Technicians

Radiology technologists perform an initial assessment on patients, position them correctly during diagnostic imaging, operate the imaging equipment, and apply basic radiology skills and knowledge to minimize the patient’s radiation exposure.
Radiology is a branch of medicine that focuses on medical imaging to diagnose disorders and develop treatment plans for patients.
Specific doctors, such as radiologists, order imaging procedures to confirm a suspected diagnosis based on symptoms, clinical records, and diagnostic exams, like laboratory exams and electrocardiograms (ECGs).
Schools and institutions use the terms “radiologic technician” and “radiology technologist” interchangeably because these titles often refer to the same occupation(4). Other similar designations for these terms may include: 

  • Radiographer(5)
  • Radiologic technician
  • Radiology technologists
  • Radiology tech
  • Radiologic tech
  • Rad tech

Radiologic technologists can specialize in various fields, including:

  • Magnetic resonance imaging (MRI)
  • Computed tomography (CT)
  • Cardiac-interventional radiography
  • Vascular interventional radiograph
  • Mammography
  • Sonography
  • Bone densitometry
  • Nuclear medicine

The American Registry of Radiologic Technologists (ARRT) notes that radiologic technologists are the third-largest group of healthcare professionals, following doctors and nurses in terms of numbers(6).

Education, Training, and Other Requirements

Individuals who want to work as X-ray techs should have a good grasp of physics and mathematics and have good interpersonal skills and critical thinking.
Physiology, computer sciences, biological sciences, chemistry, physics, and algebra are some high school classes that aspiring X-ray technicians can take(7).
Since X-ray technology and radiology technology belong to the same category,  the educational requirements for X-ray techs and rad techs may also be the same(8).
The steps below summarize the usual prerequisites and education requirements for working as a rad tech or X-ray tech:

  1. Pass the GED test or finish high school
  2. Complete an accredited educational program.

Aspiring X-ray techs typically receive two to four years of post-secondary education. Students can begin earning an associate degree or a bachelor’s degree.
An associate’s degree in a radiologic technology program may be completed within 24 months of study(9). On the other hand, a bachelor’s degree usually needs four years of coursework.
Typical coursework may include anatomy, pathology, patient care, radiation physics and protection, and imaging sciences.
Medical institutions and imaging centers may demand X-ray technicians to earn formal educational credentials through a hospital or community college accredited programs.
The credentialing agency for educational programs in radiation therapy, magnetic resonance imaging, and radiography is the Joint Review Committee on Education in Radiologic Technology (JRCERT)(10).
Students who aim to sit in a professional certification or state licensure exam can find schools with an associate of applied science degree (AAS) in radiologic technology(11).
An AAS in rad tech is typically a 75-hour degree consisting of introductory courses and professional radiologic technology coursework(12).

  1. Finish a certificate program.

In the United States, earning an ARRT certification is a standard pathway X-ray or rad tech graduates take to stand out in their field. 

Licensing and Certification

According to the Bureau of Labor Statistics (BLS), individuals who apply for a license in radiologic technology must be graduates of accredited programs(13).
Furthermore, the applicant must pass a state certification exam or obtain accreditation from an accreditation agency(14).
Graduates of a JRCERT-approved degree program are eligible to apply to take the American Registry of Radiologic Technologists national certification exam (ARRT)(15).

Wages and Benefits

The BLS recorded that the median annual salary for radiologic technologists and technicians in May 2021 was approximately $61,370(16).
In May 2021, the following were the median annual salary for radiologic technologists and technicians working in the primary industries(17):

The Federal government, excluding postal service$71,530
Outpatient care centers$67,240
Medical and diagnostic laboratories$62,410
Hospitals; state, local, and private$61,670
Physicians’ offices$59,500

Some advantages of working as a radiology technician include:

  • An individual can become a radiology technologist after only two years of study in an AAS program.
  • According to the table above, a radiology technician is one of the highest-paying full-time professions in the United States.
  • From 2020 to 2030, the US Bureau of Labor Statistics presumes a 9% increase in overall employment of radiologic and MRI technologists. 

This prediction indicates that rad techs will have a good job outlook(18).

  • There are numerous opportunities for X-ray techs to broaden the scope of their career paths. Radiographers who have certification or license may pursue additional training in related specializations.

Job Outlook

The Bureau of Labor Statistics presumes a 9% growth in overall employment of radiologic and MRI technologists between 2020 and 2030(19).
The BLS predicts that radiologic and MRI technologists will have 20,800 job opportunities per year over the next ten years.
Many of the opportunities mentioned may arise due to individuals leaving the workforce because of retirement or career changes(20).

Important Tasks and Related Skills

X-ray techs are frequently in charge of correctly positioning patients for x-rays, ensuring the highest quality images, and performing other duties such as:

  • Inject vital trace agents 
  • Administering X-ray imaging procedures
  • Upkeeping imaging equipment
  • Managing radiation exposure for patients(21) 

Radiologic or X-ray technicians work in hospitals, nursing homes, and doctor’s offices and clinics. These professionals can work with patients of all ages and within various specialties, including pediatrics, cardiology, and pulmonary medicine.
Some technical skills that can be advantageous for X-ray technologists include:

  • Sensitometry skills: Radiology technicians must be keen to use sensitometers to monitor and evaluate how radiation and processing affect the film emulsion.
  • Mathematical skills: X-ray techs need math skills to use accurate calculations when mixing chemicals used in X-ray imaging processes. 

The study of mathematics can develop critical and logical thinking, which are helpful in an X-ray tech daily.
Mathematical thinking can be advantageous because working with imaging technology and machines entails obtaining detailed images for physicians to examine.

  • Anatomical, physiological, and medical knowledge: X-ray techs should be able to apply their learning of human anatomy, have cross-disciplinary clinical experience, and understand general medical and surgical concepts.
  • Technological skills: X-ray techs must be capable of calibrating X-ray machines, employing imaging procedures, and adjusting the duration and dosage of radiation exposure.

Some “soft skills” that can boost the productivity and effectiveness of X-ray techs include:

  • Excellent communication: X-ray technicians may need to thoroughly explain X-ray protocols and expectations to patients at each stage of the treatment process. 

If a patient has an inquiry about a procedure or a tool, X-ray technicians should be ready to give clear and straightforward answers.
Therefore, written and verbal communication are critical components of the job of an X-ray technician.
X-ray techs usually need to fill out medical forms and patient histories correctly so that those reading the information can understand the findings.
Other medical professionals will frequently use the results of X-ray procedures to make a proper diagnosis.

  • Ability to empathize: Some X-ray patients may be concerned about the X-ray procedure, the results of their X-ray exam, or both. 

Other patients may have a history of physical distress that prompted their doctor to order an X-ray imaging. X-ray technicians must be compassionate to their patients.

  • Attention to details: X-ray technologists must pay close attention to subtleties when recording X-ray images.

X-ray techs control the image’s resolution, angle, coloring, and other parameters that influence how well a physician can perceive potential diagnoses.

  • Physical stamina: X-ray technicians must be capable of lifting and carrying patients who require assistance and can stand for extended periods during their shifts.

Schools and Colleges

Health care facilities and diagnostic centers may require X-ray techs to complete structured accredited education programs at a hospital or community college.
The Joint Review Committee on Education in Radiologic Technology (JRCERT) received an acknowledgment from the Council for Higher Education Accreditation (CHEA) and the United States Department of Education (USDE) as the only credentialing agency for the accreditation of traditional and distance delivery programs in radiography and other related fields(22).
Individuals interested in pursuing a full-time career in radiologic technology may check the website of JRCERT to see what schools and programs are JRCERT-approved.

Career Requirements for X-ray Technicians 

The career requirements for an official X-ray tech are the minimum educational requirements, necessary certifications, and licenses listed above.

History of X-ray

Wilhelm Conrad Roentgen (1845-1923), a Professor at Wuerzburg University in Germany, discovered X-rays in 1895(23).
He also discovered that the new ray could move through most materials and cast shadows of solid objects. Roentgen found that the ray could travel through human tissue but not bones or metal objects(24).
Within a month of the discovery’s announcement, several medical radiographs became available in Europe and the United States, which helped advise surgeons in their work(25).
In many aspects, radiography has not changed much since its inception. Practitioners still use a detector opposite the X-ray source to capture a shadow image of the sample.
Moreover, procedures and processes technicians still use films that were also used in the late 1800s(26).
Radiography, computerized tomography (CT), and fluoroscopy operate within the same basic principle: an X-ray beam passes through the body, where some of the X-rays are absorbed or scattered by the internal systems(27).
The rest of the  X-ray pattern radiates to a detector (e.g., film or a computer screen) for capturing or further refining by a computer.

Benefits and Risks of X-ray

The invention of CT and the discovery of X-rays represented significant advances in medicine. X-ray imaging exams are a popular and valuable medical tool for many examinations and procedures.

X-rays may benefit individuals in the following ways(28):

  • Noninvasively and painlessly assist in disease diagnosis and therapy monitoring.
  • Assist in planning medical and surgical treatments
  • Guide medical personnel when inserting catheters, stents, or other devices into the body, treating tumors, or removing blood clots or other blockages.

As with many facets of medicine, some risks may be linked with X-ray imaging, which uses ionizing radiation to produce body images.
Ionizing radiation has sufficient radiation energy to harm DNA possibly. Ionizing radiation exposure poses the following risks(29):

  • Tissue changes such as cataracts, skin reddening, and hair loss occur at relatively high levels of radiation exposure but are uncommon for many imaging modalities. 

However, the dose to the skin from long, complex interventional fluoroscopy procedures may be high enough to cause such effects.

  • A slight increase in the likelihood of a person being exposed to X-rays developing cancer later in life.

Nonetheless, the benefit of a clinically appropriate X-ray imaging test far outweighs the risk(30). However, practitioners must still make efforts to reduce this risk by avoiding unnecessary ionizing radiation exposure.
After deliberating of the patient’s health needs, an X-ray tech will perform X-ray imaging (CT, fluoroscopy, and radiography)(31).
These procedures are only necessary when the referring physician believes it is essential to answer a clinical inquiry or guide medical interventions. 

How Do Medical X-rays Work?

Positioning a patient so that the part of the body that the technician wants to photograph is between an X-ray detector and X-ray source is the method for creating a radiograph.
When the X-ray technician turns on the machine, X-rays travel through the body, and different tissues absorb these rays in different amounts, depending on the radiological density of the tissues(32).
The density and the atomic number (the number of protons in an atom’s nucleus) of specific materials under consideration determine the radiological density of the materials.
Photographic film is one type of X-ray detector. However, there are many other procedures for creating digital images. Radiographs are the X-ray images produced as a result of these procedures.

Is It Hard to Become an X-ray Tech?

Switching from high school to a career as an X-ray tech may not be as difficult as some claim to be the case.
In X-ray or rad tech coursework, there are no proper mathematics classes. However, X-ray techs may still need to understand mathematical equations and be able to perform basic algebraic calculations.

Related Occupations

The occupations listed below have job duties that are similar to those of X-ray techs and radiology technicians:

  • Dental Assistants
  • Surgical Technologists
  • Neurodiagnostic Technologists
  • Dental Hygienists
  • Licensed Practical and Licensed Vocational Nurses
  • Nuclear Medicine Technologists
  • Cardiovascular Technologists and Technicians
  • Diagnostic Medical Sonographers
  • Endoscopy Technicians
  • Radiation Therapists

  1. What Radiologic and MRI Technologists Do https://www.bls.gov/ooh/healthcare/radiologic-technologists.htm#tab-2
  2. 5 Differences Between RT (Radiologic Technologist) and LMRT (Limited Medical Radiologic Technologist)
    https://www.chcp.edu/blog/5-differences-between-rt-and-lmrt/
  3. What’s the Difference Between an X-Ray Tech and Limited Scope X-Ray Technician?
    https://mtschool.edu/limited-scope-x-ray-technician-program/
  4. What’s the Difference Between a Technician and Technologist in Radiology?
    https://www.cambridgehealth.edu/blog/whats-the-difference-between-a-technician-and-technologist-in-radiology/
  5. What Radiologic and MRI Technologists Do
    https://www.bls.gov/ooh/healthcare/radiologic-technologists.htm#tab-2
  6. What Do Radiologic Technologists Do?
    https://www.arrt.org/pages/about-the-profession/learn-about-the-profession/what-do-radiologic-technologists-do
  7. Radiologic Technologist
    https://college.mayo.edu/academics/explore-health-care-careers/careers-a-z/radiologic-technologist/
  8. What Is the Process of Becoming an X-Ray Technician?
    https://www.cambridgehealth.edu/blog/what-is-the-process-of-becoming-an-x-ray-technician/
  9. How to Become an X-Ray Tech: A Step-by-Step Guide
    https://www.rasmussen.edu/degrees/health-sciences/blog/how-to-become-xray-tech/
  10. About JRCERT
    https://www.jrcert.org/about-jrcert/
  11. What to Know About X-ray Tech Programs and Radiography Degrees
    https://www.cleveland.edu/blog-post/~post/what-to-know-about-x-ray-tech-programs-and-radiography-degrees-20180419/
  12. Radiologic Technologist (Radiographer): 3 Steps to Be One
    https://www.cleveland.edu/blog-post/~post/radiologic-technologist-radiographer-3-steps-to-be-one-20201020/
  13. How to Become a Radiologic or MRI Technologist
    https://www.bls.gov/ooh/healthcare/radiologic-technologists.htm#tab-4
  14. Ibid.
  15. How to Become an X-Ray Tech: A Step-by-Step Guide
    https://www.rasmussen.edu/degrees/health-sciences/blog/how-to-become-xray-tech/
  16. Pay
    https://www.bls.gov/ooh/healthcare/radiologic-technologists.htm#tab-5
  17. Ibid.
  18. Radiologic and MRI Technologists
    https://www.bls.gov/ooh/healthcare/radiologic-technologists.htm
  19. Ibid.
  20. Ibid.
  21. What Is the Process of Becoming an X-Ray Technician?
    https://www.cambridgehealth.edu/blog/what-is-the-process-of-becoming-an-x-ray-technician/
  22. About JRCERT
    https://www.jrcert.org/about-jrcert/
  23. History of Radiography
    https://www.nde-ed.org/NDETechniques/Radiography/index.xhtml
  24. Ibid.
  25. Ibid.
  26. Radiography Testing Introduction
    https://www.nde-ed.org/NDETechniques/Radiography/Introduction/history.xhtml
  27. Medical X-ray Imaging
    https://www.fda.gov/radiation-emitting-products/medical-imaging/medical-x-ray-imaging
  28. Ibid.
  29. Ibid.
  30. Ibid.
  31. Ibid.
  32. X-rays
    https://www.nibib.nih.gov/science-education/science-topics/x-rays

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