Radiology is the branch of modern medicine that gives insight into an exciting and fulfilling career — especially if you have an eye to identify minute details, love technology, and want to be one of the top medical diagnosers. It is a subspecialty which combines both patient care and state-of-the-art imaging technologies to solve the mysteries that lie within the human body. In the United States, how to become a radiologist involves a journey of great commitment, intense schooling, and enormous job gratification.
There is a strong market demand for skilled radiologists. The U.S. Bureau of Labor Statistics (BLS) projects the growth of the employment of physicians and surgeons, such as radiologists, at 3 percent between 2022 and 2032. According to the Association of American Medical Colleges (AAMC), the number of active radiologists in the United States exceeded 35,000 in 2021. In addition, a recent survey by the American College of Radiology showed that more than 70 percent of diagnostic radiology residents continue their training in fellowship programs to even specialize, highlighting the field as specialized in its focus on expertise.
This article can be used as a comprehensive guide for those researching how to become a radiologist in the USA, as it describes the long process of education and training. It also discusses the related and equally important profession of a radiologic technologist and makes a clear comparison so you decide which profession suits you better depending on your personal and professional aims.
What is a Radiologist?
A radiologist is a highly trained medical doctor, having undergone long post-graduate training in interpretation of medical images in diagnosing, and in some cases treating, diseases and injuries. They are also commonly known as the doctor of the doctor since they assume a very important consultative role to other medical practitioners.
Radiologists play a key role in interpreting the images captured by the different technologies such as X-rays, CT (Computed Tomography) scans, MRI (Magnetic Resonance Imaging), ultrasound, and nuclear medicine to mention but a few and this helps in providing care to the patients, as simple as identifying a fractured bone and as complicated as identifying cancer in its most vital stages. This process is a critical component of diagnostic imaging, ensuring accurate assessments and better treatment outcomes.
Types of Radiology
Radiology can be discussed in two major areas, and each area has many subspecialties.
Diagnostic Radiology:
This is the most usual route. Diagnostic radiologists employ a vast range of imaging processes to diagnose and track diseases or trauma. They analyze the findings and make comprehensive reports to the referred practitioners. Subspecialties common include:
- Breast Imaging (Mammography): Provides information related to breast cancer detection and diagnosis by mammograms, ultrasounds, and MRIs.
- Cardiothoracic Radiology: Specializes in the heart, lungs, and other diseases of the chest. For example: a radiologist interprets a chest x-ray or CT scan looking for evidence of lung disease such as pneumonia or cancer.
- Abdominal Radiology: Focuses on the abdominal organs, such as the liver, kidney, and bowels.
- Neuroradiology: Focuses on the brain, spine, and associated structures of the head and neck.
- Musculoskeletal Radiology: Focuses on bones, joints, and soft tissue related to diagnosis of arthritis, sports injuries, and tumors.
- Pediatric Radiology: Specializes in the diagnosis of newborns, children, and adolescents related to illnesses and injuries.
- Nuclear Medicine: Nuclear Medicine specialty involves molecular diagnosis and treatment of disease by providing radiotracers, which are small amounts of radioactive materials.
Interventional Radiology:
It’s a very active subspecialty – it uses medical imaging to help perform surgery with small and minimal access incisions. Interventional radiologists diagnose and treat different types of conditions and diseases, usually without an open surgery. Examples of procedures include:
- Angioplasty and Stenting: opening blocked arteries and veins.
- Tumor Ablation: destroying cancer cells with heat or cold.
- Biopsies: getting tissue samples to examine by image guidance.
- Embolization: stopping the blood supply to tumors, or to a site of bleeding.
Are Radiologists Doctors?
Yes, unequivocally. Radiologists are physicians, and have either a Doctor of Medicine (M.D.) or a Doctor of Osteopathic Medicine (D.O.) degree. They have four years of medical school and at least five years of post-graduate training, comprising one-year internship and four-year residency in radiology. These radiology education requirements ensure they are registered doctors who have completed the same basic medical training as surgeons, pediatricians and other specialists, but have opted to specialize in medical imaging.
What’s the Difference Between a Radiologist and a Radiologic Technologist?
The functions, education, and responsibilities of a radiologist and radiologic technologist are different but they work collectively. In short, a radiologic technologist is the person who is trained to produce your medical image, while the radiologist is the medical expert who uses the image to arrive at a diagnosis and treatment.
| Feature | Radiologist | Radiologic Technologist (RT) |
| Primary Role | Interprets medical images, diagnoses conditions, consults with physicians, and performs interventional procedures. | Operates imaging equipment (X-ray, CT, MRI), positions patients, and captures high-quality diagnostic images. |
| Education | Medical Doctor (M.D. or D.O.) | Associate’s or Bachelor’s Degree |
| Total Training (Post-High School) | 13-15+ years | 2-4 years |
| Scope of Practice | Practices medicine, provides diagnoses, and recommends treatment. | Performs technical procedures under the direction of a physician. Does not interpret images. |
| Licensing | State medical license, board certification by the American Board of Radiology (ABR). | Certification by the American Registry of Radiologic Technologists (ARRT) and often a state license. |
What are the Prerequisites for Medical School if You Want to Become a Radiologist?
The route to radiology with the goal of becoming a radiologist or a graduate student radiologist begins long before entering any medical school. The prerequisites are the same for embarking on any medical profession. You can choose virtually any major, so long as you work through a core set of science and humanities courses for competitive applications.
Typical Pre-Medical Coursework:
- Biology: One year with lab (Introductory with lab and advanced classes, such as genetics or cell biology).
- Chemistry: Two years with lab (General Chemistry with lab, and Organic Chemistry with lab).
- Biochemistry: At least one semester.
- Physics: One year with a lab.
- Math: College level math (may be calculus and/or statistics).
- English/Writing: One year of composition and one year of literature.
Beyond coursework, a strong application requires:
- High GPA: Competitive GPA, mostly in the sciences, is most important.
- MCAT Score: A high MCAT score is important. The MCAT is a standardized test that assesses problem-solving, critical thinking, and knowledge of scientific concepts.
- Clinical Experience: Working or volunteering in a clinical setting (hospital, clinic) sends a message you are committed to medicine. It is also highly recommended that you spend time shadowing physicians, particularly radiologists.
- Research Experience: Research, in either basic science or clinical studies, is viewed very favorably by admissions committees.
- Extracurricular Activities & Leadership: Meaningful involvement in extracurriculars and leadership positions indicates a well-rounded person.
What Does a Radiologist Do?
The daily life of a radiologist is dynamic and intellectually stimulating. While a good part of the day is spent in the reading room (a quiet dark room outfitted with multiple high-resolution monitors), radiologists will do a lot more than just interpreting images.
A standard day may include:
- Reading and Interpreting Studies: Reviewing hundreds of images generated from various imaging modalities (X-ray, CT, MRI, Ultrasound) and dictating reports (or some similar method) documenting their impressions while interpreting those images.
- Consulting with Physicians: Discussing cases with referring physicians (i.e., emergency physicians, surgeons, oncologists) to correlate their imaging findings with the patient’s clinical condition and assist with a treatment plan.
- Performing procedures: Interventional radiologists spend much of their day in procedure suites performing minimally invasive surgery on patients. Some diagnostic radiologists perform procedures as well (e.g., fluoroscopy, which is real-time X-ray imaging; or image-guided biopsies, where a radiologist uses an image from a previous study to guide a biopsy needle into the lesion).
- Interacting with patients: Although less frequently than some physicians in any other specialty, radiologists also do communicate with patients more than one might expect. This can include performing procedures, discussing results or findings with patients, or when performing an ultrasound.
Radiologist (M.D./D.O.) Pathway: Learn How to Become a Radiologist
In order to become a practicing radiologist, the journey is a marathon and not a sprint. It is among the most prolonged educational tracks in the field of medicine and it demands firm commitment and huge expenditure of time and other resources.
Bachelor Degree (4 years)
One has to begin by earning a bachelor degree in a four year college or university. As indicated, no major is required though the student has to undertake the pre-medical course work. Common pre-med majors are biology, chemistry, physics, and biomedical engineering; these majors correlate effectively with the pre-med required courses. Achievement during this stage is quantified by a high GPA as well as a competitive MCAT score which is essential in the process of getting accepted into medical school.
Medical School (4 years)
Medical school is a four-year program that includes a transition from basic science to clinical practice. Students receive either an M.D. or a D.O. degree.
- Years 1-2 (Pre-Clinical): The first two years are focused on studying in the classroom and in the laboratory and cover the basics of medicine: anatomy, physiology, pharmacology, pathology, and microbiology.
Students will also learn clinical skills including how to take a medical history and perform a physical exam.
- Years 3-4 (Clinical): In years 3 and 4, students rotate through different specialties (internship-level), specifically internal medicine, surgery, pediatrics, psychiatry, and obstetrics and gynecology (if applicable) in a hospital and outpatient clinics. During this time, students can put their new knowledge to relevance. Students should also complete an elective rotation in radiology, if hoping to become a radiologist, during this time.
During medical school, students are required to succeed a sequence of national board exams, referred to as the United States Medical Licensing Examination (USMLE) for M.D. students or the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) for D.O. students. High performance on these tests is essential in getting paired with a competitive residency program such as radiology.
Residency in Radiology (5 years)
After completing medical school, a doctor is not yet a specialist in radiology. The doctor must complete a residency, which is a paid supervised training program in a specialty of their choice. In the case of diagnostic radiology, the commitment to residency is five years in length.
- Internship/Transitional Year (PGY-1): An internship is the first year of post-graduate training (PGY-1, or Post-Graduate Year 1), which takes the form of a clinical internship. This year is spent in a field of direct patient care whether it be internal medicine, surgery, or a transitional year that features rotations in multiple specialties. This is to ensure that when a doctor becomes a radiologist they have a solid base in general medicine before specializing.
- Diagnostic Radiology Residency (PGY-2 to PGY-5): This is the core four-year training to become a radiologist. Radiology residents will rotate through all the subspecialties where they will learn how to interpret every type of medical image and how to perform various basic procedures. Radiology residents begin by working close to the resident attending, and as their knowledge and skills improve they will be given more and more independence in managing their patients. There is a structured curriculum that is rigorous enough that residents can prepare for board exams and practice independently at the end of training.
Optional Fellowship (1-2 years)
Although a physician is certified to work as a general diagnostic radiologist upon completion of residency, the specialty has continued to subspecialize. The majority of residents now prefer to undertake a fellowship, an extra 1–2 years of subspecialty training in one area of radiology. This enables them to specialize in a subspecialty such as neuroradiology, musculoskeletal imaging, or interventional radiology.
A fellowship enhances marketability of a candidate and usually translates into greater earning power and more directed career choices, making it a crucial step in the radiologist career path. For those exploring how to become a radiologist, understanding the importance of fellowship training is key to advancing in this highly specialized medical field.
Board Certification & Licensing
- Licensure: All physicians, including radiologists, must be licensed physicians by the medical board in the state where they plan to work. In most circumstances, a state has a variety of requirements for licensure including proof of education and training, successful completion of all appropriate components of the USMLE or COMLEX, and a background check.
- Board Certification: Board certification is not required for licensure to practice medicine; however, it is the gold standard and required for virtually all hospitals, and insurance companies. The American Board of Radiology (ABR) grants board certification to radiologists and there is a considerable number of exams, written and oral, during residency and the years following residency to show expertise in this field.
Total Time
The total time to become a board-certified, fellowship-trained radiologist after high school is:
- Undergraduate Degree: 4 years
- Medical School: 4 years
- Internship: 1 year
- Radiology Residency: 4 years
- Fellowship (Optional but common): 1-2 years
- Total: 14-15 years
What is the Average Salary for a Radiologist in the U.S.?
The high investment in education and training is translated to the remuneration of the radiologists who are also one of the best-paid medical specialists. Salary may differ depending upon geographic setting, practice (private vs. academic) and subspecialty.
The current salary range of a radiologist in the United States is recorded by Medscape in their 2023 Physician Compensation Report, with an average of about $483,000 per year. Because of the procedure involved, interventional radiologists usually have higher earnings. The salaries of the private practice environment are usually higher compared to those of the academic or hospital-employed settings.
Radiologic Technologist (Technician) Pathway
And with the same fascination of medical imaging, but not the 14+ years of training and education to become a physician, the profession of a radiologic technologist is a much accelerated and yet still very fulfilling entry point into the profession.
Post-Secondary Education (2-4 years)
The most popular way to become a radiologic technologist is to receive an Associate of Applied Science (A.A.S.) degree, which requires two years of study. One-year certificate programs are also available to those who have already earned a degree in a related health area, and four-year Bachelor of Science (B.S.) programs are offered, too. The curriculum is centered on anatomy, patient positioning, imaging physics, radiation protection and equipment usage.
Clinical Training & Licensing
A significant portion of the education is encompassing, extensive, hands-on clinical training. Once the educational program is completed, graduates must earn certification to practice in most states.
- Certification: The credentials certifying body is the American Registry of Radiologic Technologists (ARRT). Candidates must pass a comprehensive exam to become certified. The designation “(RT)” denotes those who meet the national practice standards.
- Licensing: Most states, but not all, require technologists to be licensed. Most states require ARRT certification to earn a state license.
Total Time
The total time to become a certified radiologic technologist after high school:
- Associate’s Degree: 2 years
- Bachelor’s Degree: 4 years
- Total: 2-4 years
What are the Benefits of Being a Radiologic Technologist?
The role of a radiologic technologist has many benefits of its own:
- Patient Contact: Technologists provide immediate care and hands-on contact with patients, offering comfort and guidance through the process of imaging.
- Time to Practice: A technologist can become employable and earn a pay check in two years.
- Salary and job outlook: The BLS predicts that employment of radiologic and MRI technologists will grow 6% between 2022 and 2032, faster than the average for all occupations. The median annual pay was $67,180 in May 2022.
- Promotion: Technologists can earn advanced certifications in other modalities, such as CT, MRI or mammography, and move into educational, administration, or sales positions.
Career Comparison & Salary Overview of Both
| Aspect | Radiologist | Radiologic Technologist |
| Primary Responsibility | Diagnosis & Medical Consultation | Image Acquisition & Patient Care |
| Education Path | 14-15 years (Bachelor’s + M.D./D.O. + Residency + Fellowship) | 2-4 years (Associate’s or Bachelor’s Degree) |
| Core Skills | Analytical thinking, detailed knowledge of pathology, visual acuity, medical decision-making. | Technical proficiency, patient communication, attention to detail, understanding of radiation safety. |
| Decision-Making Authority | Final diagnostic authority, determines treatment plans. | Follows protocols set by radiologists and physicians. |
| Patient Interaction | Consultative, often indirect. More direct in interventional and breast imaging roles. | Direct and hands-on with every patient. |
| Average Annual Salary (USA) | ~$483,000 | ~$67,180 |
| Work Environment | Often a quiet reading room, procedure suites, hospitals, outpatient centers. | Imaging departments in hospitals, clinics, and outpatient centers. |
Tips & Considerations
- Shadowing Both Professions: If you’re struggling to make a decision on which career path is right for you, the best course of action is to shadow both a radiologist and a radiologic technologist. Firsthand experience seeing the daily work of both professionals is invaluable.
- Be Good at STEM: No matter what course you decide upon, being good at science, technology, engineering, and math (STEM) is important. Physics, anatomy, and technology are key components of radiology.
- Work on Expressing Yourself: Technologists need to be good at expressing themselves in a clear and compassionate manner with patients. Radiologists need to be good at expressing complicated findings to other physicians.
- Think about the Lifestyle: The path of a radiologist requires a longer delay to enjoy the benefits of being a radiologist because of the extra training requirements. On-call responsibilities for radiologists can add a layer of difficulty. In contrast, the path of a technologist may offer faster integration into the job market and more predictable working hours.
- Calculate the Total Cost: Medical school accrues significant student loan debt. A radiologist’s salary can allow for this debt to be paid off, but it is still a financial factor to consider in the decision-making process. Also, readers should consider the costs of a technologist program and how much lower it is than medical school.
Conclusion
A decision to pursue a career in the radiological sciences as either a physician or a technologist is a choice to join a critical and technologically sensitive sector of health. The road to how to become a radiologist is among the toughest and the longest in the entire field of medicine, requiring more than 10 years of hard studying and residency. The payoff is a job of great responsibility, intellectual stimulation, and economic security as a medical expert who supplies the final answers that make patient care go.
On the other hand, becoming a radiologic technologist is a much quicker way of getting into the healthcare sector. It is a profession that is founded on technical skills, working with people and being an inseparable member of the diagnosis team. It offers a secure, satisfying profession with growth potential without the intense time and financial requirement needed to be a physician. The radiologist vs radiologic technologist distinction is an important consideration for those comparing different medical imaging careers.
Both professions are needed. They act in symbiosis to give the window into the human body that is at the basis of modern medicine. Knowing the differences between the roles of each, their duties and the career paths they offer, you will be able to make an educated choice and follow the option that suits your skills, dreams and the vision of your future in the fascinating field of medical imaging.
Also Read: How to Become a Pharmacist
FAQs
Is it possible to be a radiologic technologist and a radiologist?
Yes, but they have to go through the full physician process, which is achieving a bachelor degree with pre-med coursework, four years of medical school, and five years of radiology residency.
Which is the most competitive subspecialty in radiology?
Interventional radiology can be viewed as one of the most competitive subspecialties to match into, as it is procedural and in high demand.
Do radiologists work at home?
Yes, teleradiology or the act of reading images at a distance has been growing in popularity. Most radiologists work hybrid or exclusively at home, which provides a lot of flexibility in lifestyle.
What is the distinction between a CT technologist and an MRI technologist?
They both are specialized radiologic technologists. A CT technologist is the one who works with computed tomography. MRI technologist works with magnetic resonance imaging scanners.
