Radiation Therapy Certification - American Registry of Radiologic Technologists (ARRT)

A career in radiation therapy is much more than standing behind a wall and operating equipment. Radiation therapists are key members of cancer-fighting teams who are responsible for administering intensive energy particles to kill cancer cells and shrink tumors.

While chemotherapy uses drug treatment to stop cancerous cells from growing and surgery can physically remove tumors, the American Cancer Society says “radiation therapy uses high-energy waves such as gamma rays [and other types of waves and electrons] to destroy or damage cancer cells”. Radiation therapy treatments can include ingesting radioactive substances to help radiation therapists locate the precise location of cancer cells.

The duties of a radiation therapist are to set up and operate radiology equipment to treat cancer as prescribed by a radiation oncologist, doctors who specialize in treating cancer. To be a radiation therapist requires precision-orientedness and following directions carefully. Being calm and kind to patients who are stressed and undergoing cancer treatment is also important as some of the cancer-fighting treatments must be administered in isolation to be effective and safe.

It’s worth noting the difference between two similar careers: radiologic technicians and radiation therapists. While both use x-ray machinery, radiologic technicians create images used by doctors to help with the diagnosis of various conditions. On the other hand, radiation therapists follow directions from doctors to set up and operate machinery to specifically treat patients with cancer.

As with most medical technology professions, radiation therapists are often required to hold a certification. The American Registry of Radiologic Technologists (ARRT) has been certifying radiology professionals around the world since 1922. Every professional seeking certification and registration must meet the ARRT Equation for Excellence standards, which requires applicants to meet education, ethics, and examination requirements. More than 75 percent of all US states require radiation therapists to be certified and registered with the ARRT to meet state licensure requirements. The ARRT also provides a database for patients and employers to verify credentials for current radiation therapists.

Following suit with other clinical healthcare careers, radiation therapy is a fast-growing field. The US Bureau of Labor Statistics (BLS) shows that radiation therapy openings are projected to grow by 7 percent nationally between 2019 and 2029, which is much faster than the national average for all occupations at 4 percent (BLS 2020). With an associate degree from an ARRT-approved educational program, certified radiation therapists earn a median annual wage of $85,560.

Read on to learn more about ARRT certification requirements for radiation therapists.

Early Preparation in High School

High school students interested in radiation therapy careers can prepare in several ways. Taking as many math and science courses possible is recommended to prepare for college-level courses. If offered, students should pursue science courses such as algebra, human anatomy and physiology, biology, chemistry, and physics. Computer science courses and learning opportunities that involve learning research methodology and immersion in clinical environments is also recommended.

Students should research educational programs approved by ARRT, which as of mid-2020, lists 108 radiation therapy programs.

Post-High School Radiation Therapy Certification (ARRT) Preparation

Earning an associate degree from an ARRT-approved educational program is the first step in the ARRT’s Equation for Excellence. This program must be in the same discipline as the credential being pursued. This means that those seeking a radiation therapy career should enroll in a radiation therapy program—not a radiology program (see above for the differences between these two careers).

A list of ARRT-approved radiation therapy schools is available and includes on-campus and online education options. Two-year associate degrees and four-year bachelor’s degrees are available. Earning an associate degree is a great place to begin a career, while a bachelor’s degree can help radiation therapists pursue more career opportunities and earn higher salaries.

A sample program is the two-year radiation oncology associate of applied science (AAS) program at Virginia Western Community College in Roanoke. This ARRT-approved program is also accredited by the Joint Review Committee on Education in Radiologic Technology and prepares its graduates to be effective communicators, life-long learners who are prepared to meet the evolving challenges in the field of healthcare. Tuition costs $12,240 for this two-year 72-credit program.

T (ARRT) Certification Exam Preparation

After completing an ARRT-approved program, radiation therapists can apply for certification and registration with ARRT’s primary eligibility pathway program. Radiation therapists who meet the educational and ethical requirements are eligible to apply for the radiation therapy exam. If a passing score is earned, radiation therapists are legally able to use the “T” credential as proof of proficiency.

While there are no ARRT-endorsed specific exam materials, most aspiring radiation therapists study the content specifications to prepare for the certification exam. There are three content categories: patient care, safety, and procedures. Each content category has a number of scored questions; patient care has 47, safety has 49, and procedures have 104 for a total of 200 scored questions. Each radiation therapy examination by the ARRT includes 20 unscored pilot questions. Sample exam questions are provided in the content specifications guide.

The ARRT has a governing document titled Standards of Ethics that clarifies what types of professional behavior will and will not be tolerated from credential holders.

T (ARRT) Certification Renewal

Once certified and registered with the ARRT, radiation therapists are required to renew credentials annually and show proof of continuing education and continuing qualifications.

Annual renewal is due every year on the last day of a certification-holder’s birth month. Those who are current with their biennial continuing education requirements are eligible for renewal.

Continuing education requirements must be met every two years and include 24 units of approved online classes, self-study readings and modules, lectures at professional society meetings, and classroom learning.

Continuing qualifications must be met every ten years to keep certified and registered ARRT professionals current on their professional abilities. Those who have earned their ARRT credentials on or after January 1, 2011 must show proof of demonstrated continuing qualifications requirements. Detailed information about these requirements is available to credential holders and described in-depth in a video by ARRT.

State Licensure for Radiation Therapists

A commonly asked question asked by radiation therapists is this: are ARRT certification and state licensure the same? The simple answer is no. While some states require only ARRT national certification and registration as a basis for state licensure, some states have other licensing requirements. Radiation therapists are advised to seek out the requirements needed for licensure in the states where they are seeking work.

Most but not all states require ARRT certification and registration as prerequisites to state licensure. The ARRT says that 75 percent of states have local licensing laws that require ARRT exam scores as standards for licensure.

For example, radiation therapists working in California must meet state and ARRT certification requirements. The state requirement includes a separate credential to use x-ray machines, which is issued by the Radiologic Health Branch of the California Department of Public Health.

In addition to this requirement, radiation therapists working in California also must earn and maintain ARRT certification and registration. To be eligible for credential renewal in California, radiation therapists must earn ten hours of continuing education credits every two years while the ARRT requires 24 continuing education credits in the same time period. Interestingly, the State of California states that the two certifications can be maintained independently of one another, meaning one certificate is not required as a prerequisite for the other.

Here’s a list of the most common ARRT licensing exams required by many states:

  • Radiography
  • Nuclear Medicine Technology
  • Radiation Therapy
  • Certain state-approved post-primary disciplines

In addition to the licensing exams above, many states require three additional exams for state licensure purposes which were developed and are administered by ARRT:

  • Limited Scope of Practice in Radiography
  • Bone Densitometry Equipment Operator
  • Fluoroscopy

The ARRT has several resources to help radiation therapists earn state licensure:

  • Frequently Asked Questions (FAQs) for state licensing: a great place to start to get straightforward answers to the most common questions about state licensure.
  • Apply for State Licensing: this outlines the process for applying for state licensure and taking the required exams to work in a specific state.
  • State Licensing Exam: the ARRT scores all exams which are administered at Pearson VUE test centers and addresses questions about test centers and exam security.
  • State Licensing Handbooks: radiation therapy applicants in California and Florida can access their state-specific licensure requirements as can applicants for all other states.
Rachel Drummond
Rachel Drummond Writer

Rachel Drummond is a freelance writer, educator, and yogini from Oregon. She’s taught English to international university students in the United States and Japan for more than a decade and has a master’s degree in education from the University of Oregon. A dedicated Ashtanga yoga practitioner, Rachel is interested in exploring the nuanced philosophical aspects of contemplative physical practices and how they apply in daily life. She writes about this topic among others on her blog (Instagram: @oregon_yogini).