Radiographers, also known as radiologic technologists, diagnostic radiographers and medical radiation technologists are
healthcare professionals
A health professional, healthcare professional, or healthcare worker (sometimes abbreviated HCW) is a provider of health care treatment and advice based on formal training and experience. The field includes those who work as a nurse, physician (suc ...
who specialize in the
imaging
Imaging is the representation or reproduction of an object's form; especially a visual representation (i.e., the formation of an image).
Imaging technology is the application of materials and methods to create, preserve, or duplicate images.
...
of
human anatomy
The human body is the structure of a human being. It is composed of many different types of cells that together create tissues and subsequently organ systems. They ensure homeostasis and the viability of the human body.
It comprises a he ...
for the
diagnosis
Diagnosis is the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines, with variations in the use of logic, analytics, and experience, to determine " cause and effect". In systems engin ...
and
treatment of
pathology
Pathology is the study of the causes and effects of disease or injury. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in ...
. Radiographers are infrequently, and almost always erroneously, known as ''x-ray technicians.'' In countries that use the title ''radiologic technologist'' they are often informally referred to as ''techs'' in the clinical environment; this phrase has emerged in popular culture such as television programmes.
The term ''radiographer'' can also refer to a ''therapeutic radiographer'', also known as a
radiation therapist.
Radiographers are
allied health professionals who work in both
public healthcare
Publicly funded healthcare is a form of health care financing designed to meet the cost of all or most healthcare needs from a publicly managed fund. Usually this is under some form of democratic accountability, the right of access to which are ...
and private healthcare and can be physically located in any setting where appropriate diagnostic equipment is located, most frequently in
hospitals
A hospital is a health care institution providing patient treatment with specialized health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically has an emerge ...
. The practice varies from country to country and can even vary between hospitals in the same country.
A global overview of the changing roles of radiographers, Cynthia Cowling, International Society of Radiographers and Radiological Technologists (ISRRT), 143 Bryn Pinwydden, Pentwyn, Cardiff, Wales CF23 7DG, UK, Retrieved on 28 October 2014.
Radiographers are represented by a variety of organizations worldwide, including the
International Society of Radiographers and Radiological Technologists which aims to give direction to the profession as a whole through collaboration with national representative bodies.
History
![Crookes tube xray experiment](https://upload.wikimedia.org/wikipedia/commons/1/10/Crookes_tube_xray_experiment.jpg)
For the first three decades of
medical imaging
Medical imaging is the technique and process of imaging the interior of a body for clinical analysis and medical intervention, as well as visual representation of the function of some organs or tissues (physiology). Medical imaging seeks to rev ...
's existence (1897 to the 1930s), there was no standardized differentiation between the roles that we now differentiate as radiologic technologist (a technician in an
allied health profession
Allied health professions are health care professions distinct from optometry, dentistry, nursing, medicine, and pharmacy. They provide a range of diagnostic, technical, therapeutic, and support services in connection with health care.
Definitio ...
who obtains the images) versus
radiologist
Radiology ( ) is the medical discipline that uses medical imaging to diagnose diseases and guide their treatment, within the bodies of humans and other animals. It began with radiography (which is why its name has a root referring to radiatio ...
(a
physician
A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
who interprets them). By the 1930s and 1940s, as it became increasingly apparent that proper interpretation of the images required not only a physician but also one who was specifically trained and experienced in doing so, the differentiation between the roles was formalized. Simultaneously, it also became increasingly true that just as a radiologic technologist cannot do the radiologist's job, the radiologist also cannot do the radiologic technologist's job, as it requires some knowledge, skills, experience, and
certification
Certification is the provision by an independent body of written assurance (a certificate) that the product, service or system in question meets specific requirements. It is the formal attestation or confirmation of certain characteristics of a ...
s that are specific to it.
Radiography's origins and
fluoroscopy's origins can both be traced to 8 November 1895, when German physics professor
Wilhelm Röntgen
Wilhelm Conrad Röntgen (; ; 27 March 184510 February 1923) was a German mechanical engineer and physicist, who, on 8 November 1895, produced and detected electromagnetic radiation in a wavelength range known as X-rays or Röntgen rays, an achiev ...
discovered the X-ray and noted that, while it could pass through human tissue, it could not pass through bone or metal.
Röntgen referred to the radiation as "X", to indicate that it was an unknown type of radiation. He received the first
Nobel Prize in Physics
)
, image = Nobel Prize.png
, alt = A golden medallion with an embossed image of a bearded man facing left in profile. To the left of the man is the text "ALFR•" then "NOBEL", and on the right, the text (smaller) "NAT•" then " ...
for his discovery.
There are conflicting accounts of his discovery because Röntgen had his lab notes burned after his death, but this is a likely reconstruction by his biographers:
Röntgen was investigating
cathode rays
Cathode rays or electron beam (e-beam) are streams of electrons observed in discharge tubes. If an evacuated glass tube is equipped with two electrodes and a voltage is applied, glass behind the positive electrode is observed to glow, due to el ...
using a
fluorescent
Fluorescence is the emission of light by a substance that has absorbed light or other electromagnetic radiation. It is a form of luminescence. In most cases, the emitted light has a longer wavelength, and therefore a lower photon energy, tha ...
screen painted with barium
platinocyanide Platinocyanide, also known as tetracyanoplatinate (IUPAC), cyanoplatinate, or platinocyanate, is a polyatomic ion with the molecular formula t(CN)4sup>2−. The name also applies to compounds containing this ion, which are salts of the hypothetical ...
and a
Crookes tube
A Crookes tube (also Crookes–Hittorf tube) is an early experimental electrical discharge tube, with partial vacuum, invented by English physicist William Crookes and others around 1869-1875, in which cathode rays, streams of electrons, were dis ...
which he had wrapped in black cardboard to shield its fluorescent glow. He noticed a faint green glow from the screen, about 1 metre away. Röntgen realized some invisible rays coming from the tube were passing through the cardboard to make the screen glow: they were passing through an opaque object to affect the film behind it.
![First medical X-ray by Wilhelm Röntgen of his wife Anna Bertha Ludwig's hand - 18951222](https://upload.wikimedia.org/wikipedia/commons/7/79/First_medical_X-ray_by_Wilhelm_R%C3%B6ntgen_of_his_wife_Anna_Bertha_Ludwig%27s_hand_-_18951222.jpg)
Röntgen discovered X-rays' medical use when he made a picture of his wife's hand on a photographic plate formed due to X-rays. The photograph of his wife's hand was the first ever photograph of a human body part using X-rays. When she saw the picture, she said, "I have seen my death."
The first use of X-rays under clinical conditions was by
John Hall-Edwards in
Birmingham, England
Birmingham ( ) is a city and metropolitan borough in the metropolitan county of West Midlands in England. It is the second-largest city in the United Kingdom with a population of 1.145 million in the city proper, 2.92 million in the West ...
on 11 January 1896, when he radiographed a needle stuck in the hand of an associate. On 14 February 1896, Hall-Edwards also became the first to use X-rays in a surgical operation.
The United States saw its first medical X-ray obtained using a
discharge tube
A gas-filled tube, also commonly known as a discharge tube or formerly as a Plücker tube, is an arrangement of electrodes in a gas within an insulating, temperature-resistant envelope. Gas-filled tubes exploit phenomena related to electric d ...
of
Ivan Pulyui
Ivan () is a Slavic male given name, connected with the variant of the Greek name (English: John) from Hebrew meaning 'God is gracious'. It is associated worldwide with Slavic countries. The earliest person known to bear the name was Bulgari ...
's design. In January 1896, on reading of Röntgen's discovery, Frank Austin of
Dartmouth College
Dartmouth College (; ) is a private research university in Hanover, New Hampshire. Established in 1769 by Eleazar Wheelock, it is one of the nine colonial colleges chartered before the American Revolution. Although founded to educate Native A ...
tested all of the discharge tubes in the physics laboratory and found that only the Pulyui tube produced X-rays. This was a result of Pulyui's inclusion of an oblique "target" of
mica
Micas ( ) are a group of silicate minerals whose outstanding physical characteristic is that individual mica crystals can easily be split into extremely thin elastic plates. This characteristic is described as perfect basal cleavage. Mica is ...
, used for holding samples of
fluorescent
Fluorescence is the emission of light by a substance that has absorbed light or other electromagnetic radiation. It is a form of luminescence. In most cases, the emitted light has a longer wavelength, and therefore a lower photon energy, tha ...
material, within the tube. On 3 February 1896 Gilman Frost, professor of medicine at the college, and his brother Edwin Frost, professor of physics, exposed the wrist of Eddie McCarthy, whom Gilman had treated some weeks earlier for a fracture, to the X-rays and collected the resulting image of the broken bone on
gelatin photographic plates obtained from Howard Langill, a local photographer also interested in Röntgen's work.
X-rays were put to diagnostic use very early; for example,
Alan Archibald Campbell-Swinton
Alan Archibald Campbell-Swinton FRS (18 October 1863 – 19 February 1930) was a Scottish consulting electrical engineer, who provided the theoretical basis for the electronic television, two decades before the technology existed to implement ...
opened a radiographic laboratory in the United Kingdom in 1896, before the dangers of ionizing radiation were discovered. Indeed,
Marie Curie
Marie Salomea Skłodowska–Curie ( , , ; born Maria Salomea Skłodowska, ; 7 November 1867 – 4 July 1934) was a Polish and naturalized-French physicist and chemist who conducted pioneering research on radioactivity. She was the first ...
pushed for radiography to be used to treat wounded soldiers in World War I. Initially, many kinds of staff conducted radiography in hospitals, including physicists, photographers, physicians, nurses, and engineers. The medical speciality of radiology grew up over many years around the new technology. When new diagnostic tests were developed, it was natural for the radiographers to be trained in and to adopt this new technology. Radiographers now perform
fluoroscopy
Fluoroscopy () is an imaging technique that uses X-rays to obtain real-time moving images of the interior of an object. In its primary application of medical imaging, a fluoroscope () allows a physician to see the internal structure and functio ...
,
computed tomography,
mammography
Mammography (also called mastography) is the process of using low-energy X-rays (usually around 30 kVp) to examine the human breast for diagnosis and screening. The goal of mammography is the early detection of breast cancer, typically through d ...
,
ultrasound
Ultrasound is sound waves with frequency, frequencies higher than the upper audible limit of human hearing range, hearing. Ultrasound is not different from "normal" (audible) sound in its physical properties, except that humans cannot hea ...
,
nuclear medicine
Nuclear medicine or nucleology is a medical specialty involving the application of radioactive substances in the diagnosis and treatment of disease. Nuclear imaging, in a sense, is "radiology done inside out" because it records radiation emitting ...
and
magnetic resonance imaging
Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. MRI scanners use strong magnetic fields, magnetic field gradients, and radio wave ...
as well. Although a nonspecialist dictionary might define radiography quite narrowly as "taking X-ray images", this has long been only part of the work of "X-ray Departments", Radiographers, and Radiologists. Initially, radiographs were known as roentgenograms, while ''Skiagrapher'' (from the
Ancient Greek
Ancient Greek includes the forms of the Greek language used in ancient Greece and the ancient world from around 1500 BC to 300 BC. It is often roughly divided into the following periods: Mycenaean Greek (), Dark Ages (), the Archaic peri ...
words for "shadow" and "writer") was used until about 1918 to mean ''Radiographer''.
The history of
magnetic resonance imaging
Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. MRI scanners use strong magnetic fields, magnetic field gradients, and radio wave ...
includes many researchers who have discovered
NMR
Nuclear magnetic resonance (NMR) is a physical phenomenon in which nuclei in a strong constant magnetic field are perturbed by a weak oscillating magnetic field (in the near field) and respond by producing an electromagnetic signal with ...
and described
its underlying physics, but it is regarded to be invented by
Paul C. Lauterbur
Paul Christian Lauterbur (May 6, 1929 – March 27, 2007) was an American chemist who shared the Nobel Prize in Physiology or Medicine in 2003 with Peter Mansfield for his work which made the development of magnetic resonance imaging (MRI) poss ...
in September 1971; he published the theory behind it in March 1973.
The factors leading to image contrast (differences in tissue relaxation time values) had been described nearly 20 years earlier by Erik Odeblad (doctor and scientist) and Gunnar Lindström.
In 1950,
spin echoes and
free induction decay
In Fourier transform nuclear magnetic resonance spectroscopy, free induction decay (FID) is the observable NMR signal generated by non-equilibrium nuclear spin magnetization precessing about the magnetic field (conventionally along z). This non-e ...
were first detected by
Erwin Hahn
Erwin Louis Hahn (June 9, 1921 – September 20, 2016) was an American physicist, best known for his work on nuclear magnetic resonance (NMR).Filler, AG: The history, development, and impact of computed imaging in neurological diagnosis and neuros ...
and in 1952,
Herman Carr
Herman Y. Carr (November 28, 1924 – April 9, 2008), who published as H. Y. Carr, was an American physicist and pioneer of magnetic resonance imaging.
Carr was born in Alliance, Ohio where he was an Alliance High School graduate in January 1943 ...
produced a one-dimensional NMR spectrum as reported in his Harvard PhD thesis. In the
Soviet Union
The Soviet Union,. officially the Union of Soviet Socialist Republics. (USSR),. was a transcontinental country that spanned much of Eurasia from 1922 to 1991. A flagship communist state, it was nominally a federal union of fifteen national ...
,
Vladislav Ivanov filed (in 1960) a document with the USSR State Committee for Inventions and Discovery at Leningrad for a Magnetic Resonance Imaging device, although this was not approved until the 1970s.
By 1959, Jay Singer had studied blood flow by NMR relaxation time measurements of blood in living humans.
Such measurements were not introduced into common medical practice until the mid-1980s, although a patent for a whole-body NMR machine to measure blood flow in the human body was already filed by Alexander Ganssen in early 1967.
In the 1960s and 1970s the results of a very large amount of work on relaxation, diffusion, and chemical exchange of water in cells and tissues of various types appeared in the scientific literature.
In 1967, Ligon reported the measurement of NMR relaxation of water in the arms of living human subjects.
In 1968, Jackson and Langham published the first NMR signals from a living animal.
Role in healthcare
A radiographer uses their expertise and knowledge of
patient care
Health care or healthcare is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health profess ...
,
physics
Physics is the natural science that studies matter, its fundamental constituents, its motion and behavior through space and time, and the related entities of energy and force. "Physical science is that department of knowledge which r ...
,
human anatomy
The human body is the structure of a human being. It is composed of many different types of cells that together create tissues and subsequently organ systems. They ensure homeostasis and the viability of the human body.
It comprises a he ...
,
physiology
Physiology (; ) is the scientific study of functions and mechanisms in a living system. As a sub-discipline of biology, physiology focuses on how organisms, organ systems, individual organs, cells, and biomolecules carry out the chemical ...
,
pathology
Pathology is the study of the causes and effects of disease or injury. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in ...
and
radiology
Radiology ( ) is the medical discipline that uses medical imaging to diagnose diseases and guide their treatment, within the bodies of humans and other animals. It began with radiography (which is why its name has a root referring to radiat ...
to assess patients, develop optimum radiological techniques and evaluate the resulting radiographic media.
This branch of healthcare is extremely varied, especially between different countries, and as a result radiographers in one country often have a completely different role to that of radiographers in another. However, the base responsibilities of the radiographer are summarised below:
* Autonomy as a professional
* Accountability as a professional
* Contribute to and participate in continuing professional development
* Enforcement of radiation protection (There is a duty of care to patients, colleagues and any lay persons that may be irradiated.)
* Justification of radiographic examinations
* Patient care
* Production of diagnostic media
* Safe, efficient and correct use of diagnostic equipment
* Supervise students and assistants
On a basic level, radiographers do not generally interpret diagnostic media, rather they evaluate media and make a decision about its diagnostic effectiveness. In order to make this evaluation radiographers must have a comprehensive but not necessarily exhaustive knowledge of pathology and radiographic appearances; it is for this reason that radiographers often do not interpret or diagnose without further training. Notwithstanding, it is now becoming more common that radiographers have an extended and expanded clinical role, this includes a role in initial radiological diagnosis, diagnosis consultation and what subsequent investigations to conduct. It is not uncommon for radiographers to now conduct procedures which would have previously been undertaken by a cardiologist, urologist, radiologist or oncologist autonomously.
Contrary to what could be inferred, radiographers conduct and contribute to investigations which are not necessarily radiological in nature, e.g.
sonography
Medical ultrasound includes diagnostic techniques (mainly medical imaging, imaging techniques) using ultrasound, as well as therapeutic ultrasound, therapeutic applications of ultrasound. In diagnosis, it is used to create an image of internal ...
and
magnetic resonance imaging
Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. MRI scanners use strong magnetic fields, magnetic field gradients, and radio wave ...
.
Radiographers often have opportunities to enter military service due to their role in healthcare. As with most other occupations in the medical field many radiographers have rotating shifts that include night duties.
Career pathways
Radiography is a deeply diverse profession with many different modalities and specialities. It is not uncommon for radiographers to be specialised in more than one modality and even have expertise of interventional procedures themselves; however this depends on the country in which they operate. As a result of this the typical career pathway for a radiographer is hard to summarise. Upon qualifying it is common for radiographers to focus solely on plain film radiography before specialising in any one chosen modality. After a number of years in the profession, non-imaging based roles often become open and radiographers may then move into these positions.
Imaging modalities
Generally, imaging modalities are all diagnostic, all have the potential to be used therapeutically in order to deliver an intervention. Modalities (or specialities) include but are not limited to:
:
1Prefixes such as pediatric, geriatric, trauma are routinely placed used in conjunction with professional titles.
:
2This list of technologies is not exhaustive.
Non-imaging modalities
Non-imaging modalities vary, and are often undertaken in addition to imaging modalities. They commonly include:
*
Academia
An academy (Attic Greek: Ἀκαδήμεια; Koine Greek Ἀκαδημία) is an institution of secondary education, secondary or tertiary education, tertiary higher education, higher learning (and generally also research or honorary membershi ...
– Education role.
*
Clinical Management – Clinical managerial role which can be varied; may include managing audits, rotas, department budgets, etc.
*
Clinical Research
Clinical research is a branch of healthcare science that determines the safety and effectiveness ( efficacy) of medications, devices, diagnostic products and treatment regimens intended for human use. These may be used for prevention, treatm ...
– Research role.
*
Medical Physics
Medical physics deals with the application of the concepts and methods of physics to the prevention, diagnosis and treatment of human diseases with a specific goal of improving human health and well-being. Since 2008, medical physics has been incl ...
– Multidisciplinary role ensuring the correct calibration of and most efficient use of diagnostic equipment.
*
PACS Management – Managerial role concerned with maintaining and supervising appropriate and correct use of the
RIS and
PACS systems.
*
Radiation Protection
Radiation protection, also known as radiological protection, is defined by the International Atomic Energy Agency (IAEA) as "The protection of people from harmful effects of exposure to ionizing radiation, and the means for achieving this". Expos ...
– A managerial role concerned with monitoring the level of ionising radiation absorbed by anyone who comes into contact with ionising radiation at their site.
*
Reporting Radiography – A clinical role involved with interpretation of radiographs and various other radiological media for diagnosis.
Education and role variation
Education varies worldwide due to legal limitations on scope of practice.
Belgium
The profession of diagnostic radiographer is called "medical imaging technologist" in Flanders, it is a regulated healthcare profession. A diploma of a specific professional Bachelor is a requirement for registration and recognition.
Since 2 December 2014, everyone who works at a Medical Imaging department, is obliged to be in possession of the recognition and the visa issued by the Ministry of Health (a professional identity card that is considered a license)
To practice a health care profession with a foreign diploma from within the EEA or equivalent in the EEA, it is necessary to request the recognition for the profession from Government of Flanders (Agency of Care and Health).
It is possible to request the recognition if:
* The person have a diploma of their healthcare profession and want to practice their profession in Belgium.
* The person have obtained their degree in one of the countries of the European Economic Area (EEA) or Switzerland.
* Or the person's diploma is equivalent in a country of the EEA and they are a European national.
Germany
In Germany radiographers must complete a 3-year apprenticeship before they qualify as a 'Medizinisch-technischer Radiologieassistent'. Only after qualifying do radiographers in Germany fulfil the requirements to practise as a fully qualified MTRA.
Similar to other countries, they work within the areas of radiography diagnostics (
CT scans,
magnetic resonance imaging
Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. MRI scanners use strong magnetic fields, magnetic field gradients, and radio wave ...
,
radiography
Radiography is an imaging technique using X-rays, gamma rays, or similar ionizing radiation and non-ionizing radiation to view the internal form of an object. Applications of radiography include medical radiography ("diagnostic" and "therapeut ...
,
digital subtraction angiography
Digital subtraction angiography (DSA) is a fluoroscopy technique used in interventional radiology to clearly visualize blood vessels in a bony or dense soft tissue environment. Images are produced using contrast medium by subtracting a "pre-contra ...
),
radiation therapy
Radiation therapy or radiotherapy, often abbreviated RT, RTx, or XRT, is a therapy using ionizing radiation, generally provided as part of cancer treatment to control or kill malignant cells and normally delivered by a linear accelerator. Radia ...
,
radiation dosimeter
A radiation dosimeter is a device that measures equivalent dose, dose uptake of external ionizing radiation. It is worn by the person being monitored when used as a personal dosimeter, and is a record of the radiation dose received. Modern electro ...
s and
nuclear medicine
Nuclear medicine or nucleology is a medical specialty involving the application of radioactive substances in the diagnosis and treatment of disease. Nuclear imaging, in a sense, is "radiology done inside out" because it records radiation emitting ...
.
Ireland
in the
Republic of Ireland
Ireland ( ga, Éire ), also known as the Republic of Ireland (), is a country in north-western Europe consisting of 26 of the 32 counties of the island of Ireland. The capital and largest city is Dublin, on the eastern side of the island. A ...
(ROI) must be registered with
CORU before they can practice in the Republic of Ireland. Student radiographers training in the ROI will typically study for 4 years on an approved bachelor's degree program; currently degree programs only exist at
University College Dublin
University College Dublin (commonly referred to as UCD) ( ga, Coláiste na hOllscoile, Baile Átha Cliath) is a public research university in Dublin, Ireland, and a collegiate university, member institution of the National University of Ireland ...
.
Applicants must have either an approved qualification, a schedule 3 qualification, an appropriate letter of recommendation/accreditation or another qualification which is deemed 'suitably relevant' by registration board in order to successfully fulfil the vocational education requirements to become a Radiographer in the ROI. Applications for registration with qualifications outside of this are considered on an individual basis; typically this includes most international applicants.
The professional body representing Radiographers in the ROI is the
Irish Institute of Radiography and Radiation Therapy (IIRRT).
To practice as a Radiographer or Radiation Therapist in Ireland, one must register with CORU as of 31 October 2015.
Registering as a Radiographer in Ireland, retrieved on 7 February 2018 CORU is Ireland's multi-profession health regulator. Set up under the Health and Social Care Professionals Act 2005, CORU is used to protect the public by promoting high standards of professional conduct, education, training and competence through statutory registration of health and social care professionals.
CORU registration requirements, retrieved on 7 February 2018 If a radiographer commences clinical practice without registration then they may be prosecuted with a fine or an imprisonment of up to six months.
Malta
Radiography is a regulated profession in Malta and anyone wanting to practice Diagnostic or Therapeutic Radiography would need to obtain state registration in order to be licensed as a Radiographer, obtained from the Council for Professions Complementary to Medicine (CPCM).
In Malta, in order for an individual to become a Radiographer he/she first has to follow a course offered by the University of Malta. The course is BSc (Hons) Radiography and its duration is of four years. On completion of the course, the graduate will have the conditions to be eligible for registration with the council for professions complementary to Medicine
A foreign radiographer can work in Malta should the necessary documentation and competencies have been obtained and presented. Radiographers working on Malta should abide by the rules of the host country and title of radiographer will be used.
REQUIREMENTS FOR REGISTRATION WITH THE COUNCIL FOR THE PROFESSIONS COMPLEMENTARY TO MEDICINE], Retrieved on 7 February 2018
An application form has to be filled along with the necessary authenticated copies of several documents. The application form includes the insertion of personal details of the individual along with the description of qualifications and the university which granted the qualifications. The individual has to declare whether he or she is registered with another Health Care Profession Register in Malta.
Below is a list of the documents needed for a professional to register with the council:
* Application Form
* Original or authenticated copies of the following documents (English versions): a. Birth and marriage (if applicable) certificates.
* Identification document such as ID or Passport.
* Recent Police Conduct certificate.
* Professional Document Diploma/Degree.
* Letters of Reference in English.
* A detailed transcript of Theoretical and Practical Training and Studies in hours associated with the Profession and in relation with the profession syllabus performed by their Institution being the university/College. This has to be endorsed in the original format by the Head/Registrar of their Institution being the university/College.
* A recent (six months) verification certificate of current registration and good standing with the council the person are registered with.
* A secure English Language test (SELT) for foreign applicants.
* Curriculum Vitae in English.
In cases where the professional qualification acquired was not obtained from an Accredited Institution in Malta, a letter is to be submitted, issued from the Malta Qualifications Recognition Information Centre
MQRIC, certifying that the Institution from where the qualification was obtained is equivalently accredited and indicate the level of qualification in accordance to the Malta Qualifications Framework.
For applicants from the
European Economic Area
The European Economic Area (EEA) was established via the ''Agreement on the European Economic Area'', an international agreement which enables the extension of the European Union's single market to member states of the European Free Trade Ass ...
countries, once the application is submitted, it will follow the regulations established on the Directive 2005/36/EC on the recognition of qualifications between member states. In these cases, the professional document and theoretical and practical training are required to be equivalent to the requirements of Malta, i.e. An EQF Level 6 Bachelor's Degree with an equivalent syllabus to that of the University of Malta and their course is no more than one year shorter. Should the radiographer have a substantial difference between their professional qualifications and those required by CPCM, the radiographer has the right to provide further evidence of competence (including professional experience or CPD), otherwise, the CPCM board should offer the applicant the possibility to do an aptitude test or adaptation period (as chosen by the applicant).
Flow chartexplaining this procedure for EEA applicants can be found on the government's website.
Nepal
As a developing country, the health care sector in
Federal Democratic Republic of Nepal
Nepal (; ne, नेपाल ), formerly the Federal Democratic Republic of Nepal ( ne,
सङ्घीय लोकतान्त्रिक गणतन्त्र नेपाल ), is a landlocked country in South Asia. It is mai ...
has very limited resources meaning radiological services are rather limited.
Nepal is still struggling to improve and manage conventional radiological examinations. Radiological Services in Nepal commenced in 1923 at Military Hospital by Dr. Rana and Dr Asta Bahadur Shrestha. The first health related training program began in 1933 at the Nepal Rajkiya Ayurved School; the Civil Medical School was later established in 1934. Radiological education in Nepal started in 1923 in a 64 bedded Military Hospital, Tri-ChandraElectro-Medical Institute. The post graduate (MSc) program in physics at TU began in 1965 with only Nuclear Physics specialization. In 1972, the Institute of Medicine (IOM) which is affiliated with TU started the Proficiency Certificate Level (PCL) Radiography course however this has since stopped.
Radiotherapy was first introduced at Maternity Hospital in 1976 utilising radium needle treatment. CT and Nuclear Medicine was introduced in 1988 at Bir Hospital. The Radiotherapy unit with Tele Cobalt-60 machine was established at Bir Hospital in 1991.
Nepal became a member of IAEA in 2008. Since 2008 onwards diploma level radiography courses have been conducted across the country by the Council for Technical Education and Vocational Training (CTEVT) and other affiliated institutions.
In Nepal there are 125 vocational health training institutes however only 15 are conducting radiological technological education. Bachelor level radiography education is taught in two universities & one college whereas master level radiography course is taught
in one where another university is in pipeline. Until recently, therapeutic radiography courses have not been taught in Nepal;
radiation therapists are predominantly trained abroad.
The Nepal Health Professional Council (NHPC) is the legislative body for registering, accrediting, developing & enforcing quality assurance of Health Professionals, including Radiographers, in Nepal.
The Netherlands
The Quality Register Paramedics
Until 1997, radiographers were required to register the Evidence of Competence at the Chief of Medical Inspections. This was mandatory under the Law on Paramedic professions. After innovate the law of Individual Health Care Professions (BIG), the registration requirements for radiographers were cancelled. A voluntary register has been set up in consultation with the Health Care Inspectorate: the Paramedics Quality Register.
The Paramedics Quality Register comes from the BIG. The purpose of the Paramedics Quality Register is to guarantee the quality of professional practice. Through the registration and re-registration (once in five years) it becomes visible for patients, health insurers etc. that the registered radiographer professional is and remains competent in the field of professional practice. Despite the fact that the quality register is not compulsory according to the law, many hospitals are obliged to do it. The hospitals are obliged to provide good quality care. Health insurers also attach great value to the Paramedics Quality Register because they are also required to provide good care.
Enrollment
Radiographers who are in possession of a valid Certificate of Competence, diploma of certificate and endorse the code of professional conduct of the professional association, can be enroll in the Paramedics historical register.
The official registration of the radiographer satisfies the educational requirements in the General Administrative Order (AMvB) ex. art. 34 BIG and the quality requirements of the professional group. On the basis of which is carried out radiographer is mentioned in the Diplomaregister Paramedici and / or the Quality Register Paramedics. By registration, the radiographer continues to be traced by, for example, the Health Care Inspectorate (IGZ) and the professional associations. Other organizations also intend the Quality Register Paramedics.
Re-enrollment
To be in the Paramedics Quality Register the radiographer need to request re-registration every five years. The first period of five years is determined on the basis of the diploma date. In case of re-registration, the radiographer must meet the requirements for that period. The start date of the period station local quality criteria. The quality criteria are set every five years by the Paramedics Quality Register, paramedical professional associations. To ensure that the requirements for the patient and the client-oriented exercises and expertise-enhancing activities are safeguarded for the quality of the professional practice. The quality criteria are set up in such a way that paramedics can meet the quality requirements with the set range of expertise-enhancing activities.
Nigeria
In
Nigeria
Nigeria ( ), , ig, Naìjíríyà, yo, Nàìjíríà, pcm, Naijá , ff, Naajeeriya, kcg, Naijeriya officially the Federal Republic of Nigeria, is a country in West Africa. It is situated between the Sahel to the north and the Gulf o ...
, these professionals are generally referred to as ''Radiographers'' or ''Medical Radiographers'' to differentiate them from Industrial Radiographers. Radiographers must complete a 5-year undergraduate BSc and a compulsory one year paid internship program in a hospital after graduation before attaining a full licensing by the
Radiographers Registration Board of Nigeria. The board also registers
Radiotherapists who have undergone the initial 5-year Radiography program before proceeding to the Radiotherapy training.
Radiographers in Nigeria have been striving to extend their practice to include radiographic interpretation and Ultrasound services. They are also on the verge of adopting an official professional title of "Radr" or "Rr" .
Radiographers in Nigeria normally proceed for a Masters programme and a PhD programme in the profession.
There is a recent rise in the number of radiographers available in the country unlike the situation of shortage between 2000 – 2010.
In a typical Nigerian Teaching Hospital, radiographers do not undertake sonography examinations, this is left for the radiologists, who, in some areas, have gradually improved their relationship with the radiographers in providing services in other radiographic units. The radiologist is also in charge of specific Fluoroscopic cases where the radiographer assists only with positioning and image acquisition.
Allied Health Unions (such as 'JOHESU' and 'NUAHP') that Radiographers are members of (with Nurses, Pharmacists, Physiotherapists, Laboratory Scientists, etc.), have over the years gone on strike actions to force the Nigerian government to improve their allowances/salaries in the government owned hospitals. These strikes (when it's not a response on its own) often trigger a response from the Nigerian Medical Association who will also table some requests for the medical doctors.
Apart from monetary issues, these professional bodies are also in loggerheads over non-doctors requesting to be given top administrative roles in government owned hospitals. Many radiographers, however, do not particularly involve themselves in these movements as working in a private establishment is more lucrative.
Some Radiographers in Nigeria are also keen on setting up a "Department of Radiography" in the government owned hospitals which will not be under the Head of the Radiology Department. Some hospitals however have an understanding between the Radiology head (a Radiologist) and the Chief Radiographer where all radiographers are directly answerable to their Chief, and not the HOD.
Saudi Arabia
(فني اشعة) in
Saudi Arabia
Saudi Arabia, officially the Kingdom of Saudi Arabia (KSA), is a country in Western Asia. It covers the bulk of the Arabian Peninsula, and has a land area of about , making it the fifth-largest country in Asia, the second-largest in the A ...
must successfully undertake a degree level program at a recognised higher-level education institution in Nursing before undertaking further study in radiographic imaging at university for typically 2 to 3 years; this must include a year's experience in a hospital. Upon completion, graduates are qualified X-Ray Technicians and can commence clinical practice.
United Kingdom
The
SCoR is the professional body and union for UK radiographers. In the United Kingdom, there is ambiguity in the use of the term as this does not differentiate between Therapeutic Radiographers (also known as Radiotherapists) and . As a result, all of these titles are protected titles within the United Kingdom and can not be used by any persons who has not undertaken formal study and registered with the
Health and Care Professions Council
The Health and Care Professions Council (HCPC, formerly the Health Professions Council, HPC) is a statutory regulator of over 280,000 professionals from 15 health and care professions in the United Kingdom. The Council reports its main purpose i ...
(HCPC). In order to practise Radiography in the United Kingdom candidates must now successfully obtain a pass in a degree level programme from an accredited institution. Degrees are offered by universities across the UK and last for at least 3 years in England, Wales and Northern Ireland; and 4 years in Scotland. Student Diagnostic Radiographers spend a significant amount of time working at various hospitals affiliated with their university during their studies to meet the requirement for registration with the HCPC.
They specialise in the acquisition of radiographs of General Practitioner referred (GP) patients, Outpatients, Emergency Department (ED) referred patients and Inpatients. They conduct mobile X-rays on wards and in other departments where patients are too critical to be moved and work as part of the operating team in mainly Orthopaedic and Urology cases, offering surgeons live radiographic imaging. Once qualified, Diagnostic Radiographers are able to acquire X-rays without supervision and work as part of the imaging team. They will have basic head examination qualifications in CT and even basic experience of MRI, Ultrasound and Nuclear Medicine.
Diagnostic Radiographers can specialise in-house or through a university course as a postgraduate in CT, MRI, Ultrasound or Nuclear Medicine with opportunities to gain an MSc or PhD in their field. Diagnostic Radiographers in the UK are also taking on roles that were typically only undertaken by the Radiologist (a medical doctor who specialised in interpreting X-rays), Urologist or Cardiologist in the past. This extended practice includes various interventional procedures not excluding barium enemas, barium meals/swallows, peripheral angioplasties, nerve root injections, central line insertions and many other procedures.
The professional body and workers union for Radiographers in the United Kingdom is the
Society and College of Radiographers (SCoR). The union has been heavily involved in extending practice of Radiographers in the United Kingdom and has helped expand the role of the Radiographer greatly.
Expanded practice
Radiographers are now able to write reports and diagnose pathologies and/or conditions seen on differing diagnostic media after completing a HCPC and SCoR accredited university course; completing a course in this modality allows the Radiographer to become a reporting Radiographer in their chosen specialty.
Diagnostic Radiographers are able to become supplementary prescribers which allows them the capacity to prescribe medications in partnership with an independent prescriber (a doctor or a dentist); the supplementary prescriber is to implement an agreed Clinical Management Plan for an individual patient with that patient's agreement. An accredited university course must be undertaken before this role extension is annotated onto a HCPC registrant's record. It is thought that in the future Diagnostic Radiographers in will gain independent prescribing rights, however this is currently limited by their restricted and varied scope of practice. In 2016, the introduction of independent prescribing right was agreed for Therapeutic Radiographers after a consultation by the
Medicines and Healthcare products Regulatory Agency (MHRA)
United States
In the United States, these professionals are known as . Formal training programs in radiography range in length that leads to a certificate, an associate or a bachelor's degree. The American Registry of Radiologic Technologists (ARRT), the primary credentialing organisation for Radiologic Technologists in the United States, requires that candidates for ARRT Certification Exams must have an associate degree at minimum as of January, 2015, effectively ending non-degree granting diploma programs. Accreditation is primarily through The Joint Review Committee on Education in Radiologic Technology (JRCERT), the only agency recognised by the United States Department of Education and the Council for Higher Education Accreditation to grant accreditation to both traditional and online programs in Radiography, Radiation Therapy, Magnetic Resonance Imaging, and Medical Dosimetry. An online page where prospective students can check the accreditation of programs is maintained by JRCERT.
Radiologic Technology students study
anatomy
Anatomy () is the branch of biology concerned with the study of the structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old science, having its ...
,
physiology
Physiology (; ) is the scientific study of functions and mechanisms in a living system. As a sub-discipline of biology, physiology focuses on how organisms, organ systems, individual organs, cells, and biomolecules carry out the chemical ...
,
physics
Physics is the natural science that studies matter, its fundamental constituents, its motion and behavior through space and time, and the related entities of energy and force. "Physical science is that department of knowledge which r ...
,
radiopharmacology
Radiopharmacology is radiochemistry applied to medicine and thus the pharmacology of radiopharmaceuticals (medicinal radiocompounds, that is, pharmaceutical drugs that are radioactive). Radiopharmaceuticals are used in the field of nuclear medic ...
,
pathology
Pathology is the study of the causes and effects of disease or injury. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in ...
,
biology
Biology is the scientific study of life. It is a natural science with a broad scope but has several unifying themes that tie it together as a single, coherent field. For instance, all organisms are made up of cells that process hereditary i ...
, research,
nursing
Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health ...
,
medical imaging
Medical imaging is the technique and process of imaging the interior of a body for clinical analysis and medical intervention, as well as visual representation of the function of some organs or tissues (physiology). Medical imaging seeks to rev ...
,
diagnosis
Diagnosis is the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines, with variations in the use of logic, analytics, and experience, to determine " cause and effect". In systems engin ...
,
radiologic instrumentation,
emergency medical procedures
An emergency is an urgent, unexpected, and usually dangerous situation that poses an immediate risk to health, life, property, or environment and requires immediate action. Most emergencies require urgent intervention to prevent a worsening ...
,
medical imaging techniques,
patient care
Health care or healthcare is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health profess ...
,
medical ethics
Medical ethics is an applied branch of ethics which analyzes the practice of clinical medicine and related scientific research. Medical ethics is based on a set of values that professionals can refer to in the case of any confusion or conflict. T ...
and
general chemistry
General chemistry (sometimes referred to as "gen chem") is offered by colleges and universities as an introductory level chemistry course usually taken by students during their first year. The course is usually run with a concurrent lab section tha ...
. Schooling also includes significant amounts of documented practicum supervised by Registered Technologists in various clinical settings where the classroom theory is translated to practical knowledge and real world experience. The change from Film to Digital imaging has changed training as film quality assurance and quality control is largely obsolete. The role of computer workstations to produce synthetic images for Radiologists has steadily increased the need for computer skills as has electronic medical record software.
After primary training and licensure, continuing education is required to maintain licensure and certification with the ARRT, who sets the accepted national guidelines. The ARRT requires 24 Units of accredited continuing education every two years and the laws and the regulations of most states accept this standard. Continuing formal education or the passing of an advanced practice speciality exam may also be accepted for continuing education credit. The
American Society of Radiologic Technologists
The American Society of Radiologic Technologists (ASRT), located in Albuquerque, New Mexico, is a professional membership association for medical imaging technologists, radiation therapists, and radiologic science students.
ASRT members may spec ...
(ASRT), a professional association for people in Medical Imaging and Therapy, offers members and others continuing education materials in various media that meet the requirements of the ARRT for continuing education. Additional requirements are set forth for technologists who specialise in mammography by the US FDA.
Expanded practice
A new and evolving career for Radiologic Technologists is that of the Registered Radiologist Assistant (RRA) who is an experienced technologist (a type of Physician Assistant) who has completed additional education, training, and has passed exams to function as radiologist extenders. A list of the 9 currently accredited RRA programs is maintained by the ARRT and can be accessed online. Candidates for the RRA certification must possess a bachelor's degree at minimum.
Registered Radiologist Assistant (RRA), a new advanced practice radiographer career path in the United States for experienced technologists. RRAs do not interpret studies in the manner of the reporting radiographer. The role has been accepted by the
American College of Radiology The American College of Radiology (ACR), founded in 1923, is a professional medical society representing nearly 40,000 diagnostic radiologists, radiation oncologists, interventional radiologists, nuclear medicine physicians and medical physicists.
...
(ACR).
Risks
* Epidemiological studies indicate that Radiographers employed before 1950 are at increased risk of
leukemia
Leukemia ( also spelled leukaemia and pronounced ) is a group of blood cancers that usually begin in the bone marrow and result in high numbers of abnormal blood cells. These blood cells are not fully developed and are called ''blasts'' or ' ...
and
skin cancer
Skin cancers are cancers that arise from the skin. They are due to the development of abnormal cells that have the ability to invade or spread to other parts of the body. There are three main types of skin cancers: basal-cell skin cancer (BCC) ...
, most likely due to the lack of use of
radiation monitoring
Radiation monitoring involves the measurement of radiation dose or radionuclide contamination for reasons related to the assessment or control of exposure to radiation or radioactive substances, and the interpretation of the results.
Environment ...
and shielding. The relationship between radiation and cancer was found to correlate with women who were in the menopausal stages of their lives. In today's workplace, radiation exposure is monitored very closely and cancer cases in technologists has been found to have decreased tremendously due to the current prevention methods.
*
Ionising radiation
Ionizing radiation (or ionising radiation), including nuclear radiation, consists of subatomic particles or electromagnetic waves that have sufficient energy to ionize atoms or molecules by detaching electrons from them. Some particles can travel ...
, used in a variety of imaging procedures, can damage cells. Lead shields are used on the patient and by the Radiographer to reduce exposure by shielding areas that do not need to be imaged from the radiation source. While lead is
highly toxic, the shields used in medical imaging are coated to prevent lead exposure and are regularly tested for integrity.
* Radiographers who develop x-ray films are exposed to the various
chemical hazards
A chemical hazard is a (non-biological) substance that has the potential to cause harm to life or health. Chemicals are widely used in the home and in many other places. Exposure to chemicals can cause acute or long-term detrimental health eff ...
such as
sulfur dioxide
Sulfur dioxide (IUPAC-recommended spelling) or sulphur dioxide (traditional Commonwealth English) is the chemical compound with the formula . It is a toxic gas responsible for the odor of burnt matches. It is released naturally by volcanic activ ...
,
glutaraldehyde
Glutaraldehyde is an organic compound with the formula . The molecule consists of a five carbon chain doubly terminated with formyl (CHO) groups. It is usually used as a solution in water, and such solutions exists as a collection of hydrates, c ...
, and
acetic acid
Acetic acid , systematically named ethanoic acid , is an acidic, colourless liquid and organic compound with the chemical formula (also written as , , or ). Vinegar is at least 4% acetic acid by volume, making acetic acid the main component ...
. These agents can cause
asthma
Asthma is a long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. Symptoms include episodes of wheezing, cou ...
and other health issues.
* Theoretically, the strong static magnetic fields of
MRI scanners can cause physiological changes. After a human neural cell culture was exposed to a static magnetic field for 15 minutes, changes in cell
morphology
Morphology, from the Greek and meaning "study of shape", may refer to:
Disciplines
* Morphology (archaeology), study of the shapes or forms of artifacts
* Morphology (astronomy), study of the shape of astronomical objects such as nebulae, galaxies ...
occurred along with some modifications in the physiological functions of those cells. However, these effects have not yet been independently replicated or confirmed, and this particular study was performed
in vitro
''In vitro'' (meaning in glass, or ''in the glass'') studies are performed with microorganisms, cells, or biological molecules outside their normal biological context. Colloquially called "test-tube experiments", these studies in biology an ...
.
*
Ultrasound imaging
Medical ultrasound includes diagnostic techniques (mainly medical imaging, imaging techniques) using ultrasound, as well as therapeutic ultrasound, therapeutic applications of ultrasound. In diagnosis, it is used to create an image of internal ...
can deform cells in the imaging field, if those cells are in a fluid. However, this effect is not sufficient to damage the cells.
* As with any allied health professional, exposure to
infectious diseases
An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable dise ...
is likely, and use of
Personal Protective Equipment (PPE) and
infection control
Infection prevention and control is the discipline concerned with preventing healthcare-associated infections; a practical rather than academic sub-discipline of epidemiology. In Northern Europe, infection prevention and control is expanded from ...
precautions must be employed to reduce the risk of infection. Those with family health histories reported feeling increased amount of stress due to concern of bringing infectious diseases home.
* In 2016, 59% of technologists surveyed reported that being overworked lead to risking medical error and threatening patient safety. Being overworked also led to depersonalization due to the emotional drain it takes on technologists' mental health, also putting patients at risk.
* Due to constantly maneuvering heavy patients, technologists are at risk for work related injuries from the strain it puts on their bodies. Most technologists who develop a work related injury, later report having more work related injuries.
References
External links
CORUIrish Institute of Radiography and Radiation Therapy (IIRRT)International Society of Radiographers and Radiologic Technologists (ISRRT)
{{DEFAULTSORT:Radiographer
Radiology
Radiography
Allied health professions
Hospital staff