ISRRT’s Position Statment

Competency Requirments Therapeutic RTs

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ISRRT Position Statement
The Entry Level Competency Requirements for
Therapeutic radiographers/radiological technologists/Radiological

The ISRRT supports entry-level* competencies for therapeutic radiographers/radiological technologists which describe the practice requirements for entry-to-practice radiographers, to provide safe, effective, compassionate, and ethical patient care in a variety of global work environments.

At entry-level, therapeutic radiographers/radiological technologists are academically and clinically prepared to contribute productively as a member of the healthcare team, entry-level proficiency is characterised as follows:

  • When presented with routine situations, the entry-level therapeutic
    radiographer/radiological technologist performs relevant competencies in a manner
    consistent with accepted standards of the profession and within a reasonable timeframe.
  •  The entry-level radiographer uses professional judgement and critical thinking to reach
    decisions, anticipating outcomes and responding appropriately, using the best information
    and evidence available to adapt to individual patient needs and varying contexts of
  •  Working autonomously the entry-level radiographer understands their own limitations
    and when to seek appropriate consultation.
  • The entry-level radiographer is self-aware, takes initiative and can identify and appraise
    relevant resources to help inform and build their practice.
  •  Using effective communication and collaboration with other members of the healthcare
    team, entry-level radiographer provides quality patient and family-centered care.

The competencies establish a minimum standard for entry to the profession and are a foundation
upon which to build [1].

* Entry-level is defined as the initial entry into the profession.


Competency standards are the knowledge, skills and judgement required to perform safely [1].

Therefore, competencies:

  •  set out the threshold standards necessary to protect the public
  •  set clear expectations of practitioner’s knowledge and abilities when they start practising
    and they must continue to meet the competence standards for their scope of practice
  •  equip graduates to meet these standards through education programs
  •  outline what service users and the public should expect from therapeutic
    radiographer/radiological technologists.

The framework for competency standards is highlighted in the ‘The Health and Care Professions Council’ (HCPC) [2] standards and articulates that therapeutic radiographer/radiological technologist must:

  •  be able to practise safely and effectively within their scope of practice
  •  be able to practise within the legal and ethical boundaries of their profession
  •  be able to maintain fitness to practise
  •  be able to practise as an autonomous professional, exercising their own professional
  •  be aware of the impact of culture, equality, and diversity on practice
  • be able to practise in a non-discriminatory manner
  •  understand the importance of and be able to maintain confidentiality
  •  be able to communicate effectively
  •  be able to work appropriately with others
  •  be able to maintain records appropriately
  •  be able to reflect on and review practice
  •  be able to assure the quality of their practice
  •  understand the key concepts of the knowledge base relevant to their profession
  • be able to draw on appropriate knowledge and skills to inform practice
  •  understand the need to establish and maintain a safe practice environment. [3,4, 5,6].


Radiation therapy is used in the management of 50% of cancer patients at some point during the progress of their disease [7] and has become increasingly more complex over the last decade. Radiation therapy is a team-based discipline, but the professionals directly responsible for the rate and safe delivery of the radiation dose as prescribed and planned are therapeutic radiographer/radiological technologists. The therapeutic radiographer/radiological technologist is
the key contact person for the patient throughout their treatment. Linking technical accuracy with physical and psychosocial care is key to a positive outcome and patient experience [8]. Despite this responsibility, therapeutic radiographer/radiological technologists (known by over 30 different titles internationally) carrying out this critical role are frequently not recognised as a profession. In many jurisdictions their competences are not identified and the knowledge base
essential to their role is not a legal requirement [9].

The failure to recognise the profession and its associated competences has resulted in a significant variation in the knowledge, skills, and competences of therapeutic radiographer/radiological technologists globally [10]. In addition, currently there are impacts on staff recruitment and retention associated with low job satisfaction and poor career progression opportunities [11]. The title and associated competences of this profession have now been
defined by the European Skills/Competences, Qualifications and Occupations (ESCO) of theEuropean Commission [12].


The ISRRT endorses entry-level competencies for the profession. The content of the entry-level competencies includes Professional Practice, Leadership, Scholarly Practice, Patient Management, Health and Safety, Operation of Equipment, and Procedure Management along with education in pathologies, patient interactions, patient assessment, physics, radiation protection, radiobiology, imaging systems and procedures and accessory equipment.


1. CAMRT National Competency Profile for Entry-Level MRTs in Canada, March 2020.
Canadian Association of Medical Radiation Technologists (CAMRT),
2. The Health and Care Professional Council,
3. EFRS White Paper on the Future of the Profession Radiographer Education, Research,
and Practice (RERP): 2021-2031,
4. EFRS European Qualifications Framework (EQF) Level 6 Benchmarking Document:
5. EFRS Radiographers in Radiotherapy: Practice across the Radiotherapy Pathway,
6. EFRS Statement on Patient Engagement and Inclusion in Radiotherapy,
7. Borras, J.M., et al., The optimal utilization proportion of external beam radiotherapy in
European countries: An ESTRO-HERO analysis. (1879-0887 (Electronic)).
8. Quality Assurance Guidelines for Canadian Radiation Treatment Programs, Canadian
Partnership for Quality Radiotherapy (CPQR), December 31, 2015. Pages 16,17
9. Coffey, M. and E. Rosenblatt, Guest short communication: Is education of RTTs really
unnecessary?, Technical Innovative Patient Support Radiation Oncology 2018, © 2018
The Authors. p. 1-2.
10. Coffey, M., M. Leech, and P. Poortmans, Benchmarking Radiation Therapist (RTT)
education for safe practice: The time is now. (1879-0887 (Electronic)).
11. Taylor, M.R. and J.G. Oetzel, The sustainability of the New Zealand radiation therapy
workforce: Factors that influence intent to leave the workplace and profession. Tech
Innovation Patient Support Radiation Oncol, 2020. 16: p. 77-82.
12. Commission, E. ESCO portal. 2022 [cited 2022 April 2022]; Available from:
Note: Links to external websites may change without notice.