Established professional roles and precise professional titles in radiology

You are probably aware of the ISRRT’s proposal to promote radiography ranking to a higher level in the International Labour Office (ILO) Qualification Framework during the forthcoming professional qualification inventory update.
Profoundly, this will further enhance our global visibility and our commitment in decision making committees concerning medical imaging and therapy issues.
Moreover, it is crucial that we adhere to the associated responsibilities and the new emerging roles before we are recognized as key players by other health professionals and stakeholders within our industry. Till today, international organizations of great significance, like WHO and IAEA, consider radiographers equal partners and demand for our active involvement in numerous radiation protection projects and activities. Our contribution is always documented in reports wherein we are identified with formal nomenclature i.e. radiographer or radiological technologist. With this in mind, we must agree in using our profession’s precise title and simultaneously ensure that other health professionals do the same.

Efthimis Tim Agadakos

The ISRRT represents radiographers and radiological technologists worldwide. In several countries of the 96 represented, the titles radiographer and / or radiology technologist are not always applicable to adequately describe the profession. In fact, there are at least 15 different professional titles in Europe, consistent with each country’s diversities in language and culture, academic qualification and job duties. Several non-English – speaking countries favor the use of the title, “radiology technician”. Whilst, in English-speaking countries, we are often identified as “techs”, a term that describes both, technicians and technologists. In practice, the terms “technician” and “technologist” are considered synonyms and are often interrelated, yet they do not have the same meaning, the equivalent scope of practice or career prospects.

As a radiographer from Greece, I will attempt to discriminate the two by explaining their etymology, their Greek origin. Although, both terms include the word “techno-“, deriving from the Latinized form of the Greek word forming element “techno-”, meaning art, craft in work, skill, only the term “technologist” includes the word element “-log-ist” whereby “–logos” means to speak, to think, to use your mind.  .

Evidently the distinction between the two titles cannot be made on the basis of their etymology, alone. They should be “detached” based on their different educational requirements and their various career pathways. A radiological technician receives post secondary vocational training, limiting their working responsibilities and career prospects. In essence, a radiological technologist/ radiographer receives tertiary education leading to a degree and has a strategic role in clinical medical imaging (DSA, CT, MRI, PET-CT), therapy, nuclear medicine, sonography. They may also acquire post graduate awards in order to attain working appointments as academics, researchers, advanced practitioners, clinical auditors, hospital managers and directors.

In search of equivalent definitions by means of medical dictionaries, a technician is described “as a worker in a field of technology who is proficient in the relevant skill and technique, with a relatively practical understanding of the theoretical principles.”
Whereas a radiographer or radiologic technologist is a self regulated profession in most developed countries. They are autonomous and accountable as professionals.
“They are healthcare professionals who specialize in the imaging of human anatomy for the diagnosis and treatment of pathology. A radiographer uses their expertise and knowledge of patient care, physics, human anatomy, physiology, pathology and radiology to assess patients, develop optimum radiological techniques and evaluate the resulting radiographic media”.

Recently the ISRRT issued two Position statements on Justification and Optimization that support the importance of scope of practice for radiographers / radiological technologists and highlight our active role as health professionals in radiation protection :
1.    “Authorisation and Justification of medical exposure is considered within the Radiographer/Medical Radiation Technologist scope of practice, subject to their demonstration of appropriate educational training leading to clinical competency to carry out the task as trained.”
2.    “The ISRRT considers optimization of medical exposures to the patient to be part of the radiographer’s/radiological technologist’s scope of practice, subject to their demonstration of appropriate education and training leading to clinical competence. The ISRRT policy underpinning this statement was adopted at the Council meeting in October 2016 and is as follows: The ISRRT expects all qualified radiographers/radiological technologists to be competent in the principles and practice of ionizing radiation dose optimization relevant to their clinical work. As professionals bearing the responsibility for delivering doses of ionizing radiation to patients and in research applications, radiographers/radiological technologists must have authority to exercise their judgment in accepting a referral for exposure. This must include adjusting technique to minimize the exposure to patients, staff and the public whilst optimizing a diagnostic or therapeutic result.”

Subsequently, a technician either “creates”, constructs, repairs x-ray equipment, a radiological technician applies a specified technique to create medical images and a radiological technologist/radiographer plans, decides, applies a technique to create medical images, to administer therapy and serves as a patient advocate by communicating the radiation risks to patients and referring clinicians using scientific evidence during their daily practice.

Given that the multiplicity of professional roles and responsibilities in radiography is acknowledged to a limited extent by other health professionals and stakeholders, it is important that we endorse and guard our professional profile against anachronistic and inaccurate job descriptions by choosing our universal and official title. We should insist in being appropriately identified either as radiographers or radiological technologists, especially now that the ISRRT is striving to upgrade our ranking within the ILO Qualification Framework.

Dear radiographer/radiological technologist, hopefully you will share my view and refrain from using the titles “tech” and “technician” which lead to confusion, in relation to our educational background, our developing role, our scope of practice and may be damaging to our professional profile in future. Besides, our organization is officially known as ISRRT which stands for International Society of Radiographers and Radiological Technologists.

Efthimis Tim Agadakos BAppSc MSc
ISRRT Regional Director Europe

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