Radiation therapists play a critical role in cancer treatment, working directly with patients to administer prescribed radiation doses using sophisticated equipment. As cancer treatment technologies advance and the demand for oncology services grows, radiation therapy remains a rewarding and well-compensated allied health career. However, entering the field requires completing an accredited education program, earning national certification, and -- in most states -- obtaining a state license.

This guide walks you through every step of the process, from choosing a JRCERT-accredited program to passing the ARRT certification exam, meeting state licensing requirements, and maintaining your credentials through continuing education. We have also compiled verified data for all 51 states we track so you can compare requirements side by side.

What Does a Radiation Therapist Do?

Radiation therapists administer radiation treatments to cancer patients as prescribed by radiation oncologists. They are essential members of the oncology care team, working alongside physicians, medical physicists, and dosimetrists to deliver precise, targeted radiation doses that destroy cancer cells while minimizing damage to surrounding healthy tissue.

Day-to-day responsibilities include:

• Operating linear accelerators and other radiation delivery equipment to administer prescribed treatment plans.
• Positioning patients accurately using immobilization devices, lasers, and imaging systems to ensure radiation is delivered to the correct anatomical target.
• Calculating and verifying dosages to confirm treatment parameters match the radiation oncologist's prescription.
• Monitoring patients during treatment sessions for adverse reactions, providing emotional support, and explaining procedures.
• Maintaining detailed treatment records and documenting each session's parameters, patient positioning, and any deviations from the treatment plan.
• Performing quality assurance checks on equipment to ensure safe and accurate operation.

Radiation therapists work in hospitals, cancer treatment centers, and outpatient radiation oncology facilities. Most work full time during regular business hours, though some facilities offer evening or weekend treatment sessions.

According to the U.S. Bureau of Labor Statistics, the median annual wage for radiation therapists is approximately $98,000--$100,000, making it one of the higher-paying allied health professions. Salaries vary by geographic location, facility type, and years of experience.

Step 1: Education Requirements

Radiation therapists must graduate from a program accredited by the Joint Review Committee on Education in Radiologic Technology (JRCERT). JRCERT accreditation ensures the program meets rigorous standards for curriculum, clinical training, and student outcomes.

Associate's Degree (2 Years)

An associate's degree in radiation therapy is the minimum educational requirement for entry into the profession. These programs are typically offered at community colleges and technical schools and combine classroom instruction with extensive clinical rotations. An associate's degree is sufficient to sit for the ARRT certification exam and begin practicing in most states.

Bachelor's Degree (4 Years)

A bachelor's degree in radiation therapy provides a more comprehensive education and may offer advantages for career advancement, supervisory roles, and higher starting salaries. Some employers prefer or require a bachelor's degree, particularly in larger medical centers and academic settings.

Regardless of degree level, JRCERT-accredited programs include coursework in:

• Radiation physics
• Radiobiology
• Treatment planning and dosimetry
• Patient care and medical ethics
• Human anatomy and physiology
• Radiation safety and protection
• Oncology and pathology

Clinical Rotations

All JRCERT-accredited programs include mandatory clinical rotations in radiation oncology departments. Clinical rotations provide hands-on experience operating equipment, positioning patients, and delivering treatments under the supervision of licensed radiation therapists. These rotations are essential for developing the technical skills and patient interaction abilities needed in practice.

Step 2: ARRT Certification -- The T(ARRT) Credential

After graduating from a JRCERT-accredited program, the next step is earning certification from the American Registry of Radiologic Technologists (ARRT). The T(ARRT) credential designates a certified radiation therapist and is required or preferred by the vast majority of employers and state licensing boards.

Of the 51 states we track, 51 require ARRT certification as a condition of state licensure or practice.

ARRT Certification Requirements

To be eligible for ARRT certification in radiation therapy, you must:

• Education: Graduate from a JRCERT-accredited radiation therapy program.
• Ethics: Meet ARRT's ethics requirements, including disclosure of any criminal history or regulatory actions.
• Examination: Pass the ARRT radiation therapy certification examination.

The ARRT Radiation Therapy Exam

Key exam facts:

• Format: Approximately 200 multiple-choice questions.
• Time limit: 3.5 hours.
• Content areas: Treatment planning, treatment delivery, patient care and education, radiation safety and quality assurance.
• Testing: Computer-based exam delivered at Pearson VUE testing centers nationwide.
• Passing score: Scaled scoring; the ARRT sets the minimum passing standard.
• Retakes: Candidates who do not pass may retake the exam; ARRT policies govern retake eligibility and waiting periods.

Most candidates prepare using ARRT's published content specifications, practice exams, and study materials from professional organizations such as the American Society of Radiologic Technologists (ASRT). Thorough preparation during your accredited program is the strongest foundation for exam success.

State-by-State Radiation Therapist Requirements

Requirements vary significantly by state. Some states mandate a separate state license in addition to ARRT certification; others rely primarily on national certification. Click any state name to see its complete licensing guide with step-by-step instructions, fees, CE details, and more.

Data sourced from official state licensing board websites and the ARRT. Requirements change frequently -- always verify with your state board before applying.

Continuing Education Requirements

Maintaining your ARRT certification and state license requires ongoing continuing education (CE). Requirements exist at two levels: ARRT national certification and state licensure.

ARRT Continuing Education

The ARRT requires all certified radiation therapists to complete 24 continuing education (CE) credits per 2-year biennium. CE activities must be relevant to radiation therapy practice and can be earned through a variety of approved methods, including:

• Workshops, conferences, and seminars offered by ASRT, ARRT-approved providers, and state radiologic technology societies.
• Online CE courses and webinars from recognized continuing education providers.
• Academic coursework at accredited institutions relevant to radiation therapy.
• Professional presentations, published research, and other scholarly activities.

State License Continuing Education

States that issue a separate radiation therapist license often have their own CE requirements for license renewal, which may or may not align with the ARRT's 24-credit requirement. Across the 51 states we track, the average CE requirement is 24.5 hours per renewal cycle. Some states accept ARRT-approved CE toward state license renewal; others require state-specific coursework, including instruction in state laws and regulations.

Tips for managing CE requirements efficiently:

• Track your credits year-round rather than scrambling at renewal time. The ARRT provides an online CE tracking system through your certification portal.
• Attend your state radiologic technology society's annual conference -- it typically offers multiple CE credits in a single weekend.
• Look for opportunities where a single CE activity satisfies both ARRT and state license renewal requirements.
• Stay current with advances in radiation therapy technology, treatment planning, and patient safety -- these topics are both clinically valuable and CE-eligible.

Frequently Asked Questions

Sources

The information in this guide is compiled from official sources. We recommend verifying current requirements directly with these organizations before making career or educational decisions:

• American Registry of Radiologic Technologists (ARRT) -- Radiation Therapy Certification
• Joint Review Committee on Education in Radiologic Technology (JRCERT) -- Accredited Program Directory
• American Society of Radiologic Technologists (ASRT)
• U.S. Bureau of Labor Statistics -- Radiation Therapists Occupational Outlook
• Individual state licensing board websites -- see each state page for direct links to official regulatory authorities.