How to Become a Radiologist


By Michael Sapko, M.D.
Radiologist studies a patient's X-ray

Radiologists are physicians who use cutting-edge imaging technology to examine organs and tissues inside the body in gentle, noninvasive ways. Their expertise in physics, anatomy and the disease process allow them to diagnose injuries and illnesses so treatment can begin. A growing subset of these specialists called interventional radiologists performs surgical procedures under imaging guidance in order to minimize damage to healthy tissue.

While early radiologists had only film X-rays to work with, modern professionals have a variety of tools at their disposal, including:

  • X-ray radiography
  • Ultrasound
  • Computerized tomography (CT)
  • Magnetic resonance imaging (MRI)
  • Positron emission tomography (PET)
  • Nuclear imaging

Radiologists generally work behind the scenes analyzing studies, making diagnoses and consulting with physicians. In some cases, they get involved in the procedure in order to help prepare the patient or outline further instructions to the technician.

Interventional radiologists take imaging technology a step further by using it to treat certain diseases and conditions. These professionals create electronic maps to guide their instruments as they insert catheters, remove malignant tissue and perform other delicate procedures. This gentle approach allows patients to recover faster and with fewer complications.

Physicians who thrive on intellectual stimulation find radiology an especially rewarding area of practice. Because the field advances so rapidly, there is always something new and exciting to learn. These specialists are among the first to pilot cutting-edge imaging technologies and procedures developed in research laboratories. Radiologists also enjoy the challenge of interpreting complex studies and putting together medical clues to arrive at an accurate diagnosis.

Work Environment

Though most radiologists still work in hospitals and outpatient diagnostic centers, advances in digital technology now allow imaging studies to be transmitted electronically. This practice, which is known as telemedicine, means radiologists can now practice in any location equipped with a computer, high-resolution monitor and Internet connectivity. Telemedicine helps emergency departments and intensive care units obtain emergency consultations after hours and also promotes consultation among experts around the globe.

Unlike most other physicians, radiologists have limited patient contact. In fact, some go weeks without a face-to-face consultation. Instead, these specialists spend their time analyzing image results and formulating diagnoses.

Radiologists who work in the hospital work long, irregular shifts that include nights, weekends and holidays. Those employed by outpatient centers are more likely to work regular business hours.



The first step in becoming a radiologist is to obtain a bachelor’s degree. Pre-medicine students may major in any subject but need to meet prerequisites in math, biology, organic and inorganic chemistry, physics and the humanities. Students can strengthen their medical school application by earning academic honors, volunteering, conducting scientific research and achieving high scores on the Medical College Admission Test (MCAT). Many four-year colleges and universities have pre-med advisors who assist students in planning an appropriate program of study. 

Next, aspiring radiologists move on to medical school. Because radiology is an extremely competitive specialty, candidates must excel academically in order to compete for available residencies. They will also benefit from top scores on Steps I and II of the United States Medical Licensing Examination (USMLE).


During the final year of medical school, students should apply for a four-year diagnostic radiology residency through the National Resident Matching Program (NRMP). Residents work an average of 60 hours per week and spend some nights on call. Upon completion, some candidates pursue a 1-3 year fellowship in a subspecialty such as neuroradiology or interventional radiology. 

Licensing and/or Certification

State licensure is mandatory for all practicing physicians, including radiologists. Most employers require radiology candidates to hold board certification. Effective 2013, this will require passage of a two-part examination covering medicine, anatomy, imaging modalities and physics.

Necessary Skills and Qualities

Because competition for radiology residencies is fierce, students seeking to enter this field must be top academic performers with excellent test scores. More so than other medical specialties, radiology requires a strong interest in and knowledge of physics and math. 

Opportunities for Advancement

Radiologists earn excellent salaries throughout their careers. As they advance, many choose a more comfortable lifestyle over pay increases. This usually takes the form of fewer nighttime, weekend and holiday shifts.

Other radiologists advance their careers by gaining new skills and expertise. It is not uncommon for an interventional radiologist to be the only professional in the region performing certain cutting-edge procedures. This allows the person to command a higher income and may present opportunities for leadership, research and community outreach.

Experienced radiologists sometimes leave the clinical setting to pursue research opportunities, take teaching positions or move into health care administration.

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The salaries of radiology residents range from $42,000 to $58,000 per year. Earnings increase with experience and vary across regions. 

Newly certified diagnostic radiologists can expect to earn about $275,000 per year. Starting salaries at academic centers are usually slightly lower than those in private practice. The median annual salary for all diagnostic radiologists regardless of experience is $380,000 a year, and interventional radiologists make closer to $500,000.

Job Outlook

Newly certified radiologists have plenty of job openings from which to choose. There is currently a shortage of these specialists in the United States and residency programs are not graduating enough candidates to meet the current demand. In addition, many diagnostic radiologists are leaving the field to seek more lucrative careers in interventional radiology.

At present, radiologists are especially scarce in rural areas. However, the emergence of telemedicine may ease some of this demand.

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