Progress Report on the Radiologist Assistant


By Charles D. Williams, MD, chair, ACR Human Resources Commission, and Lynn May, CEO, American Society of Radiologic Technologists

For some time now radiologists have talked of a workforce shortage as well as increasing demands on their time. Today, we are closer to addressing these critical issues.

Last April marked the second anniversary of the ACR Council's decision to endorse a policy statement advocating an expanded clinical role for radiologic technologists, called the radiologist assistant (RA). The College and the American Society of Radiologic Technologists (ASRT) supported the development of this new role to relieve some of the time pressures experienced by radiologists due to increased workloads, and to address the shortage of radiologic technologists by creating an expanded career path.

The RA is envisioned as an advanced-level radiologic technologist who works under a radiologist's supervision to enhance patient care. The individual would be a graduate of an academic program (baccalaureate or higher) that teaches an RA curriculum endorsed by the ACR and ASRT and is equipped with the skills and knowledge to perform a number of radiology procedures. While an RA may provide observations on medical images that he or she has taken to the supervising radiologist, the individual would not interpret medical images.

Since the spring of 2003, the following steps have been taken to support the development of the RA's role:

  • The American Registry of Radiologic Technologists (ARRT), the nationally recognized certification body of radiologic technologists, has developed a role delineation, content specifications, and clinical competency requirements as part of its efforts to develop a certification program for radiologist assistants. The ACR, ASRT, and other stakeholder organizations offered their input through their participation in the ARRT's RA Advisory Committee, which includes 3 ACR appointees. The initial administration of the ARRT's RA certification examination is expected later this year.

  • The ASRT formed an RA Education Council, consisting of educational program directors representing institutions currently developing RA programs. The council refined the RA curriculum, developed program guidelines, and discussed entrance criteria.

  • The ACR and ASRT offered their input into state legislation and regulations addressing RAs. The organizations jointly developed a model state statute and provided it to relevant organizations and agencies.

  • ACR and ASRT representatives met with officials of the Centers for Medicare and Medicaid Services to discuss RA development. Reimbursement for RA-associated services will be made to their employers.

  • Four universities have initiated RA educational programs—Loma Linda University (California), Midwestern State University (Texas), Virginia Commonwealth University, and the University of Medicine and Dentistry of New Jersey. Three of these schools received RA program development grants from the ASRT Education and Research Foundation. The first RA students at Loma Linda will graduate in August 2005. Two additional programs, the University of North Carolina at Chapel Hill and Bloomsburg University of Pennsylvania, will welcome their first RA students in 2005.

Radiologists have demonstrated strong support for the RA concept and a number of practices have volunteered to serve as clinical sites for RA education. Others, meanwhile, have provided financial support to RA students.

A potential obstacle to the appropriate utilization of RAs is the emergence of alternative advanced-level practitioners, who aspire to a level of practice that is beyond the current scope envisioned by the ACR, ARRT, and ASRT. However, these organizations remain committed to advancing the RA as the highest level of practice for radiologic technologists.