To become a radiation therapist, you typically need an associate's or bachelor's degree in radiation therapy, and in most states you must be licensed or certified, which often means passing a national certification exam. Many jobs also ask for CPR or basic life support certification.
Radiation therapists operate the machines that deliver radiation treatment to cancer patients, so the route is tightly regulated. Here's what the US Bureau of Labor Statistics (BLS) said when I read its handbook on 26 October 2026.
Radiation therapist requirements at a glance
| Requirement | What BLS says |
|---|---|
| Education | Associate's or bachelor's degree in radiation therapy; some positions accept a certificate program |
| Coursework | Radiation therapy procedures, anatomy and physiology, physics, algebra, plus clinical experience |
| Licence | Required or certification required in most states |
| Certification | Approved program, ethical standards, and a certification exam on radiation protection, treatment planning and patient care |
| Extras | CPR or basic life support certification for many jobs |
| Median pay as of October 2026 | $105,310 a year (May 2025) |
How to become a radiation therapist, step by step
- Take science and maths seriously at school. Programs include anatomy, physiology, physics and algebra, so a solid base helps.
- Enroll in an accredited radiation therapy program. Employers usually prefer an associate's or bachelor's degree in radiation therapy or a related field such as science technologies or biology.
- Complete your clinical experience. Programs often include supervised work in a clinical setting.
- Pass the certification exam. It covers radiation protection, treatment planning, and patient care and education.
- Get licensed in your state. Requirements vary, but often include graduating from an accredited program and passing an exam or holding certification.
- Add CPR or basic life support. Many employers require it.
What radiation therapists do
Radiation therapists are part of the oncology team. BLS says they operate machines such as linear accelerators to deliver concentrated radiation to the region of a patient's tumor. On a typical day you'd:
- explain treatment plans and answer patients' questions
- protect patients and yourself from improper exposure to radiation
- locate tumors so the patient is positioned correctly for each treatment
- calibrate and operate the machine
- monitor the patient for unusual reactions
- keep detailed treatment records
You'll work alongside medical dosimetrists, who calculate the radiation dose, and medical physicists. For safety, therapists stay in a separate room while radiation is delivered and wear a film badge dosimeter to track their own exposure.
Degree or certificate?
BLS says employers usually prefer an associate's or bachelor's degree in radiation therapy or a related healthcare field, or in science technologies or biology. It also says some candidates qualify for certain positions by completing a certificate program. In practice, the certificate route tends to suit people who already have a degree or a healthcare background, while school leavers usually go straight into an associate's program. Whichever you pick, check it leads to the certification exam and meets your state's licence rules, because that's what employers check first.
Pay: where the higher salaries sit
BLS put the median annual wage at $105,310 in May 2025, as of October 2026. The lowest 10% earned less than $80,560 and the highest 10% more than $156,710. Here's the catch most guides skip: hospitals employ the most therapists but don't pay the most.
| Employer (US, May 2025) | Share of jobs (%) | Median annual wage |
|---|---|---|
| Hospitals; state, local, and private | 60 | $104,260 |
| Offices of physicians | 28 | $110,610 |
| Outpatient care centers | 5 | $127,680 |
So outpatient care centers pay a median of $127,680 against $104,260 in hospitals, but they hold only 5% of the jobs. If pay is your priority, start in a hospital to build experience, then look at physicians' offices and outpatient centers.
The job outlook, in plain numbers
This is a small field. BLS counted about 17,400 jobs in 2025 and projects 3% growth from 2025 to 2035, about as fast as average, with around 700 openings a year. That's a short list of vacancies nationally, so your clinical placement and references matter. The upside is a regular schedule: most therapists work full time and treatments are planned in advance, so night shifts are less common than in many hospital jobs.
Other imaging careers use similar training. My guides on how to become a radiology tech and how to become a sonographer compare well if you want to keep your options open.
Skills you'll need
BLS lists four qualities, and each one ties back to the treatment room:
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- Compassion: your patients have cancer or another serious disease, and they need empathy as well as expertise
- Detail orientation: you follow precise instructions and enter exact measurements so the patient gets the correct amount of radiation
- Interpersonal skills: you see the same patients over multiple weeks and work closely with the rest of the oncology team
- Technical skills: you work with computers and large pieces of technology every day
You'll also need physical stamina. BLS says therapists stand for long periods and may need to lift or turn patients. If you're squeamish about hospitals or uneasy with technology, it's worth shadowing a department before you commit to a program.
My verdict
Radiation therapy is one of the best-paid careers you can reach with an associate's degree, with a six-figure median and a predictable schedule. The trade-off is a small number of openings and a strict licensing path. If you're good at science, steady under pressure and want patient-facing work, it's a strong choice. Pick an accredited program and plan your licence from day one.
Frequently asked questions
How long does it take to become a radiation therapist?
Most people complete an associate's or bachelor's degree program, and BLS says employers usually prefer one of these. Some positions accept a certificate program.
Do radiation therapists need a license?
In most states, yes. BLS says radiation therapists must be licensed or certified, which often includes passing a national certification exam.
How much do radiation therapists make?
As of October 2026, BLS gives a median annual wage of $105,310 (May 2025 data).
Where do radiation therapists earn the most?
BLS data shows outpatient care centers had the highest median wage, at $127,680 a year.
What degree do you need to be a radiation therapist?
BLS says employers usually prefer an associate's or bachelor's degree in radiation therapy or a related field, though some positions accept a certificate program.
Is radiation therapy a growing career?
Slowly. BLS projects 3% growth from 2025 to 2035, about as fast as average, with about 700 openings a year.
