To become a radiologist in the US, you'll earn a bachelor's degree, complete 4 years of medical school, then do a year of clinical training followed by a 4-year diagnostic radiology residency. To be board certified, you pass the American Board of Radiology's Qualifying (Core) Exam during residency and a certifying exam afterwards, alongside your state medical license.
Radiologists are physicians who review and interpret x-rays and other medical images, such as ultrasounds, to diagnose injuries and diseases. They may specialize, for example in diagnostic or interventional radiology.
Figures come from the Bureau of Labor Statistics (BLS) Occupational Outlook Handbook and the American Board of Radiology (ABR), both read on 26 October 2026.
Radiologists in numbers
| Measure | Figure |
|---|---|
| Median pay, radiologists (May 2025) | $420,860 a year |
| Radiologist jobs, 2025 | 28,700 |
| Projected radiologist jobs, 2035 | 29,600 |
| Projected growth 2025 to 2035 | 3% |
| Diagnostic radiology residency | 4 years, after a clinical year |
That pay figure is as of October 2026 and is one of the highest medians BLS lists for any physician group.
How to become a radiologist, step by step
- Earn a bachelor's degree. No specific major is required, though applicants usually study biology, physical science or healthcare.
- Get into medical school. Expect to submit transcripts, MCAT scores and recommendation letters, and to interview.
- Complete medical school. 4 years for an M.D. or D.O., with clinical rotations in the second phase.
- Do a clinical year. ABR says you must complete a year of clinical training in an ACGME- or RCPSC-accredited program in the U.S. or Canada before starting residency.
- Complete a 4-year diagnostic radiology residency. It may include no more than 16 months of research.
- Pass the ABR exams. The Qualifying (Core) Exam comes after 36 months of residency; the certifying exam follows after residency.
- Get licensed and consider a fellowship. All states require a medical license. A fellowship of 1 to 3 years adds a subspecialty.
New ABR timing rules for 2026 and beyond
Here's the detail most guides haven't caught up with. ABR says that from July 1, 2026, you must complete your four-year residency within eight years of your residency start date. And the certifying stage is changing: in 2026 and 2027, you take a computer-based Certifying Exam at least 12 months after finishing residency, and after 2027 an Oral Exam takes its place.
ABR also gives you six full calendar years from residency completion to finish your certification. If you're planning a career break or a move during training, read the residency completion and leave policies early, because the clock is now firmer than it used to be.
What the Core Exam looks like
| Feature | What ABR says |
|---|---|
| When you take it | After 36 months of residency |
| Format | Computer-based, taken remotely over three days |
| Length | About five and a half hours per day |
| How often it runs | Twice a year, typically late May or early June and November |
| Physics | No separate physics exam; physics questions run through the whole exam |
Diagnostic or interventional radiology
BLS describes two broad directions. Diagnostic radiology involves reviewing images and recommending treatment or more testing. Interventional radiology includes diagnosing patients and treating them with minimally invasive techniques. ABR also notes that an accredited radiology fellowship or nuclear medicine residency completed before your diagnostic radiology residency may earn up to one year of credit, with your program director's approval.
Your state medical license
Board certification and a license are separate steps. BLS says all states require physicians to be licensed, and to qualify you must graduate from an accredited medical school and complete residency training in your specialty. Licensure also includes passing standardized national exams. Requirements vary by state, so contact the medical board in the state where you plan to work. ABR adds that while you're still in training, a valid training license is acceptable for its process.
Transfers, leave and international graduates
ABR expects you to complete all four years of residency in the same program. If you want to transfer, both your current and future program directors must approve it, and ABR needs a signed letter from both confirming your dates, your standing and which training will count. ABR also publishes a residency leave policy for personal and family needs, so read it before you plan time away.
International medical graduates can follow ABR's IMG Alternate Pathway, and ABR says those on it are eligible for the Certifying Exam any time after the fourth year of training. If you trained abroad, check the pathway rules early, because they change the order of your exams.
What the work is like
Most physicians work full time and some work more than 40 hours a week, with long shifts that can include overnight hours or being on call. Much of the job is reviewing images and recommending treatment or additional testing. If you're exploring the wider field first, our guide to healthcare jobs in demand covers other roles, and this look at medical transcription shows how reports and dictation fit in.
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My verdict
Radiology is one of the best-paid physician routes, but it takes a bachelor's degree, 4 years of medical school, a clinical year and a 4-year residency before you even reach the certifying exam. Go in knowing ABR's 2026 timing rules, plan for the Core Exam at the 36-month mark, and keep an eye on the switch to an oral certifying exam after 2027. If you love diagnosis and detail, it's a rewarding specialty.
Frequently asked questions
How long does it take to become a radiologist?
A bachelor's degree, 4 years of medical school, a clinical year and a 4-year diagnostic radiology residency, with an optional 1 to 3 year fellowship.
How much do radiologists make?
BLS reports a median of $420,860 a year for radiologists in May 2025.
What exams do radiologists take?
The ABR Qualifying (Core) Exam after 36 months of residency, then a certifying exam: a computer-based Certifying Exam in 2026 and 2027, and an Oral Exam after 2027.
Do you need board certification to work as a radiologist?
BLS says board certification isn't required for physicians, but it may increase employment opportunities. You do need a state medical license.
Is there a time limit to finish radiology residency?
Yes. ABR says from July 1, 2026, you must complete your four-year residency within eight years of starting it.
How long do you have to get board certified after residency?
ABR gives you six full calendar years from residency completion to complete diagnostic radiology certification.
What is interventional radiology?
A branch of radiology that diagnoses patients and treats them with minimally invasive techniques.
Is radiology a growing field?
BLS projects radiologist jobs to rise from 28,700 in 2025 to 29,600 in 2035, a 3% increase.
