Radiation Oncologist

A cancer doctor who treats with radiation beams instead of a scalpel. Thirteen years of training, and the survey group it is counted in has one of the highest doctor medians on this site.

Typical pay: $420,860a year
Time to qualify: 13 to 14 yearsafter high school
Demand: Moderate
License needed: Yesregulated job

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Quick answers

How much does a radiation oncologist make in the United States?

The median pay is about $420,860 a year. Across everyone in the job it runs from about $89,010 at the lower end to about $594,410 at the upper end. The source is listed under Sources at the end of this page.

How long does it take to become a radiation oncologist in the United States?

13 to 14 years after high school, on the usual route.

What does it cost to become a radiation oncologist?

$200,000 to $340,000 all in for tuition, fees, exams and kit. Living costs are not counted.

Do you need a license to work as a radiation oncologist in the United States?

Yes. It is a regulated job, so you need a license or registration before you can work.

What is the job outlook for a radiation oncologist in the United States?

Moderate demand nationally, from government outlook data. Demand varies by region, so check your area.

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Radiation Oncologist salary in the United States

What you earn and what it costs to get there.

What the pay survey shows

Median for the group

$420,860

Bottom tenth

$89,010

Top tenth

$594,410

The median for the group is $420,860 a year. The bottom tenth earn $89,010 or less and the top tenth $594,410 or more (2025 federal wage survey). The survey group behind these numbers is radiologists, the doctors who read medical images, and radiation oncologists are not broken out on their own. Both are certified by the same board. The survey only counts physicians who are paid as employees, so doctors who own their practice or are partners in a group are not in it.

While you are a resident

$71,052 to $82,992 a year

Duke University Hospital pay from the first to the fifth training year, 2026 to 2027

Each hospital sets its own scale. You are a working doctor for those five years, while medical school loans keep growing behind you. Nationally, the AAMC (Association of American Medical Colleges) survey of 345 teaching hospitals puts the average first-year stipend at $68,166 as of July 1, 2025, and about $81,807 in the fifth year. Read from the AAMC's data, downloaded in a browser with Claude in Chrome on 6 November 2026, because aamc.org refuses our checker.

The top quarter of the group

$506,010 a year or more

25% of employed radiologists earn this or more, 2025

This is the radiologists' group, not radiation oncologists alone. Treatment is built around linear accelerators, so jobs cluster where the machines are.

What it costs to get there

Bachelor's degree, in-state public: About $11,000 to $15,000 a year in tuition
Medical school: Roughly $40,000 a year at an in-state public school, around $65,000 a year private
MCAT (Medical College Admission Test) and applications: The test fee, plus several thousand more applying and interviewing
Board certification: Written qualifying exams during residency, then an oral certifying exam from the American Board of Radiology

Roughly, all in

$200,000 to $340,000

Tuition, fees, exams and kit. Not rent, food or travel

The low end is a community college transfer into an in state public university, then an in state public medical school, plus the Medical College Admission Test, applications and the national licensing exam sequence. The high end is four full years of undergraduate study and a private medical school at around $65,000 a year. The five years of residency after medical school are paid employment, so they add board fees rather than tuition. Most graduates borrow, and the interest that builds during training is not counted in these numbers.

Most graduates borrow, and the debt is large. Ten years at a nonprofit cancer center can clear it through PSLF (Public Service Loan Forgiveness).

Benefits

Predictable hours for a doctor
Treatment is scheduled weeks ahead. There is very little middle-of-the-night work compared with surgery or emergency medicine.
Malpractice cover paid
Always carried by the hospital or the group.
Research time
Academic centers build protected research days into the contract.

How to become a radiation oncologist in the United States

The exact path from high school to qualified.

The path to becoming a radiation oncologist, step by step

Medical school, then one general clinical year, then four years devoted entirely to treating cancer with radiation.

1
High school
Grades 11 and 12
Biology, chemistry, physics and math. Physics matters more here than in almost any other medical specialty.
2
Bachelor's degree
4 years
Any major with the pre-medical science courses finished, plus the MCAT (Medical College Admission Test).
3
Medical school
4 years
Classroom science then hospital rotations. You graduate as a Doctor of Medicine (MD) or a Doctor of Osteopathic Medicine (DO).
4
Preliminary clinical year
1 year
A general year in internal medicine or surgery before the specialty training starts.
5
Radiation oncology residency
4 years
Cancer biology, radiation physics, treatment planning and clinic. You learn to aim a beam at a tumor while sparing what is next to it.
6
Board certification
During and after residency
Written qualifying exams during residency, then an oral certifying exam from the American Board of Radiology.

High school courses that help you become a radiation oncologist

Physics
Radiation dose, beam energy and shielding are physics problems you will solve every week.
Biology
Why radiation kills a tumor cell and spares a healthy one is cell biology.
Chemistry
Required for every pre-medical track.
Calculus and statistics
Treatment planning is mathematical, and you will read clinical trials for your whole career.

Time and money, at a glance

Years after high school: 13 to 14
How hard to get in: Medical school is the first gate. Radiation oncology is a small specialty with few training spots
Total cost: $200,000 to $340,000 across college, medical school and exams
Paid while training?: Yes, for all five years of residency

State license, national board

Each state licenses doctors through its own medical board, and you hold a license in every state where you treat patients. The exams themselves are national: the United States Medical Licensing Examination sequence during medical school and residency, then certification by the American Board of Radiology, which covers both radiology and radiation oncology. Residency programs must be accredited by the Accreditation Council for Graduate Medical Education, and finishing an accredited program is what makes you eligible for the board exams.

Who you work with

Medical physicists
They make sure the machine delivers exactly the dose that was planned, and check it constantly.
Dosimetrists
They build the treatment plan on a computer, shaping the beams around the tumor.
Radiation therapists
They position the patient and run the treatment every day of the course.
Medical and surgical oncologists
Cancer care is decided together. You argue over the plan in a weekly meeting with the whole team.

What helps you get ahead as a radiation oncologist

Things you don't need, but that help.

Ways the job specializes

Brachytherapy
Placing a radioactive source inside or against the tumor. Hands-on, procedural, and a skill in short supply.
Stereotactic treatment
Very high doses aimed with millimeter accuracy, sometimes in a single session.
Pediatric radiation oncology
Treating children, where sparing growing tissue matters for the next sixty years.
Proton therapy
A different kind of beam at a small number of centers. Working with it means moving to where the machine is.

Nice-to-haves

Genuine comfort with physics
This specialty attracts people who liked physics and medicine equally, and it rewards them.
Research during medical school
Radiation oncology programs are small and selective, and publications carry weight.
The ability to talk about dying
Some of your patients are being treated to buy time or to ease pain, not to be cured.
Attention to detail
A plan aimed a few millimeters wrong can injure a spinal cord. Checking is a habit, not a task.

A small specialty, and that cuts both ways

There are far fewer radiation oncologists in the country than internists or surgeons, and far fewer training spots. That makes the community tight, but it also means jobs cluster where the machines are. New graduates often have to move to a specific city rather than choose freely, and the number of training positions has been argued over inside the field for years because nobody wants to train more doctors than the machines can employ.

What being a radiation oncologist is really like

Day to day, pros and cons, where you'd work.

What a radiation oncologist does day to day

Morning clinic: new patients who have just been told they have cancer, and follow-ups weeks or years into treatment. You explain what radiation does, how many sessions it takes, and what it will feel like. Midday is treatment planning at a screen, drawing the tumor and the organs around it on CT (computed tomography) images with a dosimetrist. Afternoon is the weekly cancer conference where surgeons, medical oncologists and pathologists argue about a single patient, plus checks on people partway through a course of treatment.

The honest pros and cons of being a radiation oncologist

The good

The survey group it is counted in, radiologists, has a median of $420,860
Hours are predictable by doctor standards, with little night work
You follow patients through a whole course and see the result
Technology and physics are part of the daily job

The hard parts

Thirteen years and a large debt first
Few training spots and jobs tied to where the machines are
Some patients you treat will die anyway, and you tell them so
The work is exacting and a small error has serious consequences

Work life

Typical hours: 45 to 55 a week, with light call
Remote work: Some treatment planning can be done remotely, but clinic cannot
Physical demand: Low
Unionized: Rarely, though resident doctors at some hospitals are

Similar paths

Things nobody tells you about being a radiation oncologist

Things people don't tell you.

Many cancer patients get radiation

It is used to cure tumors, to shrink them before surgery, and to relieve pain when cure is not possible. That makes this a small specialty involved in a very large share of cancer care.

The dose is built up over weeks

A standard course is a short treatment every weekday for several weeks. Splitting the dose lets healthy tissue repair between sessions while the tumor falls behind.

Eight examiners, eight cases

The American Board of Radiology's oral certifying exam is eight 25-minute one-on-one sessions, each with a different examiner and a different area of cancer care. Before that come three written exams, including one on radiation physics.

How a radiation oncologist compares

Every list is built from the same numbers shown above, so you can see where this career sits next to the others.

More health careers in the US

Doctors first, then the rest of the field. See every career in health.

Where these numbers come from

Last checked November 2026. Pay figures are typical full-time annual amounts in United States dollars, based on Bureau of Labor Statistics wage data and published pay scales. They vary by state, employer and experience. Tuition is for in-state students at public schools unless the card says otherwise. How every figure on this site is sourced and checked.