You run the machine that treats cancer, and you see the same patients every weekday for weeks. A two year degree for six figure pay.
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Programs in the fields this career usually comes through. Each has its own page: what it takes to get in, the courses you need and what it costs.
The median pay is about $105,310 a year. Across everyone in the job it runs from about $80,560 at the lower end to about $156,710 at the upper end. The source is listed under Sources at the end of this page.
2 to 4 years after high school, on the usual route.
$8,000 to $50,000 all in for tuition, fees, exams and kit. Living costs are not counted.
It depends where you work. You need a license, certificate or registration in Arkansas, Arizona, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Iowa, Illinois, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Maryland, Maine, Michigan, Mississippi, North Dakota, New Hampshire, New Jersey, New Mexico, Nevada, New York, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Texas, Utah, Virginia, Vermont, Washington, Wisconsin, West Virginia and Wyoming. Elsewhere there is none to hold, though many employers still ask for training or a certificate.
Moderate demand nationally, from government outlook data. Demand varies by region, so check your area.
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What you earn and what it costs to get there.
Median
$105,310
Bottom tenth
$80,560
Top tenth
$156,710
The national median is $105,310 a year. The bottom tenth earn $80,560 or less and the top tenth $156,710 or more (2025 federal wage survey). You can reach it with a two year degree, and the range is narrow.
$80,560 to $92,060
What the bottom tenth to bottom quarter of radiation therapists earn, 2025
Pay depends on the employer and the state.
$126,340 a year or more
The 75th percentile of the national wage survey, 2025
The survey does not say who is at the top. Some therapists move into medical dosimetry, designing the treatment plan on a computer, after adding a certificate.
Roughly, all in
$8,000 to $50,000
Tuition, fees, exams and kit. Not rent, food or travel
The low end is a two year associate degree at a community college in your own district, the national certification exam and the state license where your state requires one, and that is a complete qualification on its own. The high end is the four year degree route at a public university in your own state, which some hospitals prefer but few actually require. A Pell Grant does not have to be repaid and often covers most of a community college program. This is a short, low cost route to a job with a national median of $105,310.
This is a short, low cost route into health care. Fill in the FAFSA (Free Application for Federal Student Aid) first, because a Pell Grant can cover most of a community college program and does not have to be paid back.
Daytime hours
Treatment runs on a schedule. Unlike nurses and imaging technologists, you are mostly done by early evening and rarely work nights.
Hospital benefits
Health cover, retirement matching and often a pension in public and university hospitals.
Paid continuing education
Employers fund the credits you need to keep your credential.
Tuition help to move up
Many cancer centers will pay toward a dosimetry certificate for a therapist already on staff.
The exact path from high school to qualified.
Short, specific and almost entirely decided by which program you get into.
High school diploma
Grade 12
Physics, biology and math. Some programs also want a health care course or documented volunteer hours.
Get into an accredited program
Apply a year ahead
Look for accreditation by the Joint Review Committee on Education in Radiologic Technology. Class sizes are small and admission is competitive.
Associate degree or bachelor's degree
2 to 4 years
Anatomy, radiation physics, oncology and treatment planning, combined with clinical rotations in a real cancer center from early on.
Pass the national certification exam
After graduation
The radiation therapy exam from the American Registry of Radiologic Technologists, which also checks an ethics requirement before it lets you sit.
Get your state license
Weeks
39 states regulate radiation therapists separately from the national credential. Then you can treat patients unsupervised.
Physics
Radiation dose and beam behavior are the core science of this job.
Biology and anatomy
You position bodies precisely and must know what is under the skin.
Math
Dose calculations and daily verification checks.
English
You explain frightening treatment to frightened people, then record everything you did.
Two separate things stand between you and the treatment room. First is certification by the American Registry of Radiologic Technologists, which nearly every employer requires and which you keep through continuing education. Second is a license or required credential from your state: 39 states regulate radiation therapists. The other 11, and the District of Columbia, do not license this role at all and rely on employers to ask for the national credential. Check your own state before choosing a program, and check that the program itself is accredited, because an unaccredited one can leave you unable to sit the exam.
Straight into a radiation therapy program
Two years from high school, and you graduate ready to sit the exam.
Cross-train from radiography
If you are already a certified radiographer, a shorter certificate program adds the radiation therapy credential.
Bachelor's degree programs
Four years, and they open management, teaching and dosimetry doors later.
Check the program's exam pass rate
Accredited programs publish it. A weak number is the clearest warning sign there is.
Things you don't need, but that help.
Medical dosimetry
Design treatment plans instead of delivering them. A one year certificate after some experience.
Lead or chief therapist
Run the schedule, the machine time and the staff at a center.
Equipment applications specialist
Work for the manufacturer, training staff at hospitals on new machines. Comes with travel.
Teaching
Accredited programs need clinical instructors, and they usually want a bachelor's degree.
Steadiness around sick people
You will treat someone every weekday for six weeks and watch them get more tired each week.
Precision as a habit
Position, verify, record. Every single day, the same way.
Comfort with technology
Imaging systems, planning software and a machine that costs millions.
A driver's license
Cancer centers are often outside city centers, and some therapists cover two sites.
Day to day, pros and cons, where you'd work.
Start early with machine warm-up and quality checks before the first patient. Then treatments, one after another: greet the patient, position them exactly as the plan says, take a verification image with CT (computed tomography) or x-ray, step outside, deliver the beam, record it. Between patients you note side effects, flag anything for the doctor and reset the room. A full day of treatments is normal, and you know most of those people by name.
The good
The hard parts
Things people don't tell you.
Patients see their oncologist every week or two. They see the radiation therapists every single weekday for the whole course. People tell you things they do not tell the doctor.
The beam is delivered while you watch from a control area outside the shielded treatment room, on camera and over an intercom.
O*NET (Occupational Information Network) counted about 17,400 radiation therapists in 2025 and projects average growth, 3% to 4%, from 2025 to 2035, with about 700 openings a year across the country. Plan on being willing to move for the job you want.
The American Registry of Radiologic Technologists charges the same $225 primary application fee for radiation therapy as for radiography, nuclear medicine, MRI (magnetic resonance imaging) and sonography.
Every list is built from the same numbers shown above, so you can see where this career sits next to the others.
Diagnostics and lab first, then the rest of the field. See every career in health.
Last checked October 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.
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