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Radiography workforce and education
Radiologic technologist vacancies are high, but the evidence does not support one simple explanation. Retention, recruitment, education capacity, and clinical readiness all need different responses.
Evidence reviewed and updated:
There is no single measured cause. Current evidence points to a combination of occupational exits and retirement, demanding schedules, physical workload, staffing pressure, and burnout. At the same time, education providers face limits on clinical placement capacity, which constrains the supply of new professionals. Virtual reality cannot fix pay, workload, management, or retention by itself. It can strengthen the workforce pipeline by expanding access to repeatable pre-clinical practice and helping learners use limited clinical time more effectively.
The American Society of Radiologic Technologists reported vacancy rates at or near record levels in its 2025 staffing survey. CT reached 19.4%, MRI reached 17.4%, and radiography remained high at 15.6%.[1]
| Imaging discipline | 2023 vacancy rate | 2025 vacancy rate | Direction |
|---|---|---|---|
| Computed tomography | 17.7% | 19.4% | Increased |
| Magnetic resonance imaging | 16.2% | 17.4% | Increased |
| Cardiovascular interventional technology | 18.6% | 17.4% | Decreased, but remained high |
| Radiography | 18.1% | 15.6% | Decreased, but remained high |
| Bone densitometry | 6.9% | 16.3% | Increased |
Source: ASRT 2025 Radiologic Sciences Staffing and Workplace Survey.[1]
The U.S. Bureau of Labor Statistics projects employment of radiologic and MRI technologists to grow by 5% between 2024 and 2034. It also projects about 15,400 openings each year, with many arising because workers transfer to other occupations or leave the labor force, including through retirement.[2]
The most accurate answer is that departures arise from several interacting pressures. Some are measured directly, while others are supported by broader occupational evidence.
BLS explicitly identifies transfers to other occupations and exits from the labor force, including retirement, as major sources of projected openings.[2]
Imaging is required around the clock. BLS notes that some technologists work evenings, weekends, or overnight, while the work can involve long periods of standing and assisting patients who need lifting or turning.[2]
High vacancy rates can place more demand on the professionals who remain. This is a reasonable operational inference, although the ASRT vacancy survey does not itself establish an individual worker's reason for leaving.
A systematic review covering medical imaging and radiation science professions found that most included studies reported moderate burnout. The authors also stressed that evidence remained limited for radiographers and some related groups.[3]
Burnout matters, but it should not be used as a catch-all explanation. Employers need local evidence from exit interviews, vacancy duration, overtime, sick leave, workload, pay, career progression, and employee feedback before deciding what will improve retention.
Workforce supply depends on more than attracting applicants. Radiography students need supervised clinical education, yet placement capacity is limited by available departments, educators, equipment and patient activity.
A UK study evaluated a one-week simulation-based education package that replaced 30 hours of clinical placement for first-year diagnostic radiography students. Participants perceived the package as valuable for skill development and placement capacity. This was a study of one program and should not be treated as universal proof that simulation can replace clinical education.[4]
| Workforce challenge | Primary response | Possible role for simulation |
|---|---|---|
| Existing staff leave because of workload, schedules or conditions | Retention, staffing, leadership and workplace reform | Limited. Simulation does not correct employment conditions. |
| Programs cannot provide enough equipment practice | Expand structured practice opportunities | Strong. Learners can repeat positioning and technique-selection tasks without occupying a clinical X-ray room. |
| Clinical placements are constrained | Increase placement partnerships and use evidence-based simulation | Potentially useful as a planned component of education, subject to accreditation and local requirements. |
| Students arrive at placement underprepared | Pre-clinical skills development, feedback and assessment | Useful for rehearsal before supervised patient care. |
| Qualified staff need modality upskilling | Protected learning time, supervised practice and formal competency pathways | Useful for orientation and rehearsal, but not a substitute for clinical competency assessment. |
Virtual reality is most useful when it connects theory with repeated action. A learner can position a virtual patient, align equipment, select exposure factors, review the resulting image and try again. This creates practice opportunities that do not require a patient, ionizing radiation or an available clinical imaging room.
In a 2023 study, O'Connor and Rainford reported that structured 3D VR radiography practice had a positive effect on first-year students' clinical assessment performance, particularly in patient positioning, exposure parameter selection and image appraisal.[5]
A 2025 systematic review of nine studies found advantages for VR in assessed equipment and patient positioning, as well as self-reported confidence in equipment positioning, exposure-parameter selection and radiation safety. Importantly, the review also concluded that VR alone does not guarantee improved performance or confidence and called for stronger controlled research.[6]
Simulation should be described precisely. It can improve access to practice and support preparation, but it does not automatically increase the number of qualified professionals or retain existing staff.
| VR can support | VR cannot replace |
|---|---|
| Repeated technical and spatial practice | Supervised clinical experience with real patients |
| Preparation before equipment access | Accreditation, registration or formal competency decisions |
| Consistent scenarios and structured feedback | Professional judgement across unpredictable clinical situations |
| Access to practice away from an X-ray room | Safe staffing, fair pay, manageable workload and supportive leadership |
| Earlier exposure to workflows and decisions | Employer responsibility for retention and well-being |
Buying headsets is not an implementation strategy. The strongest approach starts with curriculum and workforce needs, then selects the simulation format that supports them.
| Step | Action | Evidence to collect |
|---|---|---|
| 1. Define the constraint | Identify whether the problem is equipment access, placement capacity, preparation, feedback or upskilling. | Room availability, placement demand, student numbers, educator time and baseline performance. |
| 2. Map the curriculum | Connect each simulated task to a learning outcome, taught content and supervised clinical activity. | Curriculum map and assessment blueprint. |
| 3. Design the learning sequence | Use briefing, guided practice, feedback, repetition and debriefing rather than unsupervised exposure alone. | Completion, repeat attempts, common errors and educator observations. |
| 4. Preserve clinical learning | Use simulation to prepare learners for patients, not to remove essential patient-facing education. | Placement performance and clinical educator feedback. |
| 5. Evaluate outcomes | Compare cohorts and measure relevant performance, not just enjoyment. | Positioning accuracy, exposure-factor selection, image appraisal, confidence and transfer to practice. |
The shortage reflects both workforce demand and replacement needs. U.S. data show high vacancy rates across radiography, CT and MRI, while BLS projects continuing employment growth and openings created when workers transfer occupations, retire or otherwise leave the labor force. Local causes vary, so vacancy and exit data should be examined separately.
No. VR cannot solve pay, workload, staffing or retention problems. It can support the education pipeline by increasing access to repeatable pre-clinical practice, helping students prepare for placement and allowing institutions to use limited equipment and clinical time more deliberately.
VR should not be treated as a complete replacement for supervised clinical education. Simulation can replace or supplement defined learning hours in some programs when evidence, accreditation rules and local governance support that decision. Real patient care, communication, adaptation and competency assessment remain essential.
Depending on the system, students may practice patient positioning, equipment alignment, exposure-factor selection, workflow, radiation safety and radiographic image appraisal. Virtual Medical Coaching supports radiography practice in immersive VR and desktop environments.
Peer-reviewed studies have reported positive effects on positioning, exposure-factor selection, image appraisal and learner confidence. A 2025 systematic review found promising results but also warned that VR alone does not guarantee improved outcomes and that stronger controlled research is still needed.
See how Virtual Medical Coaching supports patient positioning, exposure selection, image evaluation and structured practice in VR and desktop environments.
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