As the population grows and ages, the demand for diagnostic imaging is increasing - and radiologists, the physicians who specialize in imaging, are having a hard time keeping up. The average radiologist's workload increased by more than 25 percent between 1992 and 2002, and the pace shows no sign of slowing.

It's clear that overworked radiologists need help, and patients need more timely care. So the American College of Radiologists ( and the American Society of Radiologic Technologists ( have worked together to define a new role in imaging: the registered radiologist assistant.

What do they do?

Registered radiologist assistants (RRAs) are experienced, registered radiographers (also called radiologic technologists or X-ray techs) who have completed additional education and advanced certification. RRAs are supervised by a radiologist and have three main areas of responsibility:

  1. Managing and assessing patients, which can include determining whether a patient is properly prepared for a procedure, obtaining history and consent, and answering questions.
  2. Performing selected radio-logy exams and procedures, such as barium enemas.
  3. Evaluating image quality and passing preliminary observations along to the supervising radiologist.

A win-win situation

"When radiologists work with an RRA, they have more time to read images and to perform more complex procedures," says Nance Cavallin, a radiographer and testing specialist with the American Registry of Radiologic Technologists (, the national certifying organization for radiographers and RRAs, located in St. Paul.

The creation of the RRA role has also given radiographers a more defined career path. "It's a win-win situation for everyone: radiologists, technologists and patients," Cavallin says.

Education and outlook

An RRA candidate must be an ARRT-certified radiographer before enrolling in an educational program. All RRA programs are at the baccalaureate level or higher and include a clinical preceptorship directed by a radiologist. Graduates must pass an additional ARRT certifying exam.

Cavallin notes that preliminary discussions are under way about similar advanced practice roles for sonographers, nuclear medicine technologists and radiation therapists.

Nancy Giguere is a freelance writer from St. Paul who has written about healthcare since 1995.