CT Jobs Abound – Do We Have an Answer to the Shortage of RT’s?

Advertisements, sign on bonuses, and robust hiring packages are the grist of the labor mill recently.  It appears that COVID-19 took a toll on more than just our patient population. Many health care practitioners retired, changed fields, and/or decided to stay home in the aftermath.  Those that remain loyal and determined find themselves working in environments with extended hours, more overtime, and severe staffing shortages.  

I wondered if I could make some sense out of the numbers, or if what the statistics show are false and misleading.  It could mean that active certificates or licensure may not show the real situation if those sitting out the current trends hold a valid credential but are not applying it to patients. In other words, they are not working in patient care.  

I started my search by looking at the number of student technologists who took the American Registry of Radiologic Technologists certification exam for the first-time last year in 2021. Were the numbers increasing or decreasing for first time candidates? Candidates decreased significantly in 2020 and rebounded and increased in 2021. Many training facilities closed their doors to students during the early days of the pandemic, and a high number of students found themselves without a clinical site to complete their training and remote classrooms which made a bad situation even more intolerable.  This fact was also demonstrated from the candidates who sat for the Radiography exam in 2021 and the candidate group receiving lower scores than other years. 

After verifying the rebound of candidates entering the entry level radiography status, I began to compare the candidates who entered the CT certification exam this year to CT candidates last year. Obviously, the COVID-19 pandemic changed the importance of CT in the evaluation of the disease and catapulted the CT scanner patient load into the stratosphere.  As the subvariants have decreased the initial virus response in the respiratory system and the lungs, there may have been some decrease in demand, but not enough to be significant. Coupled with trying to apply infection control and use of PPE in the CT environment, you are sure to get a bad headache. I found that the ARRT does not publish the results of the CT certification exams as they do with other modality specialties. I had to find another yardstick to look for answers.  

I decided to track the certificate census by state. The three largest ARRT radiologic technologist census states are Texas (27,289), Florida (25,408), and California (25,071) (July,2022 – ARRT Census Data*). The lowest census states are Hawaii (1,021), Wyoming (771), Alaska (708), Vermont (679) (July 2022 – ARRT). These numbers only tell us where technologists live, not where they work or if they are employed in radiology.  No yardstick is perfect, and as I use these numbers to evaluate staffing personnel, they are not a complete picture of an uncertain job market.

In Texas, where the radiologic technologist numbers are the highest, there are certainly more square miles to provide services than in other states. That is the first caveat. But also in Texas, health care facilities must register their CT scanners to obtain a permit to operate. At the time of this article, the data reports 963 Registrants operating 1,469 sites or machines in Texas. I’m assuming that each CT scanner is running two shifts or extended hours requiring an operator. Some of those are overlapping shifts, and many are operating more than two shifts per day.  

The ARRT census also reports 26.9% of RTs in Texas hold a CT certificate as well. In Florida and California, 24.6% of RT’s hold a CT certificate. In contrast, the smaller census states have higher percentages Hawaii 25%, Wyoming 33.6%, Alaska 29.8%, and Vermont 33%.

CT Technologist per state

 If I use Texas as an example for machines, shifts, hours of operation, and personnel, there obviously are not enough personnel to operate 24/7 or the expanded hours CT scanners are operating.  This means many CT staffing personnel do not hold a CT certificate yet. After The Joint Commission backpedaled the requirement for all CT Scanner operators to hold a CT certificate showing the completion measurement of successfully demonstrating a pass rate on an exam, only lead techs were required to have a CT certificate.  The dictates of the job market have not slowed the demand for CT scanner services.   

The question remains: Why is there such a shortage of CT technologists? Fortune Business Insights reported in April 2022 that the CT scanner sales growth in 2020 was 9.3% higher than in 2019 (pre-pandemic). Amber Diagnostics reported an estimated 90 million CT scan procedures performed each year in the USA.  “This, combined with increasing technological advancements in computed tomography, drives market growth during the forecast period.” 

There are speed bumps in the road to obtain CT training for technologists. The most modern way to obtain training is through a short course for theory and then clinical procedure rotations. There are colleges that offer continuing education coursework, but the speed bumps are the overly heavy admission process and the ridiculous requirements to register for online training. Who needs to get and submit a physical to attend a campus that they will never visit during the online training? The better choice is training where admissions only require the entry level certification in radiography with a short length of time in the field or experience.  

Another speed bump is actually obtaining clinical practice without a health facility sponsor. There are long contracts and costs repayment for permission to train before or upon employment. These deterrents affect the rural or suburban radiologic technologist who require a different opportunity to train with an experienced CT technologist for a short period of time.  Facilities do not want to assume the liability of a radiologic technologist who is not an employee.  Malpractice insurance coverage for and during the training is required. To have access to insurance coverage during clinical training the sponsoring entity must be covered for students or continuing education activities.  Despite these speed bumps, a radiologic technologist seeking to advance their career should seriously consider training for CT. The future is there, and the rewards match the effort.  

To answer our original question: There is a definite shortage of qualified radiologic technologists trained and certified in CT. The demand for new technology, CT services, and increased equipment utilization has overwhelmed the available Certified CT technologists in the marketplace.  Short term travel positions of 13 weeks abound, most with sign-on bonuses or increased pay. At this time, it’s like the lottery. Who wins the spin? And until the balance returns with more training and certification, there will not be much change.  

*These numbers are current at the time of publication of this article but are updated in real time. Please refer to this website for the most current census.

***Looking to cross train into CT? The required 16 hours ARRT structured education to qualify for the CT certification exam can be fulfilled by our CT Prep and Exam Review in September, as well as our Introduction to CT Course! You can also find CT Continuing Education by visiting aheconline.com. If you need CT CE in bulk, we have an 8-hour CT Bundle designed to get you quality education.


  • Marilyn Sackett, MEd, RT(R), FASRT

    Marilyn Sackett is passionate about mentoring and education. She has experience establishing and teaching at the colligate level, she was a Director of Imaging for a large healthcare system in the Texas Medical Center, and she led the charge to improve radiation protection and licensure in the state of Texas, to this day she holds license #1 for radiology in the state. A former Ernst & Young Entrepreneur of the Year award winner and a Fellow of the American Society of Radiologic Technologists, Marilyn is a pioneer in radiology education.

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