Staffing the Radiology Department: Part One

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The pros and cons of cross-training radiology department staff

By Ron Jones MSRS, RT (R, CT) ARRT

Editor note: This is the first in a 2-part series on staffing in radiology departments. In Part One, we look at the benefits and process of cross-training current employees to fill a vacant position.  In Part Two, we look at the pros and cons of hiring new talent.

When you need to replace or increase the number of specialized radiologic technologists, two options exist. One, you may opt to cross-train a current employee for the job, or two, hire a skilled rad tech from outside the company. What does each option mean for your radiology department? And which one is the best option? In this 2-part series, I will give an in-depth analysis of the choices, their pros and cons, and explain why it is a great idea to cross-train rad techs to become advanced modality technologists.

Data illustrations and people walking in the background of image along with text "Cross training radiology staff: Pros and Cons"
Cross-training can be effective to increase the number of specialized radiologic technologists in your department.

Positives of cross-training current rad techs

  • Internal training increases employee morale as they are rewarded for their exemplary work
  • Employees already know the environment (computer systems, departmental locations, staff, etc.)
  • Cross-training promotes employee engagement and leadership
  • Management is seen as willing to invest in staff which breeds loyalty
  • Staff become multi-modality technologists
  • Cross-train pay remains at the prior modality rate, lower than hiring an experienced tech from outside
  • Once licensed, the cross-trained employee salary, although higher than previous, is lower than an experienced new hire
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Negatives of cross-training current employees

  • Will create a gap in the modality where the trainee is coming from (usually general X-ray)
  • Could be higher costs associated with internal cross-training, depending on the modality
  • Takes longer for receiving department to get the help they may desperately need
  • The newly trained employee could leave for greener grass upon completion of cross-training

What does cross-training an employee mean?

Cross-training is when you teach a current employee the skills and responsibilities of a different position within your radiology department. It is a common practice among companies that want to increase the efficiency of their employees while promoting loyalty and career growth. 

image of radiologists smiling at camera and holding a x-ray film
Cross-training rewards exemplary rad techs.

Over the years, it was mainly used to ensure the smooth running of companies by having someone available to step in when a specific employee could not make it to work. The company remains productive even when key employees are sick, on vacation or quit the company entirely. It has also been popularized as a way of cutting down on costs by having employees perform multiple roles depending on the demand. Night shift employees are a perfect example of the benefits: they are multi-modality trained and utilized when volumes are high. 

Cross-training also comes in handy when one section is overwhelmed due to an unexpected increase in volumes. When a Level One trauma center gets flooded by mass casualties, cross-trained employees are able to move from modality to modality as needed. 

Certified radiologic technologists can, therefore, be cross-trained to become proficient and licensed within many different modalities throughout the department.  

Should employees be paid while cross-training?

It all depends on the facility. Employees can get paid when training on the job.  It is the best option for trainees as it makes the transition smooth, especially financially. Employees also may need to be paid due to employer policy. Many facilities cannot allow technologists to see patient information or work hands-on with patients if they are not actively on the clock. However, some facilities are able to cross-train during evening shifts when patient volume is low. Training an X-ray tech to do CT scans when there are no X-rays to be performed is financially responsible, but can make it difficult for the trainee to learn concepts if they are constantly pulled back to their original department every time a new exam is ordered. 

older female radiologist teaching younger radiology staffs
When staff are cross-trained, they can easily fill in when employees are out sick or on vacation.

Employees are not paid if training as a student during clinical rotations outside their work shift. Student clinical rotations are more akin to volunteer work and the student is governed by the school policies. There are instances where hospitals can hire students before they complete their schooling. In this case, they are a hired employee who is also finishing clinical hours. 

Administrators like student clinical rotations as it allows an evaluation period of the potential future candidate for employment. Clinical rotations are known to be pseudo job interviews.

Why should you cross-train employees?

There has never been a better time to cross-train. Your employees form a resource pool with high potential. Cross-training utilizes that potential to move the department to the next level.

Wait too long to cross-train and you may find yourself in a situation where your current staff is being overworked and become unhappy with a staffing shortage. With proper cross-training, you can comfortably let your key employees have their leaves and vacations while someone fills their role during that period. Efficiency is thus achieved as every employee will be at their best.

Cross-training not only addresses current challenges but also cushions your department against future problems. You will manage to stay afloat when a key employee decides to quit or has to be terminated. An employee who has been cross-trained can fill in right away. That also applies to accidents, ill health, or other unavoidable circumstances that leave a modality without a technologist or understaffed. With cross-training, you will always be future proof and will give your employees an upward mobility path.

Cross training also provides these benefits:

image of a job interview
One disadvantage: the cross trainee will have almost no experience on the new modality as opposed to someone from outside who may have years of experience.
  • Increases morale
  • Staff already know each other
  • Cheaper in the long run
  • Employee already knows your EMR, policies, and procedures
  • Rewards staff for loyalty and hard work
  • Opens up a new job
  • Trains future trainers
  • Improved job security

Cons of cross-training

Cost of training

If you backfill the vacated position, you are paying both the trainee and the backfill. However, this is a net neutral to your budget. Prior to the need for cross-training, you were paying someone to work in the advanced modality already. Should multiple needs occur simultaneously in one advanced modality, you will not be able to fill all the need with cross-training. You will have to hire from outside to get the department back to operational. You simply won’t have the time to cross-train. 

Less experience

The cross trainee will have almost no experience as a specialist in the field. In contrast, a new hire could have years of experience at the time of hiring. 

Unhealthy competition

As with most promotions, unhealthy competition may arise between employees. The senior registered technologists already in the modality where you want to cross-train might feel threatened.

What do you believe is the better option for filling vacancies in radiology staff: cross-training or new hires? I’d love to hear about your experiences. And be sure to read Part Two on the Pros and Cons of External Hires in the Radiology Department.

Learn more about radiology department staffing in these blogs:

Ron Jones MSRS, RT (R, CT) ARRT, is a Technologist, Administrator, Guest Speaker, and Mentor. He has worked in healthcare for over 25 years. Phlebotomist turned Rad Tech, he is trained in X-ray, CT, US, and MRI. This past decade, he focused more on imaging administration. He is passionate about sharing his knowledge and helping to mentor incoming Rad Techs or others interested in the field of Radiology. Visit his blog site, The Radiologic Technologist.
He was selected as an AuntMinnie Semifinalist for Most Effective Radiology Administrator/Manager.


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