Radiology Department Staffing: Part 2

Reading Time: 7 minutes read

The pros and cons of new hires for radiology department staff.

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

Editor note: This is the second in a 2-part series. In Part One, we looked at the benefits and process of cross-training current employees to fill a vacant position.  But what about hiring from the outside? Is it a better option? Read on.

Pros of hiring radiology staff from outside the company

Already has modality experience

Perhaps the greatest advantage is that the new employee already has experience in the job you need to fill. Radiology administrators understand that a technologist’s skills improve over time. The years spent in the field mean unparalleled expertise which your department gains by hiring.

image of doctors/nurses rushing in a medical hallway in background with text "New hires for radiology: pros and cons"
Pro: a new hire from outside the department will already have experience in the modality.

An experienced technologist can spend less time on each scan. They can get to what the radiologist will need to see in less time. That means more scans can be done, and thus, the department earns more for the facility or business. It is, however not the case for a starter who has been cross-trained as they try to find their way around in the new modality.

Can perform on day one

The R.T. you hire can get started right away and deliver from day one. Cross-training an internal rad tech will require time for the training and easing into the job. Hiring from outside will allow you to get the right person for the job right away. They will still have to learn the current EMR, PACS system and other software, but they will have the fundamentals. There is also a chance that their prior employer used the same software as your radiology department. 

Hiring from the outside also allows you to fill the vacancy and get the modality running right away. Cross-training requires time for at least one technologist to educate the employee who is being cross-trained.

Brings new energy

An outside hire can inject new energy into the X-ray department and transform it. They will bring with them better alternatives and can be a source of significant improvements. They might be what your department needs to get to the next level. “Fresh eyes” as they call it, can be very beneficial to a stale department. 

Cons of External Hiring

Little knowledge of the hospital

A new employee will have little knowledge of the hospital and department and will, therefore, have a long time settling in. There are procedures, policies, and the EMR to learn before they can comfortably deliver in their position.

In addition to the first few months being challenging for the employee, the department will not be able to get the best out of the new employee during that time. Given the critical role the radiology department plays in the hospital in terms of income, the adaptation period may negatively affect the hospital.

Not familiar with computer system

Medical imaging facilities tend to have customized software for the operation of their machines. An individual hired from outside will thus have a steep learning curve. It may take some serious orientation to get them adapted to the computer system in use. An employee used to scanning on one vendor’s equipment may have to learn a new imaging system, including changing their scanning protocols. While the basics are still there, the workflow to achieve the scans could be completely different. 

Cross-training counters this problem by having the candidate train on the job and hence will understand the system well by the time of assumption of the specialist role. 

Female doctor analyzing brain MRI scan results of a patient on computer monitor in control room.
Con: a new hire won’t have experience in your software.

Unfamiliar with co-workers

One of the main challenges to new employees becoming productive is the dynamics of joining the existing workforce. It may take some time to earn the respect of co-workers that will allow a smooth flow at work.

It gets even more challenging when the person being replaced was well-respected. The new employee will have to work hard to fit in the shoes of their predecessor.

Low morale among employees

When nobody looks forward to promotions because the employer will hire someone from outside, the department suffers low morale. External hiring reduces the career ladder of the employees, and thus, they may not perform at their best.

New employee may not work out

There is a risk that the new employee will not fit in to the position. They may pass the interview and screening processes, but not be a good fit overall. This is the purpose of a 90-day evaluation period. If you need to let them go and hire someone else, the X-ray department will suffer a significant loss of time and money.

Comparing the cost of cross-training to external hiring

Studies show that hiring new employees costs as high as 50-60% of their annual salary. This is significantly higher than training a current employee a new skill and responsibility (1).

Close-up Of A Businessperson's Hand Balancing Stacked Coins On Wooden Seesaw With Finger Over Desk
Hiring an experienced professional will mean a higher annual salary compared to a cross-trained employee.

However, in the beginning, it may seem as if cross-training costs more as the trainee is paid while they learn on the job. Also, the trainer may need a salary enhancement if they feel the training impacts on their job description.

Hiring, on the other hand, will cost less at the beginning (if there is backfilling during cross-training as explained in Part One. But hiring a skilled professional will mean a higher annual salary as their experience also comes into play immediately upon hire. Over the long term, the cost of a skilled outside employee will cost more than a cross-trained loyal internal employee.


Based on my observations and research, cross-training radiology staff to fill vacancies on advanced modalities is superior to external hiring.  It has many advantages, including lesser run-rate costs, better employee morale, and smoother transition, among others.

Hiring from outside is only optimal when an immediate replacement is needed, and there is no one to train in-house. Ideally, radiology administrators have plans to cross-train in anticipation of events such as future staff shortages and forecasted patient volume increases. Your radiology staff will appreciate it. And who couldn’t use better employee survey results?

What do you believe is the better option for filling vacancies in radiology staff: cross-training or new hires?

  1. The Cost of Hiring the Perfect Candidate vs. Training an Existing Employee
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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