"How do I become a brachytherapist?" is a fair question with an unusual answer: you don't train as one directly. No board or regulator covered in this guide issues a credential called "brachytherapist". Instead, you qualify in one of the core radiotherapy professions and then build brachytherapy-specific competence on top of it.
In practice that means three layers. First, the core qualification for your profession and country (for example ABR board certification for US radiation oncologists, or the FRCR and specialty training for UK clinical oncologists). Second, supervised brachytherapy cases logged during that training, with formal minimums in some systems. Third, optional extras: short courses run by ESTRO, the American Brachytherapy Society (ABS) or the IAEA, and fellowships that give concentrated hands-on volume.
This guide maps those layers by profession, lists the courses and fellowships we could verify at the time of writing, and gives you a practical way to compare them. If you want to know what each role actually does on a treatment day, read our guide to the roles in the brachytherapy team first.
Career routes by profession
Every brachytherapy team combines several professions, and each has its own route in. The diagram shows the common pattern: a core qualification first, then brachytherapy-specific experience, then ongoing education.
Radiation oncologist (clinical oncologist in the UK)
This is the doctor who prescribes brachytherapy and usually places the applicator, needles or seeds. In the US, the American Board of Radiology (ABR) requires one year of accredited clinical training followed by a four-year ACGME- or RCPSC-accredited radiation oncology residency, a three-part qualifying exam and an oral certifying exam. In the UK, the Royal College of Radiologists' 2026 clinical oncology curriculum describes an indicative five-year programme (an oncology common stem year at ST3, then roughly four years from ST4 to ST7).
Medical physicist
The physicist is responsible for the sources, the afterloader, quality assurance and the independent plan check. In the US, ABR medical physics certification requires a programme accredited by the Commission on Accreditation of Medical Physics Education Programs (CAMPEP) for Part 1 and a CAMPEP-accredited residency (or professional doctorate) for Part 2. In the UK, radiotherapy physicists work as clinical scientists registered with the Health and Care Professions Council (HCPC).
Dosimetrist
Dosimetrists design the dose plan. The US credential is the CMD, awarded by the Medical Dosimetrist Certification Board (MDCB), which requires a bachelor's degree and a JRCERT-accredited dosimetry programme for US applicants; MDCB states it ended its international eligibility route after the September 2025 exam. In the UK, planning sits within radiotherapy physics rather than a separate "dosimetrist" title.
Radiation therapist (therapeutic radiographer)
Radiation therapists position the patient, connect the applicator to the afterloader and run the treatment console. In the US, the credential is ARRT certification in radiation therapy, R.T.(T)(ARRT). In the UK, therapeutic radiographers complete an approved degree and must register with the HCPC before they can practise. Brachytherapy skills are mostly built on the job and through courses rather than a separate credential.
Core certification by country
The table summarises the core qualification and, where it exists, the brachytherapy-specific requirement. It is a map, not a substitute for the rules of the body you will apply to.
| Profession | United States | United Kingdom | Brachytherapy-specific element |
|---|---|---|---|
| Radiation / clinical oncologist | ABR certification (1 clinical year + 4-year residency + exams) | FRCR (Clinical Oncology) + specialty training; GMC specialist register | US: ACGME case minimums; NRC "authorized user" status. UK: RCR curriculum capability (CiP 18) |
| Medical physicist | ABR certification via CAMPEP programme and residency | Clinical scientist (HCPC) | US: NRC "authorized medical physicist" for HDR units |
| Dosimetrist | CMD (MDCB) | Planning within radiotherapy physics | Planning experience; no separate brachytherapy credential |
| Radiation therapist | R.T.(T)(ARRT); state licensure in most states | Therapeutic radiographer (HCPC) | Local training and competency sign-off |
The US regulatory layer: "authorized user"
In the US, using radioactive sources also requires regulatory status from the Nuclear Regulatory Commission (or an Agreement State). For remote afterloaders (HDR), 10 CFR 35.690 lets a physician qualify either through board certification recognised by the NRC or through an alternative pathway: 200 hours of classroom and laboratory training, 500 hours of supervised work experience, three years of supervised clinical experience in an approved residency, a written attestation, and device-specific training. Manual brachytherapy such as seed implants is covered by a parallel rule, 10 CFR 35.490.
Europe and elsewhere
Specialty training is regulated nationally in Europe. ESTRO has published harmonised core curricula for radiation oncologists, medical physicists and RTTs (updated in 2012) and recommends that national training authorities align with them. In 2025, the ABS and GEC-ESTRO (ESTRO's brachytherapy group) published a joint consensus statement on the objectives of brachytherapy training for physicians, which describes brachytherapy as "an essential skill in the practice of radiation oncology" and leaves detailed curricula to individual programmes and licensing jurisdictions.
How much brachytherapy do residents actually do?
This is the question trainees ask privately and guides rarely answer. In the US, the ACGME sets minimum case numbers that residents must log before graduating. For radiation oncology residents graduating from academic year 2023–2024 onwards, the minimums are:
| Case type (ACGME) | Minimum per resident | Notes |
|---|---|---|
| Interstitial brachytherapy | 7 procedures | Was 5 for the 2022–2023 graduating class |
| Intracavitary brachytherapy | 15 procedures | At least 5 must be tandem-based insertions for at least 2 patients; no more than 5 can be cylinder insertions |
| Combined (our arithmetic) | 22 procedures | 7 + 15; the ACGME does not publish a combined figure |
Those numbers are a floor, not a measure of independence. A 2026 commentary in Applied Radiation Oncology titled "Procedural Competency in Brachytherapy: Stepping Beyond Case Minimums" argues exactly that point. It is also why procedure-focused fellowships exist: a resident who wants to offer prostate seeds or interstitial gynaecological implants independently usually needs more volume than the minimum.
Short courses and e-learning
Short courses do not replace supervised cases, but they give structure, physics depth and hands-on time with applicators and planning systems. These are the options we verified on the providers' own websites in October 2026. Dates change every year, so treat the editions below as examples and check the provider for the next run.
ESTRO School (Europe)
- Comprehensive and Practical Brachytherapy — ESTRO's foundation course for "trainees in radiotherapy, radiation oncologists, medical physicists and radiation therapists (RTTs)". The 2025 edition in Porto ran 14–18 June with 18 hours of lectures, 4 hours of hands-on practical sessions (applicators and treatment planning) and about 5 hours of contouring homework and discussion. It covers sources, afterloaders, imaging, dosimetry, radiobiology and radiation protection, and clinical use in gynaecological, head and neck, genitourinary, breast, skin and paediatric cancers. ESTRO's 2026 School calendar listed the 2026 edition in Ljubljana, Slovenia, 22–25 March 2026 (already held); check ESTRO's current School calendar for the next date.
- Advanced Physics for Brachytherapy — aimed "primarily" at medical physicists, ideally with at least a year of clinical experience: 3D dose calculation (TG-43 and model-based algorithms), optimisation, quality assurance, in vivo dosimetry and uncertainties. The 2026 edition was listed in Vilnius, Lithuania, 19–22 April 2026 (already held); check the current calendar for the next one.
- Image-Guided Radiotherapy and Chemotherapy in Gynaecological Cancer — a blended course whose 2026 edition was listed in Aarhus, Denmark, 5–8 October 2026 (already held). The calendar entry does not mention brachytherapy explicitly, so check the programme for the depth of brachytherapy content before booking.
- AROI–ESTRO Teaching Course on Gynaecological Cancers — its 2026 edition was listed in New Chandigarh, India, 26–29 March 2026 (already held), run jointly with the Association of Radiation Oncologists of India.
ESTRO also offers Junior Brachytherapy Travel Grants (sponsored by Elekta Brachytherapy) to help "in training" members attend its annual congress: five grants of €1,000 for 2026, with priority for applicants who have an accepted abstract.
American Brachytherapy Society (ABS)
- Webinars and journal clubs — for example, a webinar on brachytherapy monotherapy versus SBRT for prostate cancer (15 October 2026) and a resident-led GYN journal club (6 November 2026), described as "designed especially for radiation oncology residents". Members attend free; non-members pay a fee for some sessions.
- On-demand recording packages — including an ABS GYN Virtual School and an ABS Prostate Simulation Workshop, with reduced prices for resident members.
- Annual conference — the 2027 conference is listed for 23–26 June 2027 in Tampa, Florida.
IAEA e-learning
The International Atomic Energy Agency (IAEA) hosts e-learning on its Cyber Learning Platform. Its 3D Intracavitary Brachytherapy module is an interactive, beginner-level module (about 15 minutes) on applicator insertion, imaging and planning, delivery and aftercare for cervical cancer, aimed at radiation oncologists, physicists, dosimetrists and radiation therapists. It needs an IAEA NUCLEUS account.
Fellowships: how to find them
Fellowships are where most doctors get the volume and independence that residency minimums don't guarantee. There is no central international register, so you have to combine a few sources.
United States: the ABS directory and "300 in 10"
The ABS publishes a Fellowship Directory. When we checked it in October 2026 it listed 13 programmes, all at US institutions (among them Albert Einstein College of Medicine, Cleveland Clinic, Columbia, Brigham and Women's/Harvard, Johns Hopkins, Mayo Clinic Rochester, MD Anderson, Memorial Sloan Kettering, Stanford and UCLA), with coordinator and programme director contacts. Durations are not standardised; where they are stated they range from one to two years. A separate ABS page lists programmes currently accepting applications.
The ABS "300 in 10" two-month fellowship is a different model: a short, intensive, standardised rotation. According to the ABS, applicants must be PGY-4 or PGY-5 residents and ABS members (membership is free for residents), and must apply to a training site that offers LDR prostate brachytherapy. The curriculum includes TRUS anatomy and set-up, phantom-based seed training, didactics, and participation in at least 10 LDR or HDR prostate cases over two months. A Brian Moran Scholarship of $5,000 is available.
Memorial Sloan Kettering, for example, runs a two-month "300 in 10" site for PGY-4/PGY-5 residents and early-career radiation oncologists, covering high-volume HDR gynaecological and HDR/LDR prostate brachytherapy, real-time planning and MRI-guided techniques.
The initiative's name comes from an ABS board goal described in a 2021 editorial: to train 30 brachytherapy teams a year over a decade, in response to declining brachytherapy use. The same editorial reports that fewer than 2% of US residents surveyed by ARRO were interested in a full one-year brachytherapy fellowship, which is why the short format was created.
Canada, Europe, the UK and India
- Canada: the 2021 ABS editorial notes that the University of Toronto brachytherapy fellowship had trained 42 fellows since 2014.
- Europe: GEC-ESTRO and the EMBRACE studies are described in that editorial as "the most successful brachytherapy educational platform" for image-guided cervical brachytherapy. We found no central European register of clinical brachytherapy fellowships; in practice, contacts made through ESTRO courses and congresses and direct approaches to high-volume university departments are the realistic starting points.
- United Kingdom: brachytherapy competence is part of clinical oncology specialty training (RCR curriculum CiP 18, "Safely and effectively managing patients treated with brachytherapy and their complications"). We found no central UK register of post-training brachytherapy fellowships, so check the RCR and individual hospital vacancy listings.
- India: the Indian Brachytherapy Society supports national practice surveys, and ESTRO runs joint teaching courses with AROI. Ask these societies directly about current fellowship and observership opportunities.
If you need the clinical background behind the techniques you will be trained in, our explainer on HDR and LDR techniques and the afterloader is a useful primer to share with junior colleagues.
Comparison table: courses and fellowships
| Provider · programme | Format and length | Main audience | Best for |
|---|---|---|---|
| ESTRO · Comprehensive and Practical Brachytherapy | In person, about 4–5 days; lectures + hands-on + contouring homework | Trainees, oncologists, physicists, RTTs | A structured foundation across all sites |
| ESTRO · Advanced Physics for Brachytherapy | In person, about 4 days | Medical physicists with clinical experience | Dose calculation, QA, uncertainties |
| ESTRO · IGRT and Chemotherapy in Gynaecological Cancer | Blended | Gynaecological radiotherapy teams | Gynae radiotherapy (check brachytherapy content) |
| ABS · webinars, journal clubs, recorded schools | Online; single sessions or on-demand packages | Residents, physicians, physicists, nurses, RTTs | Keeping up with evidence; site-specific refreshers |
| ABS · "300 in 10" fellowship | In person, 2 months, standardised curriculum | PGY-4/PGY-5 residents (US) | Starting an LDR/HDR prostate practice |
| ABS Fellowship Directory programmes | In person, typically 1–2 years where stated | Graduating residents, early-career oncologists | Broad, high-volume procedural training |
| IAEA · 3D Intracavitary Brachytherapy | Online, about 15 minutes | Whole team, beginner level | A quick introduction to cervical brachytherapy workflow |
Links to each provider are in the sources list at the end of this guide.
How to compare a fellowship: a checklist
Fellowship web pages rarely publish the details that decide whether you will be independent at the end. Ask the programme director these questions and write the answers down side by side.
- Case volume by technique. How many intracavitary, interstitial, LDR prostate, HDR prostate, breast, skin and other cases will I personally perform, not just observe?
- Imaging. Is planning MRI-based, CT-based or ultrasound-based for each site? Will I contour and plan, or only implant?
- Graduated autonomy. At what point will I lead procedures with supervision rather than assist?
- Physics and planning time. Will I spend time with physicists and dosimetrists on planning and QA?
- Regulatory sign-off. (US) Will the programme provide the documentation needed for NRC or Agreement State authorized-user status?
- Research and teaching. Is protected time included, and is it expected?
- Funding and eligibility. Is it salaried? Are international graduates eligible, and is visa support provided?
- Outcomes. Where are recent fellows working, and are they still doing brachytherapy?
Keeping skills current (CME/CPD)
Brachytherapy skills fade without volume, and every certifying body expects continuing education. The headline requirements are:
| Body | Requirement |
|---|---|
| ABR (radiation oncology, medical physics) | Online Longitudinal Assessment: at least 52 questions per certificate per year as part of continuing certification |
| ARRT (radiation therapists) | 24 continuing education credits every two years (a "biennium") |
| HCPC (UK radiographers, clinical scientists) | Continuing CPD aligned with your scope of practice; 2.5% of each profession randomly audited at each renewal |
| ESTRO courses | ESTRO course pages state whether European CME (EACCME) recognition has been applied for; check each course page for the credits actually granted |
Beyond formal credits, the most useful habit is to keep your own annual case log by technique and review it with your department: if a technique drops to a handful of cases a year, plan proctoring or a refresher before it becomes a safety question.
Brachytherapy jobs: what the data says
Official labour statistics do not separate brachytherapy from radiotherapy as a whole, so be wary of "brachytherapist salary" figures online. The closest reliable data point is for US radiation therapists: the Bureau of Labor Statistics reports a median annual wage of $105,310 (May 2025) and projects employment growth of 3% from 2025 to 2035, about as fast as the average for all occupations. Equivalent official figures specifically for brachytherapy-focused oncologists or physicists are not published.
Qualitatively, the ABS describes declining brachytherapy use as the reason for its training push, which suggests that people with genuine procedural skills, especially in gynaecological and prostate brachytherapy, remain in demand. That is an inference, not a measured shortage.
New to the field and want the basics first? Start with our short explainer on what brachytherapy is.
FAQ
How do I become a brachytherapist?
Qualify first in a core profession, usually radiation oncology (clinical oncology in the UK), and log brachytherapy cases during training. Then add brachytherapy-specific courses and, if you want a procedural focus, a fellowship. No board issues a credential called "brachytherapist".
How long is a brachytherapy fellowship?
It varies. The ABS "300 in 10" fellowship lasts two months for PGY-4 and PGY-5 residents. Longer clinical fellowships in the ABS directory typically run one to two years where a duration is stated.
Are there brachytherapy fellowships in Europe or the UK?
They exist, but we found no central register for either. In Europe, ESTRO courses, congresses and direct contact with high-volume university departments are the realistic starting points. In the UK, brachytherapy is part of clinical oncology specialty training (RCR curriculum), and any further fellowship posts are advertised by individual hospitals.
Which ESTRO course is best for brachytherapy beginners?
ESTRO's Comprehensive and Practical Brachytherapy course is designed as the foundation course for trainees, radiation oncologists, medical physicists and RTTs, combining lectures, hands-on applicator and planning sessions and contouring homework. Physicists can follow it with Advanced Physics for Brachytherapy.
How many brachytherapy cases do US radiation oncology residents need?
For residents graduating from 2023–2024 onwards, the ACGME minimums are 7 interstitial and 15 intracavitary procedures, with at least 5 tandem-based insertions. These are minimums, not a measure of independent competence.
Can radiation therapists and physicists specialise in brachytherapy?
Yes. There is no separate brachytherapy credential for them, but physicists can take courses such as ESTRO's Advanced Physics for Brachytherapy, and therapists and dosimetrists build expertise through in-house training, ABS resources and ESTRO courses open to RTTs.
Sources
- American Board of Radiology — Get Certified in Radiation Oncology (accessed 9 October 2026)
- American Board of Radiology — Get Certified in Medical Physics (accessed 9 October 2026)
- American Board of Radiology — Online Longitudinal Assessment (Part 3) (accessed 9 October 2026)
- Commission on Accreditation of Medical Physics Education Programs (CAMPEP) (accessed 9 October 2026)
- Medical Dosimetrist Certification Board — About MDCB (accessed 9 October 2026)
- ARRT — Radiation Therapy credential (accessed 9 October 2026)
- ASRT — Continuing education FAQ (ARRT 24 credits per biennium) (accessed 9 October 2026)
- NHS Health Careers — Therapeutic radiographer (accessed 9 October 2026)
- Royal College of Radiologists — Clinical Oncology specialty training curriculum 2026 (PDF) (accessed 9 October 2026)
- Royal College of Radiologists — Clinical oncology exams (FRCR) (accessed 9 October 2026)
- Health and Care Professions Council — Continuing professional development (accessed 9 October 2026)
- eCFR — 10 CFR 35.690 Training for use of remote afterloader units, teletherapy units, and gamma stereotactic radiosurgery units (accessed 9 October 2026)
- eCFR — 10 CFR 35.490 Training for use of manual brachytherapy sources (accessed 9 October 2026)
- ACGME — Case log requirements by graduating class (PDF) (accessed 9 October 2026)
- Dayani F. Procedural Competency in Brachytherapy: Stepping Beyond Case Minimums. Applied Radiation Oncology. 2026 (accessed 9 October 2026)
- Keyes M, et al. Joint ABS/GEC-ESTRO Consensus Statement on the objectives of training in brachytherapy for physicians. Brachytherapy. 2025;24(5):631-643 (accessed 9 October 2026)
- Eriksen JG, et al. The updated ESTRO core curricula 2011 for clinicians, medical physicists and RTTs. Radiother Oncol. 2012;103(1):103-108 (accessed 9 October 2026)
- ESTRO — Comprehensive and Practical Brachytherapy (2025 edition) (accessed 9 October 2026)
- ESTRO — School calendar 2026 (PDF) (accessed 9 October 2026)
- ESTRO — 2026 Junior Brachytherapy Travel Grants (accessed 9 October 2026)
- American Brachytherapy Society — Webinars, schools and recording packages (accessed 9 October 2026)
- American Brachytherapy Society — Fellowship Directory (accessed 9 October 2026)
- American Brachytherapy Society — Fellowships in Brachytherapy (accessed 9 October 2026)
- American Brachytherapy Society — 300 in 10 two-month fellowship (accessed 9 October 2026)
- American Brachytherapy Society — Increasing global access to brachytherapy: the ABS 300 in 10 initiative (editorial, 2021) (accessed 9 October 2026)
- Memorial Sloan Kettering — ABS "300 in 10" Brachytherapy Fellowship (accessed 9 October 2026)
- IAEA — 3D Intracavitary Brachytherapy (e-learning) (accessed 9 October 2026)
- Chatterjee A, et al. Patterns of cervical cancer brachytherapy in India: results of an online survey supported by the Indian Brachytherapy Society. J Contemp Brachytherapy. 2019;11(6):527-533 (accessed 9 October 2026)
- US Bureau of Labor Statistics — Occupational Outlook Handbook: Radiation Therapists (accessed 9 October 2026)
Career information compiled from the official sources listed above and checked on 9 October 2026. Programmes, dates and requirements change: always confirm with the provider or certifying body. Written by the brachytherapist.com editorial team.