Who performs brachytherapy? Meet the team

If you have been told you will have brachytherapy, you may meet more professionals in a few days than you expected: doctors, physicists, planners, radiographers, nurses and, sometimes, an anaesthetist or surgeon. That is normal. Brachytherapy is performed by a team, and each person has a specific, regulated job.

In short, a radiation oncologist (called a clinical oncologist in the UK) prescribes the treatment and usually places the applicator, needles or seeds. A medical physicist is responsible for the radioactive source, the equipment and the safety checks on the plan. A dosimetrist or physicist calculates the dose plan. Radiation therapists (therapeutic radiographers in the UK) help position you, take images and run the treatment, while nurses and anaesthetists look after your comfort and safety.

This guide explains who does what, which credential each role holds in the US and the UK, what US federal rules say about who must be physically present during high-dose-rate treatment, and how to check a professional's credentials yourself using the official lookup tools. If you are new to the treatment itself, start with our short explainer on what brachytherapy is.

Is there such a thing as a "brachytherapist"?

Yes, as a working description — but not as an official job title. "Brachytherapist" is used inside the specialty to mean a clinician, usually a radiation oncologist, who focuses on brachytherapy. For example, the American Brachytherapy Society (ABS) describes its 2012 prostate guideline committee as "a committee of brachytherapists and researchers", and the Society introduces itself with the words "We at the American Brachytherapy Society are interventional radiation oncologists".

None of the certifying or registration bodies covered in this guide — the American Board of Radiology (ABR), the American Registry of Radiologic Technologists (ARRT), the Medical Dosimetrist Certification Board (MDCB), the UK's Health and Care Professions Council (HCPC) or the Royal College of Radiologists (RCR) — issues a credential called "brachytherapist". So when you want to know whether someone is qualified, look for their actual title and credential, which the rest of this guide maps out.

The ABS itself is multidisciplinary: it states that its membership "consists of physicians, physicists, nurses, radiation therapists, trainees in various disciplines and others interested in brachytherapy". That list is a good summary of the team you are likely to meet.

Who does what, step by step

Exact steps vary by tumour site and by technique — for the difference between temporary high-dose-rate (HDR) treatment with an afterloader and permanent low-dose-rate (LDR) seeds, see HDR vs LDR brachytherapy and how an afterloader works. The diagram below shows a typical HDR pathway and who usually leads each stage.

Radiation oncologist: prescribes and places

What they do. The radiation oncologist decides whether brachytherapy is appropriate, explains the options and risks, obtains your consent, writes the prescription (dose and number of treatments) and, in most procedures, inserts the applicator, catheters, needles or seeds. They outline the target and nearby organs on the planning images and approve the final plan before treatment.

United States

Radiation oncologists are certified by the American Board of Radiology (ABR). According to the ABR, certification requires a year of accredited clinical training, a four-year accredited radiation oncology residency, qualifying exams (medical physics, radiation and cancer biology, and clinical radiation oncology), an oral certifying exam and a valid medical licence.

There is a second, legal layer specific to radioactive sources. Under the US Nuclear Regulatory Commission's rules (10 CFR Part 35), brachytherapy must be supervised by an "authorized user" — a physician who meets defined training requirements. For manual brachytherapy (for example, seeds), 10 CFR 35.490 accepts either certification by a recognised specialty board or a structured programme that includes 200 hours of classroom and laboratory training plus 500 hours of supervised work experience. Remote afterloaders (HDR) are covered by a parallel rule, 10 CFR 35.690. States that regulate radioactive materials under agreement with the NRC apply equivalent requirements.

United Kingdom

The equivalent doctor is a clinical oncologist. NHS Health Careers describes clinical oncologists as doctors who use "a combination of chemotherapy and radiotherapy", and notes that specialty training takes "a minimum of seven years" after the two-year foundation programme. Trainees sit the RCR's FRCR examinations in clinical oncology, and consultants appear on the General Medical Council's (GMC) specialist register.

Medical physicist: the source, the machine and the safety checks

What they do. The medical physicist is responsible for the radioactive source itself (receiving it, measuring its strength and keeping track of it), the quality assurance of the afterloader and applicators, the treatment-planning system, and an independent check of each patient's plan. NHS Health Careers sums up the radiotherapy physics role as being "responsible for the precision and accuracy of radiotherapy treatment", including making sure equipment "is calibrated precisely and used safely".

United States

The ABR also certifies medical physicists. To take its Part 1 exam, candidates must be in, or have completed, a programme accredited by the Commission on Accreditation of Medical Physics Education Programs (CAMPEP), and the Part 2 exam requires a CAMPEP-accredited residency or professional doctorate (DMP). NRC rules also name a legal role, the "authorized medical physicist", who must be present during HDR treatments (see below). The professional society is the American Association of Physicists in Medicine (AAPM).

United Kingdom

Qualified radiotherapy physicists work as clinical scientists, who are registered with the HCPC. UK regulations (IR(ME)R 2017) also give a legal role to the medical physics expert, defined as someone with "the knowledge, training and experience to act or give advice on matters relating to radiation physics applied to exposure".

Dosimetrist: designing the dose plan

What they do. Using your CT, MRI or ultrasound images, the dosimetrist works out where the source should stop and for how long (HDR), or how many seeds to place and where (LDR), so the tumour receives the prescribed dose while nearby organs such as the bladder, rectum or urethra receive as little as possible. The oncologist approves the plan and the physicist checks it.

In the US, the credential is CMD (Certified Medical Dosimetrist), awarded by the Medical Dosimetrist Certification Board (MDCB). MDCB states that US applicants need a bachelor's degree and graduation from a dosimetry programme accredited by the JRCERT, and that it ended its international eligibility route after the September 2025 exam.

"Dosimetrist" is mostly a North American title. In the UK, NHS Health Careers places treatment planning within radiotherapy physics, describing staff who "develop individual patient treatment plans" using "advanced computer calculations". Whatever the titles, it is reasonable to ask who planned your treatment and who checked the plan.

Radiation therapist / therapeutic radiographer

What they do. Radiation therapists position you, take verification images, connect the applicator to the afterloader through transfer tubes (HDR), operate the treatment console from outside the room and watch you on camera throughout. They also explain what is happening and are often the people you see most.

In the US, the credential is ARRT certification and registration in radiation therapy, shown as R.T.(T)(ARRT). The ARRT says radiation therapists are "part of the team that helps plans and administers these treatments, and monitors patients' conditions". The professional society is the American Society of Radiologic Technologists (ASRT).

In the UK the title is therapeutic radiographer. NHS Health Careers says you must complete an approved radiotherapy degree and then "register with the Health and Care Professions Council (HCPC) before you can start practising". The professional body is the Society of Radiographers.

Nurses, anaesthetists and other specialists

• Oncology and theatre nurses prepare you, monitor you, manage pain relief and give aftercare advice. The National Cancer Institute (NCI) notes that you will usually have a 1- to 2-hour planning meeting "with your doctor or nurse" before brachytherapy begins. In the US, oncology nurses may hold certifications from the Oncology Nursing Certification Corporation (ONCC).
• Anaesthetists (anesthesiologists) provide general or spinal anaesthesia or sedation when the applicator placement needs it — common for prostate implants and for interstitial or intrauterine gynaecological applicators. Our guide to cervical cancer brachytherapy explains when this is used.
• Surgeons and radiologists. Depending on the centre, a urologist, gynaecological oncologist, breast or eye surgeon, or an interventional radiologist may work alongside the radiation oncologist to place catheters or applicators or to guide them with imaging. NHS Health Careers lists clinical radiologists among the radiotherapy team.
• Radiation safety staff (for example a Radiation Safety Officer in the US) oversee how sources are stored, surveyed and accounted for, and the instructions you get before going home with permanent seeds — see radiation precautions for family and visitors.

Summary table: roles and credentials

Titles and rules differ in other countries. In most of Europe, for example, the doctor is a radiation oncologist, and physicists and radiographers are regulated nationally. If you are treated outside the US or UK, ask your centre which body registers each professional.

Who must be present? What the rules say

This is something most patient guides leave out. For HDR remote afterloaders, US federal rules are specific. 10 CFR 35.615(f)(2) requires:

• an authorized user (the qualified physician) and an authorized medical physicist to be "physically present during the initiation of all patient treatments"; and
• an authorized medical physicist plus either an authorized user or a physician under their supervision, trained in the unit's operation and emergency response, to be "physically present during continuation of all patient treatments".

The same section requires emergency response equipment near each treatment room in case the source does not retract. In other words, when you have HDR treatment in the US, both a qualified doctor and a qualified physicist should be on site when the treatment starts — not only the radiographers at the console.

In the UK, IR(ME)R 2017 sets out legal roles rather than job titles: the referrer who requests the exposure, the practitioner — "a registered health care professional" who takes responsibility for justifying the individual exposure (in brachytherapy, normally the clinical oncologist) — and the operators who carry out the practical aspects, which can include radiographers and medical physics experts. Each hospital's written procedures say who may act in each role.

How to check a professional's credentials

Every lookup below is free and run by the official body. Search by surname; results can be listed under the location where someone was certified rather than where they work now.

1. US radiation oncologists and medical physicists: the ABR "Check a Certification" tool. The ABR notes that people who were first certified before 2002 may not have location data.
2. Any US board-certified doctor (including anaesthesiologists and urologists): Certification Matters, the American Board of Medical Specialties' free search, which the NCI recommends for checking whether a doctor is board certified.
3. US radiation therapists: ARRT "Verify Credentials". ARRT calls it "the official source" and says it does not issue paper cards — so a card is not proof.
4. US dosimetrists: MDCB CMD verification.
5. UK radiographers and clinical scientists: the HCPC "Check the Register" (choose "Radiographer" or "Clinical scientist").
6. UK doctors: the GMC register search, which can be filtered to doctors on the specialist register.

A credential check tells you someone is qualified and registered. It does not tell you how many brachytherapy procedures they perform each year — for that, use our guide to choosing a brachytherapy centre and the questions to ask.

Questions to ask about your team

• Who will place the applicator or seeds, and will anyone else (surgeon, radiologist, trainee) be involved?
• Will I have a general anaesthetic, a spinal anaesthetic, sedation or none?
• Who plans my treatment, and who checks the plan independently?
• Who will be present when each treatment starts?
• Who do I call with a problem after I go home, and outside working hours?

Working in the field yourself? Our guide to brachytherapy training, courses and fellowships covers the career routes into each of these roles.

Sources

1. American Brachytherapy Society — About the ABS (accessed 9 October 2026)
2. Davis BJ, et al. American Brachytherapy Society consensus guidelines for transrectal ultrasound-guided permanent prostate brachytherapy. Brachytherapy. 2012;11(1):6-19 (accessed 9 October 2026)
3. American Board of Radiology — Get Certified in Radiation Oncology (accessed 9 October 2026)
4. American Board of Radiology — Get Certified in Medical Physics (accessed 9 October 2026)
5. American Board of Radiology — Check a Certification (accessed 9 October 2026)
6. eCFR — 10 CFR 35.490 Training for use of manual brachytherapy sources (accessed 9 October 2026)
7. eCFR — 10 CFR 35.615 Safety precautions for remote afterloader units, teletherapy units, and gamma stereotactic radiosurgery units (accessed 9 October 2026)
8. Commission on Accreditation of Medical Physics Education Programs (CAMPEP) (accessed 9 October 2026)
9. American Association of Physicists in Medicine (AAPM) (accessed 9 October 2026)
10. Medical Dosimetrist Certification Board — About MDCB (accessed 9 October 2026)
11. Medical Dosimetrist Certification Board — CMD Verification (accessed 9 October 2026)
12. ARRT — Radiation Therapy credential (accessed 9 October 2026)
13. ARRT — Verify Credentials (accessed 9 October 2026)
14. American Society of Radiologic Technologists (ASRT) (accessed 9 October 2026)
15. Oncology Nursing Certification Corporation (ONCC) (accessed 9 October 2026)
16. American Board of Medical Specialties — Certification Matters: Find my doctor (accessed 9 October 2026)
17. National Cancer Institute — Brachytherapy to Treat Cancer (accessed 9 October 2026)
18. National Cancer Institute — Finding Cancer Care (accessed 9 October 2026)
19. NHS Health Careers — Clinical oncology (accessed 9 October 2026)
20. NHS Health Careers — Radiotherapy physics (accessed 9 October 2026)
21. NHS Health Careers — Therapeutic radiographer (accessed 9 October 2026)
22. The Royal College of Radiologists — Clinical oncology exams (accessed 9 October 2026)
23. Health and Care Professions Council — Check the Register (accessed 9 October 2026)
24. General Medical Council — Search the registers (accessed 9 October 2026)
25. legislation.gov.uk — The Ionising Radiation (Medical Exposure) Regulations 2017, regulation 2 (interpretation) (accessed 9 October 2026)

Educational content. It does not replace advice from qualified healthcare professionals. Your own treatment team is the right source for decisions about your care. Written by the brachytherapist.com editorial team from the sources listed above.