Ethics and professionalism for medical radiation practitioners

Medical radiation practitioners have been regulated under the Health Practitioner Regulation National Law since 2012. The Medical Radiation Practice Board of Australia (MRPBA), supported by Ahpra, registers practitioners in three divisions: diagnostic radiography, radiation therapy and nuclear medicine technology. Titles such as medical radiation practitioner, radiographer, medical imaging technologist, radiation therapist, nuclear medicine technologist and nuclear medicine scientist are protected.

Registration is division-specific. A diagnostic radiographer trained on a radiation therapy CT simulator may operate it for simulation imaging, but planning and delivering treatment is radiation therapy practice. Practitioners registered in more than one division must keep each current. Sonographers who are not also registered medical radiation practitioners sit outside the National Scheme, while radiographers who perform ultrasound remain bound by their registration standards and the Code when they do so.

What makes this profession different from most others is the second regulatory layer. The use of ionising radiation is regulated separately by each state and territory, usually under a radiation safety act administered by a health department or environment protection authority. In most jurisdictions you need a licence or authorisation to use radiation apparatus or radioactive sources, and its conditions define what you may do. Your registration is national and moves with you; your radiation authorisation does not. A radiographer moving from Victoria to Western Australia keeps her registration but must check what authorisation the Western Australian regulator requires before her first shift.

The Board has adopted the shared Code of conduct that took effect on 29 June 2022. It sets the conduct expected of every registered practitioner: patient-centred care, consent, communication, cultural safety, boundaries, records, teamwork, health and professional behaviour. Alongside it, the Professional capabilities for medical radiation practice, 3rd edition, released in November 2025, took effect on 30 March 2026. It describes the minimum capabilities for safe, independent practice in each division across six roles:

• professional and ethical practitioner
• partner in care
• communicator and collaborator
• learner and educator
• safety and quality manager
• leader and steward

The capabilities are often treated as a graduate checklist, but they describe what every registered practitioner should be able to demonstrate. A practitioner who falls well below them in a way that puts patients at risk may face concerns about performance. Under section 41 of the National Law, the Board's codes and guidelines are admissible as evidence of appropriate professional practice. The six roles are also a practical way to plan CPD: choose the role you feel least confident in and set a learning goal around it.

Justification and optimisation are ethical duties

The ARPANSA Code for Radiation Protection in Medical Exposure (2019) rests on two principles: every exposure must be justified, and every exposure must be optimised. These are not only physics. They express the ethical duties to benefit the patient and avoid harm. A referral is not consent, and an unclear or apparently unjustified request deserves a professional query, documented and escalated where needed, rather than silent compliance.

The duplicate CT

A CT request arrives for a patient who had the same scan two days ago at another site. Justification means checking previous imaging and querying the request with the referrer before exposing the patient again. Document the query, the response and the decision.

The pregnancy question in a crowded waiting area

Pregnancy and, in nuclear medicine, breastfeeding enquiries must be made sensitively and privately, following local protocol and recorded. Asking across a waiting room fails both dignity and privacy, and a rushed answer is less reliable.

The wrong-direction shift

On a radiation therapy unit, a daily verification image shows a setup outside tolerance. The professional response is to stop, seek advice and follow the department's process, and to report near misses as well as incidents. Pressure to keep the schedule moving is not a reason to treat.

The celebrity scan

A well-known person is imaged in your department and colleagues are curious. Accessing images or records without a clinical reason is a privacy breach and a common source of notifications, whatever the motive. The same applies to looking up a family member's results.

The birthday invitation

Over a long course of radiation therapy, a patient and their family invite you to a birthday party. Warm, professional relationships are part of good care in long treatment courses; personal social relationships with current patients are not. Decline kindly, and manage gifts and contact in line with the Code and local policy.

The AI contour

An auto-contouring tool produces a plausible contour that excludes part of an organ at risk. The Board's statement on artificial intelligence is clear that your obligations continue to apply: check outputs critically, correct the error and report the tool's behaviour so the department can review it.

The extravasation record

After a contrast extravasation, a radiographer is tempted to record a smaller volume than was injected. Altering records to conceal an error is a serious breach of honesty and is often treated more severely than the original incident. Record the accurate volume, the response and the follow-up plan.

The MRPBA's CPD registration standard requires at least 60 hours of CPD over each three-year triennium, with at least 10 hours in any one year, and at least 35 of the 60 hours made up of substantive activities with significant intellectual or practical content relevant to your current or emerging practice. The current triennium runs from 1 December 2024 to 30 November 2027. The Board expects you to include learning that develops cultural competence and cultural safety, to keep records, and to reflect on the value of what you learned.

In 2026, 14 National Boards, including the Medical Radiation Practice Board, consulted on revised CPD and recency of practice standards. Check the Board's website for the current requirements before you plan the rest of the triennium.

Whether a course counts as substantive is your judgement against the standard. A structured course with an assessment and a written reflection will often fit that description, but the decision depends on your plan. Spreading activity across the triennium is easier than catching up in the final months, and our CPD hours planner and reflective statement template help you keep a record that is ready for audit.

Declarations, insurance and notifiable events

Renew on time, answer renewal questions about CPD, recency, indemnity, health and criminal history truthfully, and check that your indemnity cover extends to casual, locum and private work. The National Law requires you to notify the Board in writing within seven days of certain events, such as being charged with an offence punishable by 12 months imprisonment or more, or losing indemnity cover. Boards treat inaccurate declarations and failures to notify as matters of honesty.

Ethics and Professionalism for Medical Radiation Practitioners in Australia is about three hours of learning, with a 20-question scenario-based assessment (pass mark 16 out of 20) and a reflective account. It is currently A$309. It covers:

• the three divisions, protected titles, the capabilities and how radiation safety law sits alongside registration;
• justification, optimisation, consent and questioning a referral professionally;
• identification, pregnancy and breastfeeding enquiries, unintended exposures, MRI safety, contrast and medicines;
• communication, dignity, communicating findings within your role, and the privacy of images and records;
• radiation therapy relationships and treatment accuracy, radiopharmaceutical administration, theranostics and expanding scope;
• CPD, recency, records, AI, registration obligations, speaking up, teamwork, fatigue and leadership.

If you perform intimate imaging or ultrasound, Chaperones and Intimate Examinations is a useful companion course.