SAFE
The job is physically positioning frightened, often frail patients to sub-millimeter tolerance on a linear accelerator, verifying setup against imaging, and running the beam — none of which current robotics can do in an uncontrolled clinical room. AI is already absorbing the adjacent screen work (treatment plan checks, auto-contouring, image registration, dose record documentation, scheduling), so the informatics side of the role thins while the daily hands-on delivery persists. Patients see the same therapist every weekday for six weeks, which makes the relationship, not the button-press, the durable part.
Mixed — a routine tier and a judgment tier. At 13 the manual setup — immobilization masks, tattoo/surface-mark alignment, couch shifts from CBCT match, and daily side-effect checks — stays human, but a real share of the shift (record-and-verify checks, IGRT auto-registration, chart QA, ARIA/Mosaiq documentation, appointment sequencing) is already being handed to software, which is what keeps it out of the 14+ band.
Hands-on in uncontrolled environments. 17 reflects that the work happens with hands on a semi-clothed, sometimes nauseated or intubated patient in a vault, lifting and rolling them onto an index bar, seating a thermoplastic mask, and clearing a 6 MV gantry's collision path — variable bodies and variable rooms, though the machine and the vault itself are fixed and controlled, which is why it isn't 19.
Licensed human required and personally liable. 13 fits ARRT(T) certification plus state licensure in most states, with the therapist personally signing the daily treatment record and the wrong-site/wrong-dose misadministration reportable under state radiation control regs — but the prescription, dose, and plan approval belong to the radiation oncologist and medical physicist, so the deepest liability sits above you.
The human relationship is the product. 14 is earned by 25-40 consecutive weekday appointments where you are the one who notices the skin breakdown, the weight loss loosening the mask fit, and the patient who stopped talking — continuity no one else on the care team has — while the referral and the trust in the treatment itself still route through the oncologist.
Meaningful discretion. 10 is right because the prescription, fractionation, and tolerances are written for you and out-of-tolerance shifts get escalated to physics or the physician, but you decide in real time whether today's match is good enough to treat, whether a shift needs a re-sim, and whether to stop the beam — genuine calls made alone in the console, inside a defined envelope.
Has AI actually changed your work?