Question 1

Why did you choose therapeutic radiography rather than diagnostic radiography or another health profession?

Accepted Answer

I'll be honest, when I started looking at radiography I assumed I'd go down the diagnostic route, because that's the side most people have heard of. What changed my mind was a taster day in a radiotherapy department. I spent the morning on a breast and prostate linac, and I watched the same patients come in day after day. By the third patient I realised the radiographers knew what each person had done at the weekend, which grandchild had a birthday, who'd struggled with their bladder filling the day before. That continuity is what drew me in. In diagnostic imaging you often see someone once, for a few minutes. In radiotherapy you might see a patient every weekday for four or five weeks, and you're the professional they see most. You're not only delivering a highly technical treatment accurately to the millimetre, you're the person who notices that they've gone quiet, that their skin is getting sore, or that they're not eating. I also like the precision of it. I enjoy the imaging matching, the physics behind it and the fact that small details, like how someone's shoulders sit in a mask, really matter for the dose they receive. That mix of technical care and human care suits me. On placement I've seen the harder side too. I've treated patients having palliative radiotherapy who were in a lot of pain, and I've had a patient I'd got to know not come back because they'd died. That was difficult, and I talked it through with my practice educator. It didn't put me off. It made me…

Question 2

Which NHS value do you think matters most in a radiotherapy department, and how have you shown it?

Accepted Answer

The NHS values are working together for patients, respect and dignity, commitment to quality of care, compassion, improving lives, and everyone counts. They all apply, but in radiotherapy I think respect and dignity is the one that gets tested most, because of how exposed patients are. Think about a breast or pelvic treatment. Someone lies on a hard couch, often with their top half or lower half uncovered, while two or three of us move them by millimetres and talk in numbers over their head. It's very easy for that to become routine for us and humiliating for them. On my final placement I was on a pelvic linac with a gentleman in his seventies having prostate treatment. On his second day he made a joke about having no dignity left. It was clearly not really a joke. So the next day I made a point of setting things up differently. I had the gown and the modesty sheet ready before he came in, I explained exactly what we'd move and why before touching him, and I made sure only the people who needed to be in the room were there. I also asked him whether he minded students being present, rather than assuming. He didn't say much about it, but by the end of the week he was chatting on the couch rather than staring at the ceiling, and at his end of treatment review he said he'd stopped dreading coming in. That stayed with me. For me dignity isn't one big gesture. It's covering people, talking to them rather than past them, asking before touching and remembering that they're a person…

Question 3

A patient arrives for their first head and neck treatment and says they don't think they can wear the mask. How would you support them?

Accepted Answer

First I'd slow everything down. If they're telling me that on the first day, the worst thing I could do is rush them onto the couch because we're behind. I'd take them somewhere quieter, sit down at their level and ask what it is about the mask that worries them. For some people it's feeling trapped, for others it's not being able to swallow, or a memory of something else entirely. Then I'd be honest about why the mask matters. I'd explain that it holds their head in exactly the same position every day so the radiation goes where it's meant to and the sensitive areas nearby are protected. I'd tell them how long they'll actually be in it, that we can see and hear them on the cameras and intercom the whole time, and that if they raise their hand we'll come straight in and take it off. Next I'd talk about what could help. That might be playing their own music, agreeing a countdown so they always know where we're up to, having them practise lying on the couch with the mask resting on but not clipped, or bringing a relative into the room for the setup. Some departments can cut eye or mouth holes or adjust the mask, but that's a decision for the mould room and the planning team because it can affect accuracy, so I'd never just do it myself. If they're still very distressed, I'd involve the senior radiographer on the unit and the review team. There might be support from a specialist radiographer, a clinical nurse specialist or psychological support, and the oncology team might…

Question 4

You review the pre-treatment cone beam CT and the match is outside the department's tolerance. Talk us through what you would do.

Accepted Answer

The first thing is that I wouldn't treat. If the match is outside tolerance, that's exactly what the imaging is there to catch. I'd start by checking the basics before assuming the patient has moved. Have I selected the right reference images for this patient and this phase? Is the match being done to the structures the protocol says, such as bone or soft tissue or fiducial markers? Is the registration window in the right place? It's easy to get a misleading result from a wrong setting. If the imaging is right, I'd look at why. On a prostate patient, for example, it might be the bladder or rectum filling, which can push things around. On a head and neck patient it could be that the shoulders aren't in the same position, the mask has become loose because they've lost weight, or the swelling has changed. Then I'd follow the department's protocol, which usually means correcting the setup, repositioning the patient and reimaging, rather than just applying a large couch shift and carrying on. If it's a prostate patient with an empty bladder or a full rectum, I'd take them off the couch, explain kindly what's happening and follow the preparation protocol, then reimage. I'd make sure they don't feel they've done something wrong. If it still doesn't sit within tolerance, or if I see something I'm not sure about like a change in anatomy or the outline, I'd stop and ask the senior or the imaging specialist radiographer. Some situations need the physics team or the clinical oncologist…

Question 5

Tell us about the checks you carry out before every radiotherapy fraction and why patient identification matters so much.

Accepted Answer

Before every fraction, my starting point is positive patient identification. I ask the patient to tell me their full name, date of birth and usually their first line of address, rather than reading it out and asking them to say yes. I match that against the treatment record, and many departments also use a photo on the system. If the patient can't answer, for example because of confusion or a language barrier, I'd follow the local procedure, which might mean using a wristband or confirming with a carer and a professional interpreter. Under IR(ME)R, radiographers delivering treatment are acting as operators, and the employer's written procedures set out how identification must be done. It's not optional, even if I've treated that patient every day for three weeks. Familiarity is exactly when mistakes happen, because you stop really checking. After ID, I check that I've got the correct plan, phase and fraction, any changes since yesterday, the setup notes and accessories like bolus or immobilisation, and that the correct imaging protocol is selected. Where it applies, I'd confirm pregnancy status has been checked according to the employer's procedure. I'd also ask how they're feeling, because that's when you pick up side effects or changes that matter. Most departments use a two-person check at key points, and I see that as a safety net rather than a nuisance. If anything doesn't match, I stop. I don't try to work around it. I'd find out why, involve the senior on the unit…

Question 6

During daily treatment, a patient tells you her partner gets angry when she is late home from her appointments and has hurt her before. What would you do?

Accepted Answer

First, I'd make sure we were somewhere private, without her partner or anyone else around, and I'd listen. I wouldn't interrupt with questions or show shock. I'd thank her for telling me and let her know I believe her and that it isn't her fault. I'd ask her gently whether she feels safe going home today and whether there are any children or other people at home who might be at risk. That matters because if there are children involved, there's a safeguarding duty to them as well, and I'd need to share that concern. I'd be honest that I can't promise to keep everything secret. I'd explain that I'd like to share what she's told me with the safeguarding team so she can get proper support, and ask what she'd like to happen. For an adult with capacity, her wishes really matter, and many people aren't ready to leave or report. But there are times when information has to be shared without consent, for example if there's a serious risk to her life, a risk to children, or a risk to others. I wouldn't make that call alone. Straight after, I'd speak to the senior radiographer and contact the trust's adult safeguarding lead for advice the same day. Hospitals often have access to an independent domestic violence adviser, and the team might consider a risk assessment and whether a MARAC referral is needed. I'd also think practically, like making sure her appointments are scheduled so she's not late home, if that would help keep her safe, and not ringing her home number with sensitive…

Question 7

How do you work with physicists, dosimetrists and clinical oncologists as a therapeutic radiographer?

Accepted Answer

I think of radiotherapy as a chain where every link depends on the one before. The clinical oncologist justifies the treatment and prescribes the dose, outlines the target and signs off the plan. Dosimetrists and physicists produce and check the plan and look after the equipment and the quality assurance. We as radiographers often do the CT planning scan and immobilisation at the start and then deliver the treatment, image the patient and look after them every day. Because I'm the one who sees the patient daily, I often notice things others can't. On placement, I noticed on the imaging that a head and neck patient's neck had visibly shrunk, and the mask was getting loose. I raised it with the senior on the unit, who asked the review radiographer to see him, and the oncologist and physics team were asked whether a rescan or replan was needed. In the end they did a rescan. I was really struck by how that information flowed back up the chain. Working well with these teams for me means a few things. Being clear and specific when I raise something, using the right route, for example the departmental process for physics queries or the review clinic for clinical concerns, rather than catching people in the corridor. Being confident to ask questions if I don't understand a plan note. And accepting that each profession has its own expertise, so if a physicist explains why a tolerance is set a certain way, I listen and learn. I also try to make their jobs easier. Good, accurate CT…

Question 8

Radiotherapy can be emotionally demanding. How do you look after your own wellbeing and stay resilient?

Accepted Answer

I think the honest answer is that it does affect me, and I'd worry if it didn't. In radiotherapy you get to know people really well over several weeks, and some of them are young or very unwell. On my last placement I treated a woman in her forties having palliative radiotherapy to her spine. She was funny and kind, and she always asked about my studies. A few weeks after she finished, one of the radiographers mentioned she'd died. I hadn't expected to feel it as much as I did. What helped was talking about it. I spoke to my practice educator, who didn't brush it off. She told me how she handles those moments herself and reminded me that we'd made her weeks with us more comfortable. That changed how I thought about it. Day to day, I try to do a few things consistently. I take my breaks, even when the unit is busy, because tired people make mistakes and our work relies on concentration. I leave work at work as much as I can, and I've got things outside, like running and seeing friends, that switch my brain off. I also try to notice when I'm getting short with people or not sleeping, because those are my signs. I'd use what's there, like clinical supervision, peer support, Schwartz Rounds if the trust runs them, and the occupational health or staff wellbeing service if I needed it. And I'd want to be the sort of colleague who checks in on others after a hard day, because that support goes both ways.

Therapeutic Radiography Interview Questions & Answers

About this NHS interview question bank

Free NHS interview questions and model answers

Question 1: Why did you choose therapeutic radiography rather than diagnostic radiography or another health profession?

Question 2: Which NHS value do you think matters most in a radiotherapy department, and how have you shown it?

Question 3: A patient arrives for their first head and neck treatment and says they don't think they can wear the mask. How would you support them?

Question 4: You review the pre-treatment cone beam CT and the match is outside the department's tolerance. Talk us through what you would do.

Question 5: Tell us about the checks you carry out before every radiotherapy fraction and why patient identification matters so much.

Question 6: During daily treatment, a patient tells you her partner gets angry when she is late home from her appointments and has hurt her before. What would you do?

Question 7: How do you work with physicists, dosimetrists and clinical oncologists as a therapeutic radiographer?

Question 8: Radiotherapy can be emotionally demanding. How do you look after your own wellbeing and stay resilient?

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