Leadership & Workforce Management
Bridging Academia and Clinical Practice: MD Anderson Cancer Center’s Model for Allied Health Workforce Development
May 20, 2026 - Dr. Peter Hu, Deralyn Miller, Habib Tannir, Dr. William Undie, Kimberly Hoggatt Krumwiede, Diane C. Bodurka
Abstract
The United States is experiencing persistent shortages of allied health professionals, particularly in medical imaging, where demand continues to outpace the supply of qualified technologists. To address this challenge, The University of Texas MD Anderson Cancer Center established the Student Talent Advancing Retention Success (STARS) program, a collaborative initiative between the School of Health Professions and the Division of Diagnostic Imaging Services.
Designed as a workforce retention pathway, the program integrates students into UT MD Anderson’s culture and operations through part-time roles, mentorship, and professional development opportunities.
Launched in 2022, STARS has demonstrated significant operational and financial impact. The program achieved 100% graduate retention, reduced the hiring cycle from 120 to 6 days, and surpassed productivity and procedure benchmarks. The financial outcomes have shown that the revenue generated through clinical productivity and operational efficiency effectively offset the program’s associated expenses, confirming its fiscal sustainability.
Recent data from the U.S. Department of Health and Human Services suggest that healthcare organizations are experiencing significant shortages of healthcare professionals. This problem escalated during the COVID-19 pandemic and is expected to continue into the near future.1
In particular, the demand for radiologic technologists (RTs) and magnetic resonance imaging (MRI) technologists is projected to increase by 7% and 9%, respectively, between 2025 and 2037. Despite this increase, however, the Bureau of Labor Statistics forecasts that the shortage of imaging professionals will persist throughout this period.2
Workforce shortages can have effects that negatively impact healthcare services and thus patient care. Wejdan reported that RTs experience medium to high levels of emotional exhaustion and depersonalization, which contribute to fatigue, insomnia, and anxiety.3 These conditions increase the likelihood of burnout, reducing overall workforce stability.
Shubayr further noted that burnout among RTs heightens the risk of errors that compromise productivity and efficiency.4 Such errors not only strain staff but also increase workload for remaining technologists. This creates a cycle of delays, longer patient wait times, and reduced diagnostic capacity. Ultimately, these combined effects intensify existing workforce shortages by undermining retention, straining available staff, and threatening timely patient care consequences.5-7
To mitigate workforce shortages, some healthcare organizations are prioritizing employee recruitment and retention practices. Others are embracing long-term strategies, such as implementing talent pathways to train students and retain them as employees, to proactively address staffing shortages and develop a cadre of skilled professionals who are prepared to enter the workforce.7-11
Within this context, Alexander and Chapman demonstrated that structured transition-to-practice models significantly enhance workforce stability by mitigating early-career challenges. They focused on a well‑documented vulnerability point in the staffing pipeline: the first 12–24 months of professional practice, when novice technologists are at highest risk for burnout, role strain, and premature exit from the profession. Their findings indicate that technologists engaged in formalized transition pathways exhibit higher retention rates, reduced perceived stress, improved role clarity, and greater confidence in managing clinical responsibilities compared with peers undergoing traditional onboarding processes.7
Complementing these findings, the Allied Health Scholars Program described by Perticari et al. (2023) highlights the importance of early academic engagement, structured mentorship, and financial support in strengthening the allied health talent pipeline. Perticari et al. demonstrated that mentorship and intentional collaboration between academic programs and healthcare employers ensured that students developed competencies directly relevant to clinical practice, thereby improving workforce readiness at graduation.8
Similarly, Matlhaba and Khunou emphasized that mentorship from preceptors and support from senior nursing leadership are essential for building novice nurses’ confidence and reducing their self-doubt.12 Financial support elements further contributed to retention by alleviating economic stressors that disproportionately affect students in allied health pipelines and contribute to attrition. This integrated pipeline approach strengthened both short‑term recruitment and long‑term retention, as participants were more likely to persist through training and transition successfully into the workforce.
The insights described above directly informed the design of UT MD Anderson’s STARS program, which incorporates flexible scheduling, defined advancement pathways, targeted mentorship, and comprehensive wellness initiatives. Through its multifaceted approach, the STARS program has already contributed to meeting the diverse needs of its participants, and it will continue to build on this progress to further enhance their job satisfaction and retention.
Background
The STARS program is intended to produce graduates who remain at MD Anderson as employees, thereby addressing workforce challenges to enhance patient access to imaging services and contribute to overall organizational improvements. This article discusses the graduate workforce retention model encapsulated by the STARS program, highlighting the program’s return on investment (ROI) and underscoring the tangible benefits of adopting an experiential learning model.
The STARS cohorts are organized into two sequential pathways: first, the Radiologic Technologist Assistant track and then the more advanced Radiologic Technologist track, each aligned with clearly defined educational and professional milestones. Students become eligible for entry into the STARS program after successful completion of the first year of the Diagnostic Imaging program in the School of Health Professions.
Admission into the assistant cohort occurs during the fall semester, with approximately 10 students selected annually through a competitive process. Eligibility criteria include completion of a minimum of 15 clinical competency procedures and all Texas Core Curriculum prerequisite coursework prior to entry. First-year clinical performance evaluations, completed by clinical instructors, serve as an essential component of the selection process, providing an objective assessment of professional readiness, consistency in clinical performance, motivation, and capacity to meet the rigor of advanced clinical responsibilities. Participants work part-time while continuing their academic and clinical training.
As students progress and successfully complete the radiography program after the second year, they transition into the advanced technologist track, which is designed to support continued professional development through advanced imaging modalities, including computed tomography/vascular interventional radiography and magnetic resonance imaging. Eligibility for the advanced pathway requires graduation from the radiography program and certification as RT through the American Registry of Radiologic Technologists. Selection into the advanced cohort is based on standardized clinical evaluations completed by supervising clinical preceptors, assessing competencies such as professionalism, reliability, technical proficiency, and patient care.
Work Schedule and Compensation Model
To support both academic success and workforce readiness, participants in both pathways are employed on a part-time basis, working up to 20 hours per week on day, evening, or weekend shifts. Work schedules are aligned with academic and clinical obligations, ensuring flexibility and enabling students to effectively balance coursework, clinical education, and employment responsibilities.
Students in the assistant cohort attend didactic courses on Monday and Wednesday mornings and complete clinical rotations on Tuesdays, Thursdays, and Fridays. Upon progression into the advanced track, schedules are adjusted to reflect programmatic demands, with didactic instruction occurring on Tuesdays and Thursdays and clinical rotations on Mondays, Wednesdays, and Fridays.
From August through May, assistant roles are primarily supportive and focused on enhancing patient workflow within the imaging department. Responsibilities include patient intake, transportation, and preparation of imaging rooms to facilitate efficient diagnostic operations. Following successful completion of the second year of the radiography program and acquisition of ARRT certification in June, participants transition into the role of certified RTs and begin performing routine diagnostic imaging procedures.
As part of the program, students earn competitive wages and receive part-time employee benefits: assistants earn $20 per hour, and RTs are paid $34 per hour. Additionally, the institution covers 100% of participants’ tuition for the duration of the program, substantially reducing their financial burden.
To ensure continuity within the workforce pipeline, a new assistant cohort is admitted annually as participants advance. During this phase, the more advanced cohort participants continue performing routine diagnostic imaging procedures for two additional semesters while advancing their training in computed tomography (CT), vascular interventional (VI), and magnetic resonance imaging (MRI). Upon obtaining ARRT certification in CT, VI, and MRI during the summer term, participants begin performing examination procedures within these advanced modalities. At program completion, participants graduate with a Bachelor of Science in Diagnostic Imaging and are subsequently offered full-time employment at UT MD Anderson, but they are not contractually required to remain at UT MD Anderson and are free to pursue employment opportunities at other hospitals.
Increasing Demand for Imaging Technologists
MD Anderson’s five-year strategic plan focuses on expanding operations across Texas and increasing patient visits by 3% to 5%. Achieving this growth depends on recruiting and retaining CT and MRI technologists; yet the available workforce is insufficient to meet demand across imaging specialties.
The American Society of Radiologic Technologists (ASRT) Enrollment Snapshot surveys (Table 1) show radiography program enrollment has grown only 5% in two decades, far below projected workforce needs.13 Nationally, demand for imaging technologists is expected to rise 6% in the next decade, while Texas faces a 19% increase, heightening the shortage.14
The 2025 ASRT survey reported vacancy rates of 19.4% for CT technologists, 17.4% for MRI technologists, and 18.3% for RTs.15 Similar vacancy trends have been documented by other healthcare associations.16 At MD Anderson, vacancies reached 12% to 22% between 2021 and 2022 but declined to 8% to 10% by 2024 after implementation of targeted workforce retention programs, demonstrating the effectiveness of structured interventions.
Table 1: Radiologic Technologists (RT) Workforce Growth Projection and Enrollment

Source: American Society of Radiologic Technologists. (2024). Enrollment Snapshot 2024 U.S. Department of Labor, Employment and Training Administration. (n.d.). Radiologic technologists and technicians – State trends: Texas. ONET OnLine.
Partnering Academic and Clinical Operations
In the fall of 2022, the Division of Diagnostic Imaging Services and the SHP piloted the STARS program. The program was open to junior- and senior-level students who were enrolled in the SHP’s Diagnostic Imaging program, as well as senior-level transfer students from other radiography programs who were pursuing a bachelor’s degree in diagnostic imaging.
The program enrolled five junior- and five senior-level students. Junior-level students were onboarded as diagnostic imaging technologist assistants. Their primary responsibility was supporting imaging technologists in streamlining patient workflow, which encompassed duties related to patient intake, transportation, and room preparation for imaging procedures. The senior-level students, who were already certified RTs, were onboarded as RTs and permitted to perform basic routine imaging procedures.
Participants Selection
Initially, the selection process was guided by previously established criteria, including academic and clinical competency performance. However, as the STARS program evolved, the selection approach expanded beyond these metrics alone. Through sustained engagement with students, SHP faculty provided critical insight into nonacademic attributes such as emotional intelligence, teamwork, adaptability, and alignment with program goals. Based on these holistic assessments, selected candidates were invited to participate in panel interviews with SHP faculty and leaders from the Division of Diagnostic Imaging.
This change stemmed from challenges with the inaugural cohort, including the attrition of one assistant who struggled to balance academic and program responsibilities despite prior faculty concerns. In 2023, the framework was revised to formally incorporate faculty input, establishing a more holistic approach to candidate evaluation.
Mentoring and Cultural Immersion
To provide professional support for STARS participants, the Division of Diagnostic Imaging Services implemented a structured training program that prepares advanced-level technologists to mentor participants personally and professionally. The training curriculum emphasizes cultivating essential mentoring skills and establishing strong, supportive relationships with mentees. This was accomplished through activities such as role-playing scenarios, case study discussions, and reflective journaling that help mentors refine their communication style and build trust. Sessions on active listening and feedback techniques provided mentors with practical tools for paraphrasing, clarifying, and delivering constructive guidance, while exercises in empathy, emotional intelligence, and cultural awareness strengthen their ability to connect with diverse learners.
Mentors also participated in workshops on setting goals, monitoring progress, and conducting structured check-ins, ensuring that mentees would remain on track academically and professionally. Additionally, professional development modules encouraged mentors to model resilience, share career pathways, and connect mentees with broader professional networks.
Continuous improvement has been reinforced through peer feedback, observation and debriefing, and annual program completion ceremonies, where mentors and mentees celebrate program achievements. Collectively, these activities have created a dynamic framework that not only prepares mentors for their role but also enhances the overall support system available to STARS participants.
In addition to mentor development, the division collaborated with UT MD Anderson’s Leadership Institute and SHP’s Leaders Academy to design a curriculum tailored to the developmental needs of STARS participants. This curriculum emphasizes both professional readiness and personal growth, providing structured opportunities for students to cultivate the competencies necessary for long-term success. The core areas of focus include establishing clear and effective communication practices, maintaining professionalism in diverse clinical settings, and strengthening emotional intelligence to foster resilience and self-awareness.
The program also incorporates training on navigating difficult conversations, adapting to organizational change, and recognizing and addressing implicit bias, thereby preparing participants to thrive in complex workplace environments. These topics are reinforced through periodic activities such as interactive workshops, guided discussions, and experiential learning exercises that actively engage students in applying new skills. By integrating these components into a longitudinal framework, the curriculum has ensured that STARS participants are not only prepared to adapt to MD Anderson’s professional culture but are also positioned to excel in their careers as emerging health professionals.
Assessment of Program Performance
The Division of Diagnostic Imaging Services uses key performance indicators, including procedure timeliness, retention rate, and new employee onboarding time, to measure operational effectiveness and efficiency. Similar quantitative and qualitative metrics were used to assess the effectiveness of the STARS program. Quantitative indicators included the high retention of STARS graduates as UT MD Anderson employees, the realization of a positive ROI, and the reduction in recruitment and onboarding times for imaging technologists.
Retention Rate
Retention rate emerged as a principal measure of program success, with the pilot cohort achieving a 100% retention rate. All five senior-level RTs who participated in the STARS program successfully completed their academic programs and accepted full-time positions at MD Anderson.
Furthermore, four of the five assistants in the inaugural cohort advanced into the third year of the program as RTs. The vacancy left by the one assistant who withdrew owing to challenges in balancing academic and employment responsibilities was promptly filled by another SHP student who subsequently transitioned into the third-year RT role.
Recruiting and Onboarding
The retention of all five STARS RTs as MD Anderson employees led to measurable gains in recruitment efficiency and operational performance. During the height of the pandemic, the average recruitment-to-onboarding process extended to 120 days, far exceeding the division’s benchmark of 30–45 days.
By contrast, in 2024 the transition of STARS RTs to full-time roles occurred in just six days, an 87% reduction compared to the traditional timeline. This expedited process enabled the Department of Human Resources to onboard 10 full-time technologists within six weeks, a substantial improvement over the conventional four- to six-month hiring cycle.
STARS technologists achieved higher productivity benchmarks and achieved them earlier than traditional new hires because they were employed at UT MD Anderson, the same facility where they had completed their training. Their familiarity with departmental procedures and protocols minimized the need for extended orientation, allowing them to begin performing reimbursable examinations within days rather than weeks. Hence, the STARS program enhanced internal recruitment by formalizing it into a deliberate workforce strategy that accelerated productivity and revenue generation.
Since the program’s implementation, these outcomes have continued to improve in tandem with other operational initiatives. For example, in the initial 16-week orientation period, newly hired technologists in the Division of Diagnostic Imaging Services typically achieve a productivity benchmark averaging 50%, generating approximately $70,000 in revenue per MRI technologist and $100,000 per CT technologist. In comparison, in the same timeframe, the five STARS RTs achieved a 75% productivity rate, generating $123,000 per MRI technologist and $175,000 per CT technologist.
These operational efficiencies have remained consistent throughout the 2023 and 2024 STARS cohorts, with the impact further enhanced by the program’s expansion to include 10 RT participants in 2023.
Staffing Vacancy and Impact on Timely Procedure Completion
Additional quantitative metrics used to assess the STARS program included staffing vacancy and timely procedure completion in the Department of Radiography and Fluoroscopy. In 2021, the department experienced 10 vacant RT positions, representing a 17% vacancy rate, largely due to retirements and compensation-related attrition. The integration of STARS technologist assistants into exam room workflows helped mitigate these staffing gaps by supporting routine tasks and allowing licensed technologists to focus on contrast-enhanced procedures, particularly during evening and weekend shifts.
This approach contributed to improved workflow efficiency by facilitating more consistent exam throughput and reducing delays during periods of limited staffing. It also helped maintain exam capacity, allowing the department to complete procedures that may otherwise have been postponed due to workforce constraints.
Programmatic ROI
The programmatic ROI, derived from actual expenditures and operational outcomes, exceeded the Division of Diagnostic Imaging Services’ initial 2022 projections. Program-related expenditures, including salaries, fringe benefits, and tuition reimbursement, totaled $166,776 for the assistant cohort and $190,795 for the RT cohort. These amounts have shown only minimal variation over the past three years, reflecting the program’s consistent fiscal structure and stable cost framework.
Two primary factors contributed to the program’s initial positive ROI. First, the accelerated transition of STARS participants into productive, certified technologist roles significantly reduced onboarding costs and enhanced operational efficiency. After earning certification in the summer of 2023, this cohort began performing advanced imaging procedures that effectively offset total program expenditures within the first year.
Second, the assistant cohort contributed to measurable efficiency gains across the division. Although not initially expected to generate direct billable activity, their workflow support reduced procedural delays and increased overall department throughput. Once licensed as RTs in summer of 2023, their expanded clinical productivity further offset personnel expenses, transforming an originally projected negative variance of $149,000 into a positive financial outcome.
Since its launch in 2022, the STARS program has consistently enhanced operational efficiency, clinical productivity, and workforce stability. These outcomes have collectively offset the incremental investment in wages, benefits, and tuition support, affirming the program’s fiscal sustainability. Beyond financial performance, the program achieved 100% retention among RT graduates and sustained benchmark levels of productivity and timeliness. These results reinforce the STARS model as a scalable and replicable framework for workforce development across additional clinical departments.
Building on its success in the Division of Diagnostic Imaging, the STARS model expanded to Pathology Laboratory Medicine in fall 2023 with nine students, adopting the original blueprint while adding structured mentoring and quarterly progress surveys to track participant success. This strategic vision enabled Pathology Laboratory Medicine to expand its cohort to 15 participants in 2024, Currently, 35 individuals are enrolled in the STARS program across Diagnostic Imaging and Pathology and Laboratory Medicine.
Qualitative Assessment
A structured survey was used to assess STARS participants’ perceptions of the challenges involved in balancing academic responsibilities with programmatic and employment obligations. While some participants had informally shared feedback during weekly mentor meetings, the survey captured additional perspectives that may not have surfaced in those settings.
The participants’ responses reflected a strong appreciation for the support offered by departmental staff, flexibility of work schedules, consistency and transparency of communication, and accessibility of mentors for ongoing guidance and advisement.
Participants also offered specific recommendations, which included providing the opportunity to rotate through regional clinical sites, increasing the availability of weekend shifts, and providing the option to extend work hours during academic breaks. Some participants, observing that some diagnostic imaging departments had limited awareness of the STARS program, recommended broader promotion across the division. One particularly relevant suggestion was to introduce distinct badge identification to differentiate STARS participants from other students engaged in clinical education, thereby providing clarity to clinical preceptors, mentors, and technologist colleagues regarding the participants’ roles and responsibilities.
All recommendations were reviewed; those with merit were implemented within 60 days and are now standard practices in the STARS program.
Lessons Learned and Future Directions
Given the vacancy rates within the Division of Diagnostic Imaging between 2021 and 2023, the STARS program served as an important mechanism for strengthening recruitment efforts and reducing their associated costs. It continues to do so by successfully facilitating the transition of SHP students, particularly those enrolled in the three-year program, into the UT MD Anderson workforce.
Participation in professional development activities has produced positive outcomes for STARS technologists, fostering greater self-awareness, improving communication skills, and promoting overall professional growth. Reflective exercises and team-building activities within MD Anderson’s Leadership Institute curriculum fostered greater emotional intelligence, enabling participants to better recognize their strengths and target areas for improvement.
Conclusion
UT MD Anderson’s Division of Diagnostic Imaging Services must continuously adapt to meet the evolving needs of STARS participants as they balance program participation with their academic commitments. By engaging STARS participants through diverse interactions ranging from informal conversations to structured, formal meetings, clinical leaders and mentors have been able to better understand the challenges these participants face. These insights enhanced the program’s success and showed STARS participants that leaders were committed to mitigating fatigue and improving work-life balance. These efforts contributed to their overall well-being and success within the program.
The integration of lessons learned into the department’s ongoing program development has been instrumental in advancing key objectives. For the third consecutive year, the Division of Diagnostic Imaging Services has effectively built upon the insights and experience gained from the inaugural 2022 STARS pilot cohort, reinforcing the foundation of a resilient and sustainable program that continues to grow in response to the evolving needs of students, institutional leadership, and clinical departments.
Although STARS was implemented in a three-year collegiate radiography program, it can be adapted for traditional associate degree programs, which constitute most U.S. radiologic technology pathways and typically span five or six semesters (18–24 months).
The model can be restructured as a two-phase workforce pathway that does not require pre-licensure credentialing. Students enter role-appropriate, paid clinical support positions early in training, improving workflow efficiency while fostering professional identity and organizational attachment, factors associated with improved persistence and workforce readiness.7
After graduation and ARRT certification, participants transition to structured transition-to-practice roles emphasizing mentorship, competency-based progression, and graduated autonomy, approaches linked to reduced early-career stress and attrition.8 Together, this framework preserves STARS outcomes while enhancing scalability across associate degree programs.
References
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- U.S. Bureau of Labor Statistics. Employment projections. Accessed November 26, 2024. https://www.bls.gov/emp/
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- Perticari C, Maguina M, Bergolla L, et al. Allied Health Scholars Program: addressing workforce shortage and talent pipeline through educational programs. Nurs Health Sci Res J. 2023;6(1):135–141. doi: 10.55481/2578-3750.1163
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- Nursing Solutions Inc. National Health Care Retention & RN Staffing Report East Petersburg, PA: NSI Nursing Solution. Accessed on June 27, 2024. www.nsinursingsolutions.com
- Miami Dade College. Miami Dade College partners with Nicklaus Children’s hospital to launch nurse scholars program. MDC News. Updated on October 28, 2022. https://news.mdc.edu/pressrelease/miami-dade-college-partners-with-nicklaus-childrens-hospital-to-launch-nurse-scholars-program/
- Matlhaba KL, Khunou, SH. Transition of graduate nurses from student to practice during the COVID-19 pandemic: integrative review. Int J Afr Nurs Sci. 2022;17:100501.
- American Society of Radiologic Technologists. (2024). Enrollment Snapshot 2024. Accessed on September 12, 2025. https://www.asrt.org/docs/default-source/research/enrollment-snapshot/enrollment-snapshot-2024.pdf
- U.S. Department of Labor, Employment and Training Administration. (n.d.). Radiologic technologists and technicians – State trends: Texas. ONET OnLine. Retrieved September 12, 2025, from https://www.onetonline.org/link/localtrends/29-2034.00?st=TX
- American Society of Radiologic Technologists. 2025 Radiologic sciences workplace and staffing survey. Accessed on August 31, 2025.https://www.asrt.org/docs/default-source/research/staffing-surveys/2025-radiologic-sciences-workplace-and-staffing-survey.pdf?sfvrsn=7ded7a77_6
- Hospital and Healthsystem Association of Pennsylvania. (2025, April 2). Health care workforce shortages strain access to care. Accessed on August 31, 2025.https://www.haponline.org/Newsroom/News/2025/04/health-care-workforce-shortages-strain-access-to-care