The Ultimate ABR Exam guide
Introduction: Navigating the Three-Part ABR Board Exams in Medical Physics
As of January 2025, Medical Physics is the only non-physician specialty recognized by the American Board of Medical Specialties (ABMS). This specialty is certified through the American Board of Radiology (ABR), an ABMS Member Board.
For medical physicists, the American Board of Radiology (ABR) board exams represent one of the most significant milestones in their professional journey. These exams are designed to rigorously assess candidates’ knowledge, clinical skills, and ability to apply complex concepts in real-world scenarios, ensuring they are ready to practice independently. Composed of three parts—two written exams and one oral exam—the process spans several years.
The journey begins with Part 1, a foundational written exam covering general and clinical physics. Successful candidates move on to Part 2, a specialty-focused written exam in areas such as therapy, diagnostic, or nuclear medicine physics. Finally, the process concludes with Part 3, an oral exam that tests a candidate’s ability to articulate and apply their knowledge in high-pressure, real-time scenarios.
Whether you’re just starting out in medical physics or preparing for your next ABR exam, this guide offers everything you need to approach this transformative journey with confidence and clarity.
Parts 1 and 2: The Foundation – General and Clinical Physics
The first step in the ABR certification journey is Part 1, a computer-based exam that evaluates a candidate’s foundational knowledge of physics and its application to medical scenarios. Typically taken after the first year of residency, Part 1 is designed to ensure that candidates have a solid grasp of the core principles necessary for a career in medical physics. After completing residency and passing Part 1, you’ll move on to Part 2, another computer-based written exam that dives deep into your chosen specialty. This is the first step where candidates begin to focus specifically on the area of medical physics they plan to practice, whether it’s therapy, diagnostic, or nuclear medicine physics.
Structure of Part 1
Part 1 covers fundamental physics concepts, including mechanics, electromagnetism, and quantum physics, as they apply to medical applications. The clinical physics portion focuses on practical, real-world scenarios, such as interpreting medical images and understanding clinical workflows.
- Format: Multiple-choice questions delivered online.
- Timing: Each section lasts approximately two hours, completing both sections on the same day.
- Frequency: Offered only once per year, usually in August.
What to Expect
Part 1 serves as a comprehensive review of the physics knowledge acquired during graduate studies. It tests not only theoretical understanding but also the ability to apply that knowledge to clinical situations. For example, you might encounter questions that require identifying anatomical structures on imaging scans or solving physics equations relevant to radiation dosimetry.
Tips for Success
- Study the Right Materials: The ABR provides a list of recommended resources. Focusing on these materials is crucial, as exam questions are often drawn directly from them.
- Review Graduate-Level Physics: While the exam does not delve into overly complex calculations, a well-rounded understanding of basic physics concepts is essential.
- Practice Clinical Scenarios: Spend time reviewing clinical applications, such as image interpretation and safety protocols, to ensure a balanced preparation approach.
- Mock Exams: Simulating exam conditions with practice questions can help improve time management and identify areas for improvement.
Why It’s Important
Part 1 is more than just a test of knowledge; it’s a gateway to the next stages of the ABR certification process. A strong performance demonstrates that candidates are ready to move beyond foundational learning and begin focusing on their chosen specialty in Part 2. Additionally, the experience gained in taking this exam benefits the candidate throughout the certification process.
Structure of Part 2
Candidates choose one of three specialties: therapeutic medical physics, diagnostic medical physics, or nuclear medical physics. The exam content is tailored to the chosen discipline, covering advanced topics, techniques, and clinical scenarios specific to the field.
- Format: Computer-based, multiple-choice questions, similar to Part 1 but with a narrower focus on the specialty.
- Timing: Usually offered a few weeks after Part 1, typically in late August or early September.
- Results: Candidates typically receive their results within 4-6 weeks.
What to Expect
Part 2 is designed to test a candidate’s mastery of their specialty. Questions often focus on clinical applications, requiring not just theoretical knowledge but also the ability to apply concepts to real-world scenarios.
For example:
- Therapeutic Medical Physics: Candidates may encounter questions on treatment planning, dosimetry, or machine calibration.
- Diagnostic Medical Physics: Topics might include image quality optimization, equipment testing, and radiation safety.
- Nuclear Medical Physics: Expect detailed questions on radiopharmaceuticals, imaging system calibration, and regulatory compliance.
Eligibility and Preparation
- Residency Completion: Candidates must complete an accredited residency program and have their program director attest to their readiness.
- Study the Core Materials: The ABR provides a list of recommended textbooks, journal articles, and task group reports (especially from AAPM) that form the basis for many exam questions, and CAMP has a collated list of materials as well.
- Hands-On Experience: Residency training is crucial for Part 2, as it ensures candidates have applied their learning in a clinical setting. Practical experience can make a significant difference in answering application-based questions.
Tips for Success
- Deep Dive into Your Specialty: Focus your preparation on the specific protocols, techniques, and technologies relevant to your chosen field.
- Stay Clinical: Part 2 emphasizes applied knowledge, so prioritize learning through clinical practice, such as hands-on experience with equipment and case studies.
- Know the Reports: Familiarize yourself with the most relevant AAPM reports for your specialty, as they frequently inform exam content. Also knowing clinically relevant accreditation requirements and manuals can be helpful.
- Practice Eliminating Options: When unsure of an answer, use logical reasoning to eliminate incorrect choices and narrow down the best possible answer.
Why It’s Important
Part 2 is a critical step in the certification process as it focuses on determining your specialty within medical physics. The exam assesses your ability to apply both theoretical knowledge and clinical skills in that specific area, ensuring you are fully prepared to deliver safe and effective patient care.
Part 3: The Final Challenge – The Oral Exam
Part 2 is undoubtedly challenging, but passing it marks a significant milestone. It paves the way to the final step—the oral exam—while showcasing a candidate’s expertise and readiness to take on the role of a board-certified medical physicist. The ABR certification process culminates in Part 3, the oral exam. This is a critical step that evaluates not just a candidate’s knowledge but also their ability to articulate and apply that knowledge in high-pressure, real-world scenarios. Unlike the written exams, Part 3 is interactive and focuses heavily on problem-solving and professional judgment.
Structure of the Exam
- Five Examiners: You’ll meet five examiners (face-to- face on camera) , each specializing in a major topic within your chosen discipline (therapy, diagnostic, or nuclear medicine physics).
- Five Questions Per Examiner: Each examiner asks five questions (one in each topic area), resulting in 25 questions total.
- Timing: The exam typically lasts around three to three and a half hours, with each session lasting approximately 30 minutes.
- Format: Conducted remotely via video conferencing since COVID-19, though examiners have the option to participate either from home or the ABR headquarters in Tucson.
What to Expect
The oral exam is designed to mimic real-world clinical situations and test a candidate’s ability to think critically and communicate effectively.
Candidates might be asked to:
- Troubleshoot equipment failures.
- Address unexpected clinical scenarios.
- Explain complex concepts to hypothetical audiences, such as patients or colleagues.
- Resolve ethical dilemmas in a professional setting.
Unlike the written exams, where questions are multiple-choice, the oral exam requires candidates to provide detailed explanations, calculations, or justifications for their answers. Take your time with this and explain your thought process carefully.
Preparing for the Oral Exam
- Practice Communicating: Focus on clearly articulating your thought process. Candidates who can explain their reasoning, even when unsure of the exact answer, often perform better.
- Simulate the Experience: Participate in mock oral exams, either through local professional societies (e.g., AAPM chapters) or with colleagues.
- Ethics and Professionalism: Be prepared to address ethical scenarios, as these can be some of the most challenging and subjective questions.
Day-of Tips
- Compose Yourself: It’s okay to take a moment to understand the question and organize your thoughts before responding.
- Maintain Professionalism: Dress appropriately and create a distraction-free environment for the virtual exam. Professionalism not only makes a positive impression but also boosts confidence!
- Focus on Problem-Solving: Even if you don’t know the exact answer, demonstrating a logical approach and the ability to eliminate incorrect options is highly valued.
- Don’t Be Discouraged by Examiner Reactions: Examiners are trained to remain neutral and won’t give cues about whether your answer is correct. Stay focused and continue articulating your reasoning.
Why It’s Important
The oral exam is often regarded as the most challenging part of the certification process. It tests a candidate’s ability to apply their knowledge in practical, often high-stakes scenarios. More importantly, it evaluates whether they can confidently and competently function as an independent medical physicist. Passing Part 3 is not just a test of technical skill; it’s a testament to a candidate’s readiness to take on the responsibility of ensuring patient safety, troubleshooting critical issues, and collaborating effectively with medical teams.
With Part 3 complete, candidates officially achieve ABR certification—a milestone that sets them apart as experts in their field and opens the door to a fulfilling career in medical physics. Time to celebrate!
What Makes the ABR Exam Process Unique?
The ABR exam process is not just about testing knowledge; it’s a journey that blends theoretical understanding, clinical application, and professional growth. Each of the three parts builds upon the last, creating a comprehensive certification process that ensures only the most competent and well-rounded candidates earn the title of board-certified medical physicist.
The ABR exams are intentionally challenging, with pass rates that reflect the high standards of the profession:
- Part 1: A foundational exam with moderate pass rates that set the tone for the journey.
- Part 2: Higher pass rates (~80%), reflecting candidates’ increased focus and experience.
- Part 3: A significant challenge with pass rates in the mid-60% range, emphasizing the need for thorough preparation and strong communication skills.
These rigorous standards ensure that those who earn certification are fully prepared to practice independently, safeguarding patient safety and upholding the integrity of the field.
A Collaborative Effort
Behind the scenes, the ABR exam process is a monumental collaborative effort from the ABR. CAMP is proud to have multiple team members volunteer each year for tasks such as question writing.
- Question Development: Questions are meticulously crafted by committees of experienced physicists who bring diverse clinical and academic expertise. Writing questions for the exam is not a simple task—it requires deep thought to ensure they are both challenging and relevant. The committees draw heavily from trusted resources, such as AAPM task group reports and clinical protocols, to create questions that reflect real-world scenarios and current best practices.
- Comprehensive Review Process: Each exam undergoes multiple layers of review to ensure the questions are clear, fair, and aligned with the objectives of the exam. Committees analyze the wording, verify the accuracy of answers, and check references to ensure they are appropriate. Even after the questions are approved, additional steps are taken to maintain a high standard, such as evaluating whether they assess the necessary skills and knowledge.
- Hundreds of Volunteer Hours: Crafting a single exam takes hundreds of hours from volunteers who are passionate about advancing the field. This includes not only writing and reviewing questions but also refining them to meet statistical and educational standards.
- Post-Exam Statistical Analysis: After the exam, statistical analyses are conducted to identify any anomalies, such as questions that were unexpectedly difficult or misunderstood by candidates. These analyses help ensure that the exam fairly and reliably measures candidates’ knowledge and skills. The review process even includes examining whether a question might have been mis-keyed or poorly understood based on patterns in candidates’ answers.
Ethics and Professionalism
A key component of the ABR exams is the inclusion of ethics and professionalism questions. These scenarios test candidates’ ability to navigate real-world challenges like managing conflicts of interest, maintaining patient confidentiality, or addressing ethical dilemmas in clinical settings.
Rather than focusing on definitive right or wrong answers, these questions assess how well candidates can justify their approach using professional guidelines and sound judgment. They reflect the complexities of a medical physics career, where technical expertise must be balanced with ethical decision-making and effective communication.
By including these questions, the ABR ensures that certified physicists are prepared not only to excel technically but also to act with integrity and uphold the trust placed in them by patients and colleagues alike.
What It All Means
The ABR exams are more than just a series of tests—they are a transformative experience that prepares candidates to excel in their field. From the foundational knowledge assessed in Part 1 to the hands-on expertise required for Part 3, the process is designed to ensure that certified medical physicists are equipped to handle the complexities of their profession with confidence and competence. By completing the ABR certification process, candidates not only demonstrate their technical proficiency but also their commitment to excellence, lifelong learning, and the highest standards of patient care.
Common Misconceptions About the ABR Exams
The ABR certification process can sometimes feel daunting, and it’s not uncommon for candidates to have misconceptions about what to expect. Whether it’s underestimating the level of preparation needed or not fully understanding the purpose behind the exam structure, clarifying these details early on can make a big difference in building confidence and setting yourself up for success.
1. The Exams Are Just About Memorizing Facts
Many candidates assume that success on the ABR exams depends solely on memorizing physics equations, concepts, and protocols. While a strong foundation of knowledge is essential, the exams are designed to assess application rather than rote memorization.
2. All You Need Is a Graduate Degree
While a graduate degree is a prerequisite, it is not enough to qualify you for the ABR exams. The residency experience plays a critical role, especially for Parts 2 and 3, as it provides the hands-on training and clinical exposure necessary for success. In fact, you are not able to take the exam without a certified residency program.
3. The Exams Are Designed to Be Arbitrarily Difficult
Another common misconception is that the exams are unnecessarily challenging or restrictive. In reality, the rigorous standards ensure that certified medical physicists are fully prepared to practice independently and uphold patient safety.
The challenging nature of the exams mirrors the significant responsibilities candidates will take on in their careers. The pass rates, though not overly high, are designed to ensure that certification is awarded only to those who are thoroughly prepared and fully competent for the demands of the field.
4. You Can Skip Certain Study Materials
The ABR provides a detailed list of study materials and resources for each exam. Candidates who overlook even a few of these materials often miss key concepts and details that are likely to appear on the test. Don’t forget CAMP’s own list of study materials too!
5. Only Top Students Pass the Exams
Passing the ABR exams is not about being the “top student” but about preparation, persistence, and clinical competence. Many successful candidates are not top of their class but have excelled through disciplined study, practical experience, and leveraging resources like mock exams and study groups.
6. Failing Means You’re Not Qualified
Failure is more common than many candidates realize. Pass rates for Part 3 are around 60%, and even for Part 2, approximately 20% of candidates don’t pass on their first attempt. However, failing doesn’t mean a candidate isn’t capable of success. Many candidates pass on their second attempt after addressing gaps in knowledge or preparation methods.
7. The Exams Are Designed to Delay Careers
Candidates may feel frustrated by the once-a-year exam schedule and the multi-year process, assuming it’s meant to delay their career progression. In truth, the schedule reflects the complexity of creating fair and statistically valid exams, which require significant time and effort from volunteers and staff. It’s a complicated process!
How to Prepare for the ABR Exams: Strategies for Success
Preparing for the ABR exams requires a combination of strategic study, practical experience, and mental readiness. Each part of the exam poses unique challenges, but with the right approach, you can maximize your chances of success. Here are actionable strategies to help you prepare for each phase of the ABR certification process.
1. Build a Solid Foundation for Part 1
- Study Key Materials: Use CAMP’s list of recommended resources, focusing on topics like basic physics principles, clinical physics applications, and problem-solving skills.
- Practice Time Management: Simulate exam conditions by practicing multiple-choice questions with strict time limits to ensure you can complete each section comfortably.
- Strengthen Weak Areas: Identify any topics where your knowledge is weaker and dedicate extra study time to those areas.
- Leverage Study Groups: Collaborate with peers to discuss difficult concepts and review material more effectively.
2. Dive Deep into Your Specialty for Part 2
- Focus on Clinical Application: Spend time in your residency engaging with equipment, protocols, and clinical workflows relevant to your chosen specialty.
- Master AAPM Reports: These documents provide detailed guidance on clinical procedures and are often the basis for exam questions.
- Review Case Studies: Practice applying theoretical knowledge to real-world clinical scenarios, which is a major focus of Part 2.
3. Hone Communication Skills for Part 3
- Participate in Mock Oral Exams: Many local AAPM chapters and residency programs offer mock oral exams to simulate the experience and help candidates refine their answers.
- Practice Articulating Your Thoughts: Being able to clearly and confidently explain your reasoning is critical during the oral exam.
- Anticipate Common Scenarios: Review common clinical, ethical, and troubleshooting scenarios within your specialty to prepare for real-time problem-solving.
- Stay Calm Under Pressure: Practice pausing to organize your thoughts when faced with challenging questions, rather than rushing into a response.
4. General Tips for All Parts
- Create a Study Schedule: Develop a realistic timeline that allows you to review all necessary material without last-minute cramming. You should be studying for a few months before the exam.
- Take Care of Yourself: Prioritize sleep, nutrition, and exercise, especially as the exam date approaches. Mental clarity is as important as knowledge.
- Use Available Resources: Take advantage of study guides, practice exams, and peer networks to ensure comprehensive preparation.
- Seek Feedback: Work with mentors or colleagues to identify areas for improvement and gain valuable insights into the exam process.
5. Prepare for Exam Day
- Plan Logistics: Ensure you’ve tested a stable internet connection and a quiet, distraction-free environment. Make sure your computer is charged and you have a back-up, just in case. Ensure that you have completed the “ABR Tech Check” and to ensure your computer settings for audio and video are ready to go. You can access monitor requirements as well.
- Dress Professionally: Even for remote exams, dressing professionally can help you feel more confident and focused.
- Stay Focused and Confident: Remember that you’ve prepared for this moment. Approach each question methodically, and don’t let a tough question derail your confidence.
The Key to Success: Persistence and Preparation
The ABR exams are intentionally rigorous, designed to ensure that certified medical physicists are ready to handle the complexities of the profession. With a strategic and comprehensive approach to preparation, you can navigate the challenges of the exam process and achieve your goal of board certification.
Every hour of study, clinical experience, and self-reflection contributes to building the confidence and expertise you need—not just to pass the exams, but to excel in your career as a medical physicist.
What to Do If You Don’t Pass: Turning Challenges into Opportunities
Failing one part of the ABR exams can feel disheartening, but it’s important to remember that you’re not alone. Many candidates don’t pass on their first attempt, and the process is designed to challenge even the most prepared individuals. The key is to view failure as a learning experience and take actionable steps to improve for your next attempt.
1. Understand the Results
- Detailed Feedback: The ABR may provide feedback on your performance.
For Part 1 (General and Clinical) and Part 2, failing requires retaking the entire exam. For Part 3, if you fail a specific topic area, you will condition in that area and only need to retake questions related to that subject. However, if you fail more than one topic area, you must retake the entire oral exam.
- Identify Patterns: Reflect on the challenges you faced. Was it due to gaps in knowledge, poor time management, or unfamiliar question formats? Identifying these patterns can help you prepare better for your next attempt.
2. Reassess Your Study Strategy
- Revisit the Materials: Review recommended resources and ensure you’ve covered all areas comprehensively.
- Incorporate Practical Learning: If applicable, seek additional hands-on clinical experience to deepen your understanding of applied concepts.
- Join Study Groups: Collaborating with peers can offer new perspectives and help you tackle difficult topics more effectively.
3. Utilize Available Support Systems
- Local AAPM groups: Many major cities offer mock exams, study sessions, and resources specifically for candidates retaking the ABR exams.
- Mentors and Colleagues: Reach out to experienced medical physicists who can offer guidance, share their experiences, and suggest strategies for improvement.
- Continuing Education Courses: Consider enrolling in workshops or courses that focus on weak areas identified in your results.
- Reach out to CAMP on socials: We’ve been there. We encourage you to send us a message through socials (hello Reddit) if you want a different approach, perspective, or just some emotional support.
4. Adjust Your Mindset
- Embrace Growth: Failing an exam is not a reflection of your potential as a medical physicist. Use this experience to refine your skills and deepen your knowledge.
- Stay Positive: Many successful physicists didn’t pass every exam on their first attempt. Persistence and a proactive attitude are key to overcoming setbacks.
- Focus on Progress: Each attempt builds your familiarity with the process and brings you closer to success.
5. Learn from Common Pitfalls
- Insufficient Preparation: Ensure you’ve thoroughly reviewed all recommended materials, including task group reports and accreditation standards.
- Overlooking Ethical Scenarios: Ethics and professionalism questions can be particularly challenging—dedicate time to understanding these concepts.
- Stress Management: Practice techniques to stay calm and focused during the exam, such as deep breathing and time management strategies. Taking care of your mental health is the first step to succeeding.
6. Celebrate Incremental Wins
Every step forward in the ABR exam process is worth celebrating. Whether it’s passing a section of the oral exam or improving your scores from a previous attempt, take time to recognize and reward yourself for the progress you’ve made. These milestones reflect the effort and dedication you’ve invested and are important markers on the path to success.
Moving Forward with Confidence
Failing an ABR exam is not the end of the road—it’s a chance to regroup, refocus, and come back stronger. By understanding your results, seeking support, and refining your preparation strategy, you can turn this challenge into an opportunity for growth.
Final Thoughts: Embracing the ABR Journey
The ABR certification process is more than a series of exams; it’s a journey that transforms candidates into skilled, confident, and independent medical physicists. While the road is challenging, the rewards—both personal and professional—are profound.
1. The Value of Persistence
The difficulty of the exams is not a barrier; it’s a measure of readiness. Each part of the process builds on the last, testing not just what you know, but how well you can apply that knowledge in clinical and ethical scenarios. For many, the sense of accomplishment at the end of the journey outweighs the stress and challenges along the way.
2. What Success Looks Like
Earning your ABR certification is a testament to your expertise, dedication, and commitment to excellence. Beyond the credential, you’ll gain:
- Confidence in your ability to solve complex problems and contribute to patient care.
- Recognition as a trusted expert in your specialty.
- Opportunities for career advancement and leadership roles.
3. A Shared Experience
The ABR journey is one that connects candidates to a larger community of medical physicists. From study groups to mock exams, the process encourages collaboration and shared growth. Many candidates find lifelong colleagues and mentors through this experience, creating professional networks that support their careers. The potential to give back later in your career and support the ABR through volunteering and/or mentoring young professionals is
4. Beyond the Exam: A Lifelong Commitment
Certification is not the end of the road—it’s the beginning of a lifelong commitment to learning and professional growth. The ABR’s Maintenance of Certification (MOC) program ensures that certified physicists stay current with advancements in their field. This dedication to continuous improvement is what keeps medical physics a dynamic and impactful profession.
Advice for Future Candidates
For those considering or preparing for the ABR exams:
- Start Early: Build a strong foundation during your graduate and residency years.
- Be Patient: Certification is a marathon, not a sprint.
- Stay Resilient: If you encounter setbacks, learn from them and keep moving forward.
- Reach Out: Use the resources and support systems available, from mentors to professional organizations.
Your Next Steps
Whether you’re at the beginning of your ABR journey or preparing for the next step, remember that every candidate before you has faced the same challenges. With determination, preparation, and support, you’ll not only pass these exams but also emerge as a stronger, more capable professional.
The ABR certification isn’t just a credential—it’s a mark of excellence that signifies your readiness to make a meaningful impact in the field of medical physics. Take it one step at a time, and trust that the process will prepare you for an exceptional career.
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