Personal study pathway
Radiation Oncology Board Preparation
How I approached Medical Physics, Radiation and Cancer Biology, and Clinical Radiation Oncology during an integrated training pathway—and the resources I would prioritize now.
Official policy
Confirm eligibility before choosing a date
When this page was updated, the American Board of Radiology stated that candidates may take Medical Physics and Radiation and Cancer Biology after 32 months of radiation oncology training, or after 24 months with a written early-exam exception requested by the training program through the ABR’s signed-form process. The two parts may be taken together or separately. The Clinical Radiation Oncology qualifying examination follows 44 months of radiation oncology training.
Policies can change. Review the current ABR policy, confirm your eligibility and registration status in myABR, and discuss timing with your program director before making plans.
Policy language checked September 2026.
A schedule-specific decision
How I would think about timing
PGY-3
Physics and Radiation Biology
I took both examinations early because the following year had a defined fellowship schedule.
PGY-4
Away Enfolded Fellowship
Functional neurosurgery and stereotactic radiosurgery were the priority for that year.
PGY-5 · Chief Resident year
Clinical Board Preparation
I combined disease-site review with question practice and revisited the educational material we had created for this website.
My practical advice
If early testing is allowed and supports a defined research, fellowship, or elective schedule, taking one examination after 24 months and the other later may distribute the workload more reasonably. I would not routinely recommend taking both during PGY-3 unless the training calendar makes that necessary.
Foundations, repetition, and timed practice
Medical Physics
The Physics & Technology of Radiation Therapy
How I would use it: Make this the main source. In the edition I used, I spent disproportionate time on the foundational first 8–10 chapters, then returned to later chapters as questions exposed gaps. Chapter organization may differ in the current edition.
View the publisher pageRadOncQuestions
How I used it: When I prepared, I completed the physics questions available in RadOncQuestions, reviewed the explanations, and repeated missed concepts. Confirm the current categories before subscribing.
Visit RadOncQuestionsRAPHEX Therapy Examinations
How I used them: I completed five before taking the boards. Use several recent examinations under timed conditions, then study the answer explanations carefully. Check the current Medical Physics Publishing listings: the multi-year Therapy collection is often a better value than buying individual years. I would purchase the official files and avoid scanned PDFs, which may be incomplete or have illegible figures or answer material.
Browse RAPHEX examsBasic Radiotherapy Physics and Biology
Best use: A concise review source for both physics and radiation biology, especially after the foundational material is established.
View the bookRadiation Oncology Physics Review Course
Best use: A structured online option for residents who benefit from a guided physics curriculum or want an additional review pass.
View the courseActive review and question practice
Radiation and Cancer Biology
ASTRO Radiation and Cancer Biology Study Guide
How I would use it: Work through the current topic chapters and practice questions as the main structured review, then use other sources to reinforce weak areas.
View the 2026 study guideRadOncQuestions
How I used it: When I prepared, I completed the radiation-biology questions available in RadOncQuestions and reviewed why each distractor was wrong. Confirm the current categories before subscribing.
Open the question bankRadiobiology for the Radiologist
Recommendation context: I did not personally use this book for the examination, but it is widely recommended and is listed among ARRO’s suggested primary references.
View the publisher pageDisease-site synthesis and retrieval practice
Clinical Radiation Oncology
ASTRO Annual Refresher Course and onDemand
How I would use it: Let the Refresher Course provide the organized disease-site framework, then consolidate each topic with questions and a short personal summary.
View the 2026 Refresher onDemandRadOncQuestions
How I used it: Complete the clinical question bank whenever possible. If time is constrained, prioritize the high-yield clinical material and review explanations carefully.
Visit RadOncQuestionsACR Radiation Oncology TXIT Study Guide
How I would use it: Work through the official ACR TXIT Study Guide, which replicates the In-Training Exam format and provides questions, rationales, and annotated references.
Open the official ACR TXIT pageTranslate knowledge into treatment planning
Contouring and Treatment Planning
Target Volume Delineation and Field Setup
Why I recommend it: A practical, slice-by-slice guide to simulation, target delineation, field design, IMRT, and SBRT across major disease sites.
View the second editionIntracranial and Spinal Radiotherapy
Why I recommend it: A focused member of the same practical-guide series covering brain and spine tumors, SRS/SBRT, IMRT, particle therapy, and treatment technique.
View the CNS guide