Professional organizations such as the American Board of Radiology (ABR) and the American Board of Physician Specialties (ABPS) administer certification exams for both radiology specialties. Certification candidates are required to hold medical degrees and have completed relevant post-graduate programs, in addition to holding a medical license. Residency programs may help prepare qualified individuals for the specialist certification examination process, which can be rigorous.
Diagnostic Radiology Certification
Encompassing an array of imaging methods, diagnostic radiology certification exams cover nuclear radiology, diagnostic ultrasound, and computed tomography. Physicians and surgeons study for these certification exams during their residency programs.
Academic prerequisites for certification in diagnostic radiology include completion of a post-graduate program accredited by the Accreditation Council for Graduate Medical Education (ACGME) or an American Osteopathic Association (AOA)-accredited internship and an ACGME or AOA-accredited residency in Diagnostic Radiology. In addition to successful completion of written and oral exams, a board-certified diagnostic radiologist needs to have completed five years of approved training, including:
- Graduation from an accredited U.S. or Canadian program by Sept. 30 of the year in which the exam will be taken
- One year of post-graduate clinical training in an ACGME- or AOA-approved program or their foreign equivalents
- Four years in a diagnostic radiology program approved by ACGME's Review Committee, with a minimum of four months in nuclear medicine and three months in mammography
In the oral exam, candidates present their approaches to case management in relation to specific cases outlined by the examiner, who are themselves board certified in diagnostic radiology. Written exams tend to be in a multiple-choice format. Once this exam is successfully completed, candidates advance to the oral exam phase. Diagnostic radiology exams consist of four steps and are given on a schedule based on the amount of training completed by the candidates. The schedule is as follows:
- Within the first 12 months of training, candidates can apply for computer-based cognitive exams
- In the second year, they are eligible to take the physics exam
- The clinical exam can be taken during their third year
- Eligibility for taking the oral exam begins in the fifth year, providing they have passed both written exams
Radiology Oncology Certification
Radiation oncology is the study of the causes of cancer, along with the methods and techniques involved in its treatment and prevention. The aforementioned ABR and ABPS also provide initial and Maintenance of Certification (MOC) or recertification exams for radiology oncology. Radiology oncology residency programs prepare candidates for certification by immersing them in academic subjects like internal medicine, urology, and gynecologic oncology. Residents are also given practical experiences in treatment planning and radiation delivery.
Radiology oncology certification candidates must pass written and oral exams. The written exams are primarily multiple choice and focus on a variety of radiation oncology subject areas, such as physics, radiobiology, and the musculoskeletal system. The oral exam is administered by a board certified radiology oncology professional or group and involves the candidate's interpretations and approaches to five case studies. They are given 20 minutes to respond to each case and are graded in several areas, including the history of the patient, requested lab tests and diagnostic examinations, and management of the patient.
During the residents' third post-graduate year (PGY 3), they become eligible to take the certification exams in physics, cancer, and biology. The radiology oncology clinical exam is taken in PGY 4 and the oral exam in PGY 5.
Employment Outlook and Salary Info
The U.S. Bureau of Labor Statistics (BLS) classifies radiology as a specialty within the occupations of physician and surgeon. The BLS states that the career outlook for this field is very good with employment growth of 4% predicted for the decade 2019-2029. Average earnings for physicians and surgeons were $218,850 in 2020, according to the BLS (www.bls.gov).
Radiology oncologists tend to find employment in hospitals and clinics, physician offices and laboratories. According to the U.S. Bureau of Labor Statistics, the field of radiology is vital to the health care industry because as people continue to live longer, this technology will help in the diagnosis of diseases related to aging, such as heart disease and cancer.
There are a variety of fellowship opportunities available for qualified diagnostic radiologists. These often include the areas of nuclear radiology, women's and pediatric imaging and Magnetic Resonance Imaging (MRI).
A fellowship generally consists of one year of clinical rotations in the chosen subspecialty area, involving supervision and interpretation of all routine procedures and teaching the radiology residents. To qualify, physicians are normally required to have successfully finished a diagnostic radiology residency via a program approved by the ACGME and hold an ABR certification or be ABR-eligible.
One-year fellowship programs in radiology oncology are primarily offered to board-eligible PGY 6 residents who seek to further their clinical training. These fellowships are often tailored to the sub-specialties and interests of the individuals selected. A research orientation for the fellowship is typically an expectation of the candidates, who would work with a mentor to help with the focus of the research.
The diagnostic radiology certification typically has a time constraint of ten years. During this time period, certified radiologists are expected to be constantly expanding their knowledge. After about seven years, certified radiologists are expected to pass a Maintenance of Certification test in order to be re-certified.
Certification in radiology is available in the form of a certificate program in either diagnostic radiology or radiology oncology. Post-graduation, there are a range of fellowship options that can be pursued, as well as re-certification requirements.