Improving Health Through Medical Physics

How to Prepare to Apply for and Take Board Exams

From the New Professionals Subcommittee and Professional Mentorship Working Group

AAPM Newsletter — Volume 44 No. 1 — January | February 2019

General Board Exam and Certification Questions

Why would I want to become board certified?
  • Required for many jobs
  • Required for some state licenses
  • Gives you a competitive edge
  • Allows you to become a radiation safety officer
  • ABR certification allows you to become an authorized medical physicist on a materials license
  • May give you a salary bump
  • Helps you become a Qualified Medical Physicist
  • Demonstrates your commitment to the field and to patient safety
What's the typical timetable?
  • Most people take Part I during graduate school and Part II immediately after residency
  • ABMP Parts I and II are often taken at the same time with Part III the following year
  • ABSNM Parts I and II are often taken at the same time
Which board exams will I need to take?
  • It depends on what you want to do
  • If you want to be a therapy physicist, take the ABR exams
  • If you want to be an MRI physicist, ABMP MRI exams may be easier for you, but ABR diagnostic exams would also be okay
  • If you want to be a nuclear medicine physicist, you will need to take either ABSNM or ABR nuclear medicine exams
  • If you want to be a radiation safety officer, any of these exams (except ABMP MRI) is appropriate (there's also a Certified Health Physics exam)
  • If you want to be a diagnostic physicist, take the ABR diagnostic exams
What preparation do I need to take the exams?
  • Visit the website to be sure, since requirements vary among the ABR, ABMP, and ABSNM
  • Undergraduate coursework and documentation
    • You may need an official transcript
    • Two semester calculus-based introductory physics course
    • Three higher-level physics courses with particular course content (see each website)
  • Graduate coursework and documentation
    • You will need an official transcript
    • It is also wise to keep a photo or digital copy of your diploma
    • Degree in medical physics, physics, nuclear engineering, or closely related fields
  • If your education was in a country other than the United States and Canada, then you might be required to have your transcripts reviewed by a company that verifies U.S. equivalency
  • You might be required to complete a CAMPEP-accredited certificate program, graduate program, and/or residency program
    • For ABR exams, you will need a CAMPEP-accredited program.
    • ABMP and ABSNM do not require a CAMPEP program.
  • See specific sections below for what to study for each exam.
Which people will need to help me with my application?
  • You will typically need 2–3 board-certified medical physicists or physicians in closely related fields who have knowledge of your experience in the field to fill out a form and/or write a letter about their knowledge of your experience
  • If you're in a CAMPEP-accredited program, that program will need to attest for you
When should I take the exam?
  • As soon as you're eligible.
    • Exam eligibility for all three Part I exams lasts for a period of time, not a number of attempts
    • This means that you may take the exam as many times as necessary during the time window
    • You may also defer taking Part I after being approved to take it
  • Take the exams during graduate school or residency while the material is fresh in your mind
  • Taking the exam following qualifiers or residency competency exams to combine studying efforts
  • Other times when you'd need to study basic medical physics content
How to Apply to Take Board Exams
ABR
  • Part I applications due Sept - Nov for the following August exam
    • Which application form you fill out depends on your status regarding CAMPEP programs (the most recent one you're in or graduated from)
    • You must submit documentation that you are either currently in or have completed a CAMPEP program
    • You must submit an official transcript for your highest degree
  • Part II applications due Dec - Jan for the following August exam
    • You may postpone taking the exam by a year or two, etc.
      • After passing Part I, you have 10 years to be approved by ABR to take Part II
    • You will have several weeks to respond to the invitation.
    • Verify that your email address is correct in MyABR or you may miss the email
  • Part III invitations will be sent around January after you have passed part II.
    • You may postpone taking the exam by a year
    • You will have several weeks to respond.
    • Verify that your email address is correct or you may miss the email
ABMP
  • Exam Applications are typically due in mid-May
  • As of the writing of this document, the current dates and locations of the exams are as follows:
    • The next Part I MRI exams are
      • Saturday, May 11, 2019 in Montreal, Canada
      • Saturday, July 6, 2019 in Orlando, FL
      • Saturday, July 13, 2019 in San Antonio, TX
    • The next Part I MHP exams are
      • Saturday, May 11, 2019 in Montreal, Canada
      • Saturday, July 6, 2019 in Orlando, FL
      • Saturday, July 13, 2019 in San Antonio, TX
    • The next Part II MRI exams are
      • Sunday, May 12, 2019 in Montreal, Canada
      • Sunday, July 7, 2019 in Orlando, FL
      • Sunday, July 14, 2019 in San Antonio, TX
    • The next Part II MHP exams are
      • Sunday, May 12, 2019 in Montreal, Canada
      • Saturday, July 6, 2019 in Orlando, FL
      • Sunday, July 14, 2019 in San Antonio, TX
    • Then next Part III MRI oral exams are Saturday, July 13 and Sunday, July 14, 2019 in San Antonio, TX
    • Dates for the next Part III MHP oral exams have yet to be determined
  • For updated information, please see the ABMP website
ABSNM
  • Applications are due in mid-March
    • You must select one of four specialties
    • You must provide contact information for supervisors who can attest to your training
    • You must submit your CV
    • You must submit an official transcript of your Master's or Ph.D.
    • You must ask at least one supervisor to fill out a form attesting to your experience
    • You must submit a recent photo of yourself
    • You must have a Notary Public witness your signing and sealing the envelope to mail
    • The whole exam is taken one day
    • The next exam date is Friday, June 21, 2019 in Anaheim, CA

General Board Exam Preparation

When should I start studying?
  • Now!
    • Keep your graduate school and residency notes/exams.
  • 3-4 months in advance: Start studying an hour a day to get familiar with concepts.
    • Earlier if you'd like, but be careful of burnout.
  • Ramp up to ~4 hours per day 2 months before the exam.
    • Adjust as necessary based on your comfort level with the subject.
How should I study?
    You know your learning style best, but some general tips that may be helpful:
  • Begin by organizing all of your references and materials.
  • Look at the content guide, have you got all of your bases covered?
  • Identify your own weaknesses and/or gaps in knowledge.
  • Use Raphex exams as a guide to subject areas, but study more complex problems than presented there.
  • When reviewing your practice problems, be sure to understand why the correct answers are correct as well as why the incorrect answers are incorrect.
  • Discuss study strategies with a mentor or another person who has passed the exam.
    • Do not expect specific test content, as revealing such is an ethical breach.
  • Practice solving problems QUICKLY. Time is limited. You should be able to recall problem solving strategies easily.
  • Download the Pearson Vue Tutorial and Demo for the ABR Parts I and II. Practice navigating the test environment so you're comfortable with it before test day.
    • Be familiar with the test calculator (TI-30XS), you may practice with it on the practice exam. There are tutorial videos available on YouTube as well.
    • Turn on number lock on the keyboard so you can use the number pad
    • You may bring your own physical calculator. It must be the TI-30XS and have no markings. Pearson Vue staff will inspect the calculator prior to the exam.
    • Dry erase booklets are provided during the test. Be comfortable using them.
  • Practice, practice, practice! ...the more you practice, the faster you get.
  • Starting earlier is always better, spending any amount of time on a regular basis (one hour every Wednesday, for example) is far better than beginning later.
  • Do you need a partner? Having a study partner is good to keep each other on track.
  • Where do you start? Start by reviewing the content guide on ABR website. Then jump straight into practice with the ABR sample questions. This will allow you to get a feel of what a complex vs simple question may look like.
  • Questions from your medical physics homework set (e.g., MU calcs, shielding questions, and radioactive decay) are great for practicing "complex-type" questions. Book questions from those listed in the resources section are also a good resource.
  • ABRphysicshelp has great "cliff notes" of relevant material. In addition to abbreviated lecture notes, there are practice sets of questions that represent both simple and complex question types.
  • Write out formulas and problems as you solve them. This will allow you to efficiently review past problem sets as you get closer to the exam.
  • Making notecards or a "formula sheet" is great way to condense material to have handy while studying in addition to reviewing for your final preparation.
  • When practicing problems, think of alternative spins of each question. For example, how to calculate if the units were different or how to calculate a beam match angle if the patient were prone instead of supine.
  • Units save lives!! Sometimes answers are very obvious, please keep units and orders of magnitude in mind.
  • During the test, do not be alarmed if there is a typo. Do your best with the information given.
  • Be aware of the "new type" of questions that ABR is introducing. These include "case-based" questions, which will not allow the test taker to flip back to prior questions in the respective series of the case. Please see the ABR website for more details and examples of the case-based questions.
What other skills are useful?
  • Dimensional analysis
    • If one of the answers has the wrong units, it's the wrong answer
  • Unit conversion
    • If you don't remember the formula, can you combine the given information to get a result with the right units?
  • Calculus and basic trigonometry
    • Basic derivatives and integrals
    • SOHCAHTOA and unit circle
  • Practice tests and timing yourself
  • Psychology (test taking best practices)
    • Arrange to take the whole day off
    • While you're taking those practice tests, practice staying calm
    • If you can study with someone, having them ask questions and you answer, that might help you learn to remain calm while answering questions
    • Spend the extra money to stay in a hotel near your testing center the night before the exam.
    • Drive by the exam center so you're sure you know where it is
    • Get a good night's sleep before the exam
    • Have a balanced meal before the exam.
    • Get up early enough on exam day that you don't have to worry about getting to the exam site
    • Probably all the test takers will be as nervous as you are, but if there is someone trying to psych you out, try to move away from them
    • Be kind to yourself after the exam - you need to live your life for several weeks while waiting for the results - assume you did well and give yourself a break from studying for it
  • Memorize products of combinations of conversion factors.
    • Johns and Cunningham Table 1.1, p. 5
    • Be aware of what is provided on the test by the ABR and ABMP (see content guide)
What resources are available?
  • If your employer will pay for your continuing education, consider attending a review class
    • AAPM Summer Meeting has Therapy, Diagnostic, and Nuclear Medicine review courses
    • Check Chapter Meetings for reviews
  • ABMP MRI Content Description
  • ABMP MHP Content Description
  • ABR Content Guide
  • ABSNM Specialty Areas
  • We Passed
  • ABR Physics Help
  • Raphex
  • Yahoo study group
  • Textbooks—keep in mind when reading this list that it is not suggested that one reads every text. Some will find a text more readily understood and helpful than others.
    • Khan, "The Physics of Radiation Therapy"
    • Attix, "Introduction to Radiological Physics and Radiation Dosimetry"
    • Hendee, "Radiation Therapy Physics"
    • Turner, "Atoms, Radiation, and Radiation Protection"
    • Hashemi and Bradley, "MRI: The Basics"
    • Johns and Cunningham, "The Physics of Radiology"
    • Hall, "Radiobiology for the Radiologist"
    • Bushberg, "The Essential Physics of Medical Imaging"
    • Huda, "Review of Radiological Physics"
    • Podgorsak, "Compendium to Radiation Physics for Medical Physicists"
    • Cherry, "Physics in Nuclear Medicine"
    • Knoll, "Radiation Detection and Measurement"
    • Mettler, "Essentials of Nuclear Medicine Imaging"
    • Hacke MRI book
    • Elman MRI book clinical
    • Haaga CT and MR book
    • Basic Human Anatomy and Physiology Book
    • Books of cross-sectional anatomy
How to Study for ABR Part I and ABMP General MP Part I ?
The ABR Medical Physics Part I exam is the first step toward board certification common to every medical physics specialty. The ABMP General Medical Physics Part I can be the starting point for MRI (alternatively, there's also an MR Science exam) and is the starting point for Medical Health Physics. Methods of preparation may be different from individual to individual. In this guide you will find general information to help create a plan for success.
What topics should I study?
  • For the most comprehensive and up-to-date listing of topics, see the links to the content guides at the bottom of this document.
  • General Section o Atomic / Nuclear Physics, Sources of Radiation, Interaction of Radiation with Matter o Radiation Instrumentation and Measurement o Diagnostic Medical Physics o Nuclear Medical Physics o Therapeutic Medical Physics (ABR only) o Radiation Protection and Safety o Professionalism and Ethics o Mathematics - Statistics o Image Processing - Analysis, Informatics
  • Clinical Section
    • Anatomy
      • Cross-sectional anatomy (CT and MRI)
      • Disease states in images
      • Appearance of cancer in images
      • Relative positions of organs
    • Radiation Biology
    • Human Physiology
    • General Medical terminology
      • Prefixes and suffixes
    • General Radiology terminology
    • General Radiation Therapy Terminology
    • Clinical Procedure Applications
    • Radioactive package sending/receiving and transport procedures
    • Pathology
Working fast is especially important on Part I!
  • Set a timer and give yourself only 3 minutes per problem!
  • Set a timer and complete a bunch of problems in a set amount of time!
What are the last minute things I need to remember?
  • Take your photo ID with you. This ID must be valid (not expired) and have a signature.
  • Be aware that you might not be able to start the exam at the exact time you were asked to report; if they're screening people one at a time, you might have to wait
  • Be prepared for technical bugs and stay calm. If you have a technical problem with the test, Pearson Vue personnel are available to stop the test and help if warranted.
  • Bring a sweater, test centers are often kept cold.
  • ABR Part I is split into 2 sections, General (80 - 120 questions in 4 hours) and Clinical (75 questions in 1.5 hours) with an optional break (30 min) in between
  • Complete as many questions as possible. Do not spend too much time on one question -- Make an educated guess, flag it and return to it if there is time remaining at the end.
  • Read each question carefully and ensure you're giving the answer to the question asked.
  • Eat before you go to the exam
  • Take food and with you to the exam, put this in your locker to eat between the sections
  • Do not turn on your phone during the break between sections!
How to Prepare for ABR Parts II and III
The American Board of Radiology (ABR) Medical Physics Parts II and III therapy exams are the second out of a three-part series of exams towards completion of board certification. Once certified, a physicist is considered a qualified medical physicist (QMP). The Part II exam is specialty-specific, this guide attempts to group these exams together where possible and share what may be different for each in other places. Methods of preparation may be different from individual to individual. In this guide you will find general information to help create a plan for success. Please note that board certification content and policies are subject to change, for current board certification policies and procedure please visit the ABR website at www.theabr.org
When Am I Eligible to Sit for ABR Part II and How Do I Register?
  • The ABR therapy medical physics exam is offered once a calendar year, typically in August at Pearson VUE testing centers.
  • Candidate eligibility is based on completion of a CAMPEP-accredited residency unless a candidate began the process before 2012. Please visit ABR website for current guidelines.
  • If you completed a CAMPEP-accredited residency prior to the year that you are applying for the Part 2 exam, you must also provide documentation of current employment as a medical physicist.
  • Applicants will apply approximately the winter preceding the exam and will receive notification from the ABR once their application has been approved.
  • Since Pearson VUE testing centers are limited in the capacity (with not only Part II's but other test takers), it is recommended to sign up immediately once you have been approved to register for the exam with Pearson VUE. Note that you may be required to place more than one choice for testing center location.
What Are the Testing Logistics for Part II?
  • Where -- The exam is a computer-based exam that is administered over several hours at a Pearson VUE testing center.
  • Calculator -- The only approved calculator is the Texas Instruments TI-30XS. We recommend to purchase the calculator in advance to allow the opportunity to gain familiarity. Note there is also a backup calculator on Pearson VUE software, but a physical calculator will be the preferred choice for most. The backup calculator is a virtual version of the Texas Instruments TI-30XS, so you may want to become familiar with the operation of this model before you take the test.
  • Breaks -- There are allowable breaks (i.e., bathroom, get snack). Note that breaks may be "on the clock" and take away from your test time if you take one that is not scheduled. Testing center personnel may clarify as needed.
  • Scratch paper -- There is no scratch paper or anything on your person allowed into the testing room. A marker and dry erase notepad will be provided at the start of the exam. Note that if you fill up your dry erase notepad, you can raise your hand and the proctor will bring an additional notepad to you. It is advantageous not to erase past problems so that you can double check your work at the end if time permits. If your dry erase marker stops working, the proctor can also supply you with another.
  • Software -- On the ABR website is a link to download the Pearson VUE software to simulate the testing experience. It is recommended to do so in order to learn how to flag questions and navigate the online testing experience.
  • ID -- Bring a valid (not expired) government issued ID. Note that if you recently changed your legal name on your ID, then update your name with ABR, as the identification must match your ABR registered name.
  • Locker -- Upon arrival, you will have a locker number assigned to you. You can put snacks, a bottle of water, etc. in here, which you will be allowed to access during the breaks. Consider putting a sweater in your locker if you decided to not wear one.
  • Constants and Physical Values -- A list of constants and physical values that will be provided on the day of the exam is provided on the ABR website. Please note that it may be required to convert to other units and this list is not exclusive.
  • Time -- Do not spend too much time on any individual question. If you do not know the answer, take an educated guess and move on. Note that if you finish the exam before the allotted time is up, you can return to previously answered questions. Flagging questions is helpful to highlight certain questions you would like to review at the end. Note that some of the "new type" of questions may not allow you to "go back" to a prior question if in a series of questions.
  • Disabilities -- Please see ABR website for details on how to apply for disability accommodations.
When Am I Eligible to Sit for ABR Part III and How Do I Register?
  • You have six years from the end of residency or when you are approved to take Part II to pass Part III
  • The January or February after you pass Part II, you'll receive an invitation from ABR to sit for Part III
  • You need to respond to this invitation
  • A month or two later, you'll receive a bill, which you need to pay promptly
  • At this point, you should strongly consider taking Part III, no matter what happens (because they charge extra to cancel)
What Are the Testing Logistics for Part III?
  • Fly in at least the day before your exam. The ABR will attempt to accommodate examinees in the event of delayed arrival outside of the examinee's control. But it's best to arrive on time.
  • When you arrive at the facility, you'll see signs indicating where the exams are and that you should not go into the testing area until it is time for your exam
  • Bring your ID and nothing else to the exam; note that you will have to leave your phone and watch in your backpack or in a box in the orientation room
  • In the orientation room, you will receive a list of your examiners and be asked to immediately report any conflicts of interest with these
  • After orientation, you will stand outside the door of your first examiner's room until the examiner invites you in
  • In each room, one examiner will sit next to you at a table; there will be a computer in front of you on which the questions are displayed, one at a time
  • Each examiner will ask you five questions, many of which will be multi-part questions; you have approximately 5 minutes per question
  • The examiner is not allowed to give you any feedback during your exam, other than check the time
  • There will be scratch paper and a pen in each room. You are encouraged to write, draw, and calculate with these
  • Be aware that each test giver is watching the time and may move you along to the next question before you finish - this is to your benefit
  • If you don't know the answer to the question, you can write or talk through your thoughts on the subject or ask to be allowed to answer this question last in this room
  • If you have time left over after you've answered the 5 questions, you can then ask to go back to an earlier one (within the same room)
  • Note that there will be people supervising the examiners walking around during your exam, and they might come into the room to watch your examiner and monitor the test-taking environment; ignore them.
  • Bells will chime after you've had 25 minutes with one examiner, and that is the signal to wrap up your answer and go stand outside the next room
  • There are restrooms available during the test— ask. If you can, do this during the 5-minute passing period between rooms
  • There is water available if you need it— ask
  • After your exam, you will be asked to leave the exam area
How to Prepare for ABR Parts II and III Therapy
The ABR content guide (therapy) lists the relevant material of the ABR Part II and III medical physics exam and includes:
  • Reference and Relative Dosimetry
  • Treatment Machines
  • Therapy imaging and room design
  • Patient safety
  • Data transfer and integrity
  • Professionalism and ethics
  • Treatment planning for photons, electrons, SRS, SBRT, inter- and intra-fraction variations
  • Planning system safety
  • Brachytherapy
  • Radiation protection and radiation biology
  • Patient-Related Measurement
  • Calibration, Quality Control, Quality Assurance
  • Image acquisition, processing, and display
  • Equipment for QC and QA
  • Part III is more clinically applied than Part II
Resources (Note some helpful resources, not a complete list)
  • Textbooks: McGinley, Khan, Bushberg, Khan lectures, Karzmark
  • AAPM Task groups: TG 51 and its Addendum, TG 142, TG 40, MU Calc (TG71), TG 66, TG 132, TG 43 Revision, TG 25 and TG 70, etc.
  • Publications: NCRP 151, NRC regulations
  • Review Materials: ABRPhysicsHelp, Wepassed, Raphex, Yahoo Med Phys Board Preparation
  • AAPM virtual library
  • Your CAMPEP-medical physics class and residency notes
How to Prepare for ABR Parts II and III Diagnostic
The ABR content guide (diagnostic) lists the relevant material of the ABR Part II medical physics exam and includes:
  • Radiography, mammography, DBT, stereo, fluoroscopy interventional imaging, CT, MRI, and ultrasound
  • Informatics, image display, and image processing
  • Detectors
  • Radiation biology
  • Dosimetry
  • Radiation protection and safety
  • MRI safety
  • US safety
Resources (Note some helpful resources, not a complete list)
  • Textbooks: Khan, Bushberg, Hall, Knoll
  • AAPM Task groups: TG 65, 93, 96, 100, 111?, 125, 144?, 151, 190, 196, 204, 220, 232, OR03
  • NCRP 147, 160, 168, 172, 174, others???
  • Bier
  • Wagner
  • Regulations: 21 CFR 1020.30, 10 CFR 20,
  • Review materials: Wepassed, Raphex,
  • AAPM virtual library
  • Your CAMPEP-medical physics class and residency notes
  • Know how all the equations in your survey forms work and why
How to Prepare for ABSNM and ABR Parts II and III Nuclear Medicine Exams? What topics should I study?
  • Many of the same topics listed above for Part I ABR and ABMP
  • AAPM TG 52, 96, 108, 144, 160, 181, 211, OR03
  • NCRP 147, 160, 161, 164, 174
  • See the ABR and ABSNM study guides
How to Study for the ABMP MRI Exams?
From the New Professionals Subcommittee and Professional Mentorship Working Group With Dave Jordan
For ABMP Parts I and II, many of the logistics are similar to ABR Parts I and II, so read those strategies for test taking. You will have to travel to the exams, so plan ahead and travel early in case there are airline issues.
What Are the Testing Logistics for Part III?
  • You will stand in front of a three-examiner panel
  • There is an easel you can use during your answers
  • There are seven topic areas; if you fail only one or two, you will condition
What topics should I study?
  • Many of the same topics listed above for Part I ABR and ABMP
  • See the preparation instructions on the ABMP website for Part I, Part II, and Part III
  • AAPM TG 20, 28, 34, 77, 78, 100, 118, 196
  • Chemistry and biochemistry relevant to contrast agents
  • Siting issues
  • ACR siting white paper
  • ACR MRI QC manual
  • Clinical applications
  • Deep clinical awareness
  • Close work with technologists, if this is possible
  • MR safety
  • Panych and Madore MR safety article
  • Handbook of MRI Pulse Sequences
  • K-space in the Clinic review article
  • Mostly you'll need to know non-manufacturer-specific material
  • Pick a favorite manufacturer and know their sequences in detail for the oral exam
What are the last minute things I need to remember?
  • Make sure you know where the exam rooms are in advance of your exam time

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