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An outline of the subject areas covered on the certification examination is included to help candidates prepare for the exam.  Candidates should review this outline carefully and focus study on the areas listed.  Candidates should be aware that the outline reflects the responses to practice-analysis questionnaires and enables codification of the examination for subsequent analysis of the results.  Each question is linked to a specific area of the outline.  No question is meant to be obscure or tricky.  The percentage of questions in an area conveys the relative importance of each area of the examination.  The information in the outline is meant to serve as a study aid only and not as a guarantee of success in taking the certification examination.

Radiation Oncology Classification System

  Subject Area # of Questions on Exam
1 Benign Diseases 3
2 Bone Marrow Transplants 1
3 Breast 11
4 Central Nervous System 9
5 Chemotherapy/Leukemia 2
6 Childhood Cancers 2
7 GI Tract Colo-Rectal 10
8 GI Tract Esophagus 6
9 GI Tract Other Topics 4
10 Gynecologic Oncology Cervix 8
11 Gynecologic Oncology Endometrium 8
12 Gynecologic Oncology Ovarian 3
13 Gynecologic Oncology Other Topics 3
14 Head & Neck Larynx 7
15 Head & Neck Nasopharynx 7
16 Head & Neck Oropharynx 7
17 Head & Neck Other Topics 6
18 Hodgkin's Lymphoma 7
19 Non-Hodgkin's Lymphoma 7
20 Musculoskeletal System 5
21 Palliative Medicine 6
22 Physics 20
23 Radiobiology 14
24 Skin 5
25 Thorax Lung 11
26 Thorax Other Topics 6
27 Urology Bladder 6
28 Urology Kidney 3
29 Urology Prostate 7
30 Urology Testes 3
31 Urology Other Topics 3


Radiation Oncology Examination Study References

You may wish to use the study materials to prepare for the written certification or recertification examinations. The Examinations Committee uses these references to create questions for the examinations.

  Download Study References

Description of the Oral Examination in Radiation Oncology

The Oral Certification Examination in Radiation Oncology is an opportunity for the Board to examine your ability to diagnose and treat patients requiring therapeutic intervention. The cases you will be presented will be based upon real or hypothetical patients. For each case you will be given a brief history of the patient's present symptoms or complaints. You may need to probe for more information, develop a differential diagnosis, request laboratory tests or diagnostic examinations. You will be expected to describe the treatment process. Additionally, the examinee may be questioned regarding the risks related to a treatment process or what other treatment options might be considered. In obtaining the information, you should speak clearly and be cognizant of time constraints (20 minutes for each case) applicable to your handling each case. You may ask the examiner to repeat information that you did not hear clearly. Be certain that you understand what is being asked of you before responding.

The examination consists of five case studies. For each case study a threshold score has been established. The threshold score represents the minimum passing score that is expected of a practicing physician in Radiation Oncology. The threshold score for each case has been established prior to its administration. Board Diplomates in Radiation Oncology, with the guidance of a psychometrician, have estimated the expected minimal performance for each area within each case. These minimal performance expectations are combined to obtain the minimum expected score on a case.

For each case, an examinee is scored in several areas. An examinee's performance is typically scored in each of the following areas:

  • History of the patientThe examinee is expected to probe for the history of the patient (e.g., onset/course/location/associated symptoms; allergies; medications, PMH; social/family history; surgical history; psychological history)

  • Physical examinationThe examinee is expected to request information about specific aspects of the patient's physical condition (e.g., neck, chest, heart, back, neurological, skin, abdomen, and other areas applicable to the case)

  • Requested laboratory tests and diagnostic examinationsThe examinee will order appropriate laboratory tests and diagnostic examinations; the examinee will be provided the results.

  • Management of the patientThe examinee will indicate what treatment is recommended, including post-operative management. The examinee may be asked to provide a rationale.


A candidate's score on any one case is completely independent of his or her score on any other case. To pass, the examinee must minimally obtain a total score (sum of the scores from all five cases) that equals or exceeds the sum of the threshold scores for the for the five studies. Therefore, it is possible that an examinee may score less than the threshold score for one case, but still pass the examination, provided he or she scores well on the remainder of the cases to offset the lower score. Each case contains approximately the same number of possible points. Therefore, the cases are approximately equally weighted in the overall calculation of examinee's total score.

The five cases presented will address a variety of situations. No two cases will address exactly the same topic. Topics presented to the examinee may include, but not limited to:

  • Lung cancers
  • Lymphoma
  • Breast Cancer
  • Sarcoma
  • CNS Cancers
  • GU Cancers
  • H & H Cancers
  • Gynecologic Cancer

Each of the five cases is limited to 20-30 minutes. If you have not completed the diagnosis for a case within thirty minutes, the examiner will indicate that you need to move on to the next case. Examiners will not indicate whether you have passed a case or not. No comments made by the examiner should be interpreted by the examinee as implying that he or she has either passed or failed a case.

Examinees should plan to arrive one-half hour before the scheduled beginning of the examination and expect to be in the examination room for two hours. You will not be permitted to bring into the examination room books, electronic devices, backpacks, or parcels. The only thing you will absolutely need to bring is a government-issued photo ID card such as a Driver's License or Passport for examination check-in.

Drinking water will be available in the room. A restroom break is permissible, but only between cases.

AAPS will provide reasonable accommodations for persons with disabilities, provided the disabilities are documented and the accommodations requested are applicable to the disabilities. Requests for special accommodations should be made to AAPS at least two months in advance of the examination. AAPS will forward specific instructions for the documentation that will be needed from the examinee or the evaluator of the examinee's disability. Any requests for special accommodations less than one month before the examination will not be honored since there will not be sufficient time to review the documentation and arrange for the special accommodations.

All AAPS examinations are administered only in English. Responses from examinees to examination questions must be in English for the candidate to be eligible to receive credit towards his or her examination score.

The results of the examinee's performance on the Oral Examination are mailed within 75 days of the examination. A careful review of the scoring and analyses of the results are conducted after the examination and before issuing reports, to verify the accuracy and validity of the results.

Examinees who fail to pass an Oral Examination have the opportunity to take an examination consisting of five different cases at the next scheduled administration. At the current time, an examinee is permitted no more than three attempts to pass the Oral Examination.

Should you have any questions, please call the AAPS Executive Offices at 813-433-2277.


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