Alternate Pathway to Board Certification for Foreign-Trained Medical Physicists
By Matthew B. Podgorsak, PhD, ABR Board of Trustees Chair; Geoffrey S. Ibbott, PhD, ABR Associate Executive Director for Medical Physics; Kalpana M. Kanal, PhD, and Jennifer Stickel, PhD, ABR Trustees; and Sameer Tipnis, PhD, future ABR Trustee
2025;18(4):5
The ABR’s mission is to “certify that our diplomates demonstrate the requisite knowledge, skill, and understanding of their disciplines to the benefit of patients.” During the board certification process, the ABR applies several instruments to assess a candidate’s knowledge, skill, and understanding of their field. To become a board-certified medical physicist (ABR diplomate), a candidate must pass three computer-based qualifying exams (Part 1 General, Part 1 Clinical, and a specialty-specific Part 2 exam) along with the oral certifying exam in their specialty.
The usual pathway to eligibility for these exams includes matriculation into a medical physics graduate program accredited by the Commission on Accreditation of Medical Physics Education Programs (CAMPEP) followed by completion of a North American CAMPEP-accredited medical physics residency in the chosen specialty: diagnostic medical physics (DMP), nuclear medical physics (NMP), or therapeutic medical physics (TMP). The two Part 1 qualifying exams are usually taken during a candidate’s study in their graduate program, while the Part 2 qualifying exam and the oral certifying exam can be taken once a candidate becomes board eligible after passing the Part 1 exams and completing their residency. Most candidates currently enrolled in the board certification process follow this pathway.
Alternate Pathway
The ABR provides an alternate pathway for medical physicists and physicians trained in foreign countries (defined as outside the United States, its possessions and territories, and Canada) to sit for the certification exams that does not require completion of a North American residency program. These candidates are known as international medical graduates (IMGs); this broad category includes diagnostic radiologists, interventional radiologists, and radiation oncologists in addition to medical physicists. Details describing this Alternate Pathway for IMG medical physicists along with an application form and agreements can be found here.
A foreign-trained medical physicist accepted into the Alternate Pathway program must satisfy the following prerequisites:
- Have completed education (outside the U.S. and Canada) that is equivalent to the requirements of a CAMPEP-accredited Master of Science graduate program.
- Have been employed for at least one year as a qualified medical physicist in their country of origin or training.
- Possess credentials as a medical physicist in their country of origin or training.
Applicants who meet these prerequisites must then demonstrate that they meet certain eligibility requirements:
- Be employed in the United States as a medical physicist.
- Secure a Sponsoring Department Agreement for training at an institution that has a CAMPEP-accredited residency program.
- Complete and submit a Structured Mentorship Program application and fee (see below for details).
The Structured Mentorship Program is an integral part of the Alternate Pathway and is designed to prepare the foreign-trained medical physicist for the ABR certification exams. The training must take place at an institution with a CAMPEP-accredited residency program and must be overseen by a supervising medical physicist (advisor) who is a diplomate of the ABR. Having an accredited medical physics residency program suggests that the sponsoring department has access to the infrastructure needed for comprehensive clinical medical physics mentorship. It is likely that some components within a structured mentorship were part of the candidate’s prior employment portfolio in their country of origin. The ABR, however, has no way of assessing whether these employment tasks were discharged according to North American standards. Completing all parts of a comprehensive Structured Mentorship Program ensures that the candidate’s preparation and experience meets the ABR’s requirements.
A Structured Mentorship Program application must be submitted to the ABR and approved prior to the start of the program. The application must include a statement by the candidate describing their background, including education and work experience, along with a Sponsoring Department Agreement (SDA) and detailed Training Plan, signed by both the candidate and the advisor. A candidate must have their education credentials evaluated by a member organization of the National Association of Credential Evaluation Services (NACES), and the organization must send the results directly to the ABR.
The program must include a minimum of three years of training (note that this is longer than a traditional two-year medical physics residency to account for the candidate’s additional engagement as an employee during the mentorship) and must be completed within six years of the training start date. It is preferred that the entire training take place at a single institution, although it is possible with appropriate ABR approval to transfer to one other institution. (A maximum of two institutions can be involved in the completion of a Structured Mentorship Program.)
Each specialty — DMP, NMP and TMP — has specific Structured Mentorship Program requirements, with examples of clinical rotations as well as other important organizational aspects to be included.
The training plan must incorporate training toward the six competencies for practitioners established by the American Board of Medical Specialties (ABMS) and the ABR. During the mentorship, the candidate must provide the advisor with an annual statement describing their progress toward meeting these six competencies, and the advisor must attest that these competencies have been met before the ABR will consider the program to have been completed. The advisor must interact with the candidate on a regular basis. Same-location supervision is preferable, but electronic review for remote candidates is acceptable to supplement face-to-face interactions. Finally, each candidate in a Structured Mentorship must keep a portfolio describing their activities, which can be audited by the ABR at any time.
The Alternate Pathway has been increasing in popularity over the past decade, with seven candidates approved to start their Structured Mentorships from 2014 to 2020 and 12 candidates approved to start from 2021 to 2025. Of these 19 candidates, one abandoned the program, but 13 are in the process, and five are now board certified (four in TMP and one in DMP).
The ABR is pleased to be able to offer the Alternate Pathway as an option for those unable to be certified through the traditional route.
