Focus on RO: Two Complementary Pillars of Radiation Oncology: ASTRO and the ABR
By ABR Trustee Jeff Michalski, MD, MBA, FASTRO
April 2026;19(2):7
Having had the privilege of serving as a board member of the American Society for Radiation Oncology (ASTRO) and now as an ABR Trustee, I have gained a deep appreciation for how these two organizations — often discussed together but fundamentally distinct — serve complementary and essential roles in radiation oncology. Each advances our specialty in different ways, with unique missions, scopes, and responsibilities, yet both rely heavily on the dedication and expertise of volunteer physicians, physicists, and scientists.
At its core, the ABR is a certifying body. Its mission is to protect patients by ensuring that physicians and medical physicists practicing radiation oncology (as well as diagnostic and interventional radiology and medical physics) meet rigorous standards of knowledge, skill, and professionalism. Certification by the ABR is not about advocacy, education, or policy; rather, it is about public trust. Through Initial Certification and Continuing Certification (formerly Maintenance of Certification), the ABR establishes and upholds standards that define competence across a physician’s or physicist’s professional lifetime. The ABR’s authority derives from its independence and its unwavering focus on assessment, fairness, and psychometric rigor.
ASTRO, in contrast, is a professional society whose mission is to advance the practice of radiation oncology through education, research, clinical practice guidance, and advocacy. ASTRO serves as the collective voice of the specialty, engaging with policymakers, regulators, payers, and the public. It convenes the field through its annual meeting, develops evidence-based clinical practice guidelines, supports research and quality initiatives, and fosters professional development at all career stages. The ABR defines standards for entry and ongoing competence, while ASTRO shapes the future direction and identity of the specialty.
The scope of these organizations reflects their missions. The ABR operates deliberately and narrowly, focusing on exams, longitudinal assessment, and certification policies across diagnostic radiology, radiation oncology, interventional radiology, and medical physics. Its work is largely invisible to the public and even to many practicing clinicians, yet it is foundational. Board certification influences hospital privileging, payer requirements, licensure portability, and patient confidence. To maintain credibility and public trust, the ABR must remain insulated from advocacy pressures.
ASTRO’s scope, by design, is expansive. It addresses workforce issues, reimbursement, health equity, scientific innovation, education, global oncology, and patient-centered care. ASTRO is outward facing and responsive to the evolving needs of the specialty and the healthcare system. Its influence is felt in legislative arenas, regulatory comment letters, consensus statements, and educational curricula. ASTRO does not certify individuals; rather, it empowers professionals and advances the collective interests of radiation oncology.
As someone who has served in leadership roles in both the ABR and ASTRO, I can attest that neither could function without the generosity of time, expertise, and judgment provided by its volunteers.
At ASTRO, volunteers drive nearly every aspect of the organization’s output. Guideline panels, educational programming, annual meeting planning, advocacy committees, and diversity and inclusion initiatives are all led by members who volunteer countless hours. ASTRO’s strength lies in its ability to harness the passion and creativity of its membership, allowing diverse voices to shape policy, education, and clinical standards.
Volunteerism at the ABR is equally critical, though its character is different. ABR volunteers serve as question writers, oral examiners, committee members, and board members. Their role demands objectivity, confidentiality, and a deep commitment to fairness. These volunteers ensure that certification exams and Online Longitudinal Assessment are clinically relevant, psychometrically sound, and aligned with contemporary practice and do not reflect individual practice or institutional preferences. It is meticulous work and essential to the integrity of the certification process.
I view ASTRO and the ABR not as overlapping or competing entities, but as complementary pillars supporting the specialty. ASTRO inspires, advocates, and advances; the ABR validates, assesses, and safeguards. Together, they ensure that radiation oncology remains scientifically rigorous, professionally credible, and worthy of the trust placed in us by patients.
Our field is strongest when these roles are clearly understood and respected and when committed volunteers continue to step forward to serve both missions in the spirit of professionalism and public service that defines radiation oncology.
