Initial Certification for Diagnostic Radiology

International Medical Graduates Alternate Pathway

Last verified on October 25, 2018
An international medical graduate (IMG) is defined as an individual trained in a diagnostic radiology program outside the U.S., its territories, or Canada.


As an IMG, you must demonstrate the following to be considered as a candidate for certification by the American Board of Radiology:
  • Satisfy the training requirements of a non-U.S., non-Canadian country
  • Have documentation verifying your ability to practice radiology independently in your country of training or have received board certification in your country (if applicable)
  • Have had one year of clinical training
  • If you have trained in India, you must have the following degrees to be eligible for the alternate pathway: M.B.B.S. + D.N.B. and/or M.D. If you have another set of degrees from India, a sponsoring department agreement (SDA) must have been received by the ABR by 12/31/2011 for you to be eligible for this pathway. Holders of other degrees from India will not be eligible for ABR certification via the alternate pathway.
The board will assess your status relative to ABR policies and alternative pathways toward board certification (see policyonly after receipt of the following documents:
  • Current, detailed curriculum vitae with specific dates of all training
  • Verification of the following:
    • Medical school training
    • One year of clinical training
    • Radiology residency training
    • Radiology certification (if applicable)
    • Radiology training appointment and/or full-time faculty/fellowship appointment in an institution with a diagnostic radiology training program approved by the Accreditation Council for Graduate Medical Education (ACGME) or Royal College of Physicians and Surgeons of Canada (RCPSC).
    • NOTE: The board accepts copies of diplomas or letters from training institutions as verification. If original documents are in a language other than English, an English translation must accompany them.
  • Payment of a one-time nonrefundable administration fee to be included with the completed application form
  • Copy of Educational Commission for Foreign Medical Graduates (ECFMG) certificate or Licentiate of the Medical Council of Canada (LMCC) certificate
  • Sponsoring department agreement, including your four-year plan
    • NOTE: The required four years of full-time, continuous faculty/fellowship experience must be completed in one ACGME- or RCPSC-accredited program. Credit for research training of up to 12 months will be granted toward diagnostic radiology certification if the research is completed at the same institution as the remaining clinical training. 
Your department chair must complete and submit annual verification forms.
  • The four-year experience must include four months (i.e., sixteen 40-hour weeks) of clinical nuclear medicine training. These four months of nuclear medicine should be the same as those completed by diagnostic radiology residents at the sponsoring institution.
    • One-week increments of training at 40 hours a week is the minimum acceptable training increment permitted.
    • All nuclear medicine training must be clinical training; research is not applicable.
    • Training at an affiliated institution is acceptable.
    • Nuclear Medicine/PET-CT studies interpreted or reviewed as a part of clinical assignments in other than dedicated nuclear medicine rotations during a fellowship (such as chest, abdominal, or cardiac imaging), or during multidisciplinary conferences, cannot be used to satisfy this requirement.
  • Candidates with full applications accepted on or after July 1, 2013, must meet the diagnostic radiology residency curriculum requirements for nuclear medicine therapy of 131I administrations. Candidates must perform under preceptor supervision at least three therapies involving oral administration of 131I in quantities less than or equal to 33 millicuries (mCi) and at least three therapies in quantities greater than 33mCi.
  • Copies of United States Medical Licensing Exam (USMLE) Steps 1 – 2 score reports
    • USMLE Step 3 is required six months before admittance to the Certifying exam.
    • Current unrestricted medical license is required at the time of application and also when certification is conferred.


Core Exam

After your application has been approved, and you have completed 36 months of your approved training, you may take the Core Exam. IMG diagnostic radiology alternate pathway candidates are not required to take the Core Exam at their first opportunity.

Certifying Exam

IMG alternate pathway candidates will be eligible for the Certifying Exam after they comply with the following:
  • Successfully pass the Core Exam
  • Complete the four-year plan in one ACGME-accredited diagnostic radiology residency program
  • Alternate pathway candidates do not have to wait 12 months after completion of their plan to be eligible for the Certifying Exam.
  • The ABR office must receive the Final Verification Form (FVF) signed by the department chair, attesting completion of your four-year consecutive plan, including:
    • four months of nuclear medicine and/or nuclear medicine training, and
    • the diagnostic radiology curriculum requirements for radionuclide therapy for high and low dose sodium iodide 131I administrations.

More Information

Board Eligibility

Please see the Board Eligibility page for more details.


A fee schedule for the IMG alternate pathway can be found here.  


Diagnostic Radiology IMG Application Form
Diagnostic Radiology IMG Sponsoring Department Agreement


  • Candidates seeking ABR diagnostic radiology certification through the alternate pathway may be able to obtain Authorized User (AU) eligibility through the IMG pathway. If you desire AU eligibility, complete the process outlined on the Nuclear Regulatory Commission (NRC) section of this website.
  • If applicable, you must submit a plan to meet the Mammography Quality Standards Act (MQSA) Breast Imaging requirements.


Continuation of the IMG Alternate Pathway
Despite any changes implemented by other organizations, the American Board of Radiology has no plans at this time to discontinue its IMG Alternate Pathway to Certification Program. The program will continue to be available to individuals who meet the requirements outlined above.
ACGME Rule Changes
The ACGME rule changes, implemented on July 1, 2016, apply only to criteria for entrance into an ACGME-accredited residency or fellowship, and not to the ABR Alternate Pathway Program. The Alternate Pathway may be completed with four years as a resident; as a fellow (in an ACGME-accredited or a non-accredited fellowship); as a faculty member; or as any combination of residency, fellowship, or faculty service in a single institution with an ACGME- or RCPSC (Canadian)-accredited residency program. Research may be credited for a maximum of 12 months if it is part of a pre-approved four-year plan.

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