Initial Certification for Interventional Radiology

International Medical Graduates Alternate Pathway

Last verified on November 18, 2022
An international medical graduate (IMG) is defined as an individual trained in an interventional radiology program outside the U.S., its territories, or Canada.

Prerequisites and Requirements


To be considered a candidate for certification by the American Board of Radiology, an applicant must demonstrate the following:
  • Satisfy the training requirements of a non-U.S., non-Canadian country.
  • Have documentation verifying the applicant’s ability to practice interventional radiology independently in the country of training or board certification in the applicant’s country (if applicable).
  • Complete one year of clinical training.
  • Complete a DR residency program with IR training outside the U.S. or Canada.
  • If trained in India, the applicant must have the following degrees to be eligible for the Alternate Pathway: MBBS + DNB and/or MD.


  • Complete five years of IR residency training, fellowship, and/or full-time faculty appointment in one institution with an IR training program accredited by the Accreditation Council for Graduate Medical Education (ACGME).
    • Five years of training must be at one institution and completed within 10 years from training start date.
    • Up to four years of IR residency may count. However, five years of IR residency does not qualify for the ABR Alternate Pathway, as that is the standard training pathway.
    • For candidates seeking Board Eligibility prior to January 1, 2024, the five-year experience must include four months (i.e., sixteen 40-hour weeks) of clinical nuclear radiology training. These four months of nuclear radiology training should be the same as those completed by an interventional radiology resident at the sponsoring institution.
      • One-week increments of training at 40 hours a week is the minimum acceptable training increment permitted.
      • All nuclear radiology training must be clinical training; research is not acceptable.
      • Training at an affiliated institution is acceptable.
      • Nuclear radiology and/or PET/CT studies interpreted or reviewed during a fellowship or multidisciplinary conference as a part of clinical assignments in rotations not dedicated to nuclear radiology cannot be used to satisfy this requirement.
      • Candidates must meet the interventional radiology residency curriculum requirements for nuclear radiology therapy of 131I administrations. Under preceptor supervision, candidates must perform 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.
  • Pass the ABR Qualifying (Core) Exam: click here for more information.
  • Pass the ABR IR/DR Certifying Exam: click here for more information.
  • Provide proof of valid state or provincial medical license: for those in training, a valid training license is acceptable.
  • Demonstrate high moral and ethical principles. The American Board of Radiology expects candidates for initial certification to uphold fundamental moral and ethical principles.


The Board will assess an applicant’s status relative to ABR policies and the IMG Alternate Pathway to Board Certification only after receiving the following documents:
    • Interventional Radiology/Diagnostic Radiology IMG Application Form
    • Current, detailed curriculum vitae with specific dates of all training
    • Verification of the following:
      • Medical school training
      • Clinical training
      • Radiology residency training
      • Interventional radiology certification (if applicable)
      • NOTE: The Board accepts copies of diplomas or letters from training institutions as verification. If original documents are not in English, an English translation must accompany them.
    • Candidates will be notified when to submit the application fee
    • Copy of Educational Commission for Foreign Medical Graduates (ECFMG) certificate or Licentiate of the Medical Council of Canada (LMCC) certificate
    • Sponsoring Department Agreement (SDA), outlining the applicant’s five-year plan
      • The SDA is intended to be a prospective five-year training plan. Candidates may only use up to two years of retrospective training as part of their SDA.
      • Credit for research training of up to 12 months will be granted toward IR/DR certification if the research is completed at the same institution as the remaining clinical training.
      • Any changes in the above requirements carried out without the written consent of the ABR will be considered as grounds for termination of the individual’s participation in the Alternate Pathway.
      • NOTE: The required five years of full-time, continuous training or continuous faculty experience must be completed in one ACGME-accredited program. At least two of the five years must be focused in IR.
    • Copies of United States Medical Licensing Exam (USMLE)
      • Steps 1 and 2 score reports
      • A passing score on 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.


Qualifying (Core) Exam

After an applicant’s application has been approved, and they have completed 36 months of approved training, the applicant may take the Qualifying (Core) Exam.

Certifying Exam

IMG alternate pathway candidates will be eligible for the IR/DR Certifying Exam after they comply with the following:
  • Successfully pass the Qualifying (Core) Exam
  • Complete the five-year plan in one ACGME-accredited interventional radiology residency program
  • The ABR office must receive the Final Verification Form (FVF) signed by the department chair, attesting completion of the applicant’s five-year plan.

Recognition of Successful Candidates

Successful candidates are awarded a continuous ABR specialty certificate in interventional radiology/diagnostic radiology (IR/DR).

More Information

Board Eligibility

Please see the Board Eligibility Policy for more details.


A fee schedule for the IMG Alternate Pathway can be found here.