Studying for the IR/DR Certifying Exam

ABR exams are developed by volunteers from a wide range of practice settings and reflect the breadth of information a candidate is expected to know by the time of an exam. While we offer study guides on our website, each candidate should decide what type of resources to use for our exams. Candidates who use test preparation materials developed by other organizations or commercial entities should not expect an ABR exam to completely align with these materials regarding the scope or item types on ABR exams. To understand how exam questions are written and learn more about different types of exam questions, please see the ABR Item Writers’ Guide. For a look at the extensive QA process that each question goes through, please see the Illustrated Life Cycle of an ABR Exam Item. For information about the remote exam delivery format and what to expect on exam day, please see the IR/DR Remote Certifying Exam Guides.  

Computerized Portion Study Guides

Candidates who do not have ABR certification in diagnostic radiology will take the computerized portion of the exam, which has two required models: Essentials of Diagnostic Radiology and Interventional Radiology. Study guides for the two required modules can be found at these links: Essentials of Diagnostic Radiology Study Guide Vascular/Interventional Radiology Study Guide The Essentials of Diagnostic Radiology module will contain Noninterpretive Skills (NIS) content. The Noninterpretive Skills Study Guide provides detailed content that examinees are expected to know to answer the NIS questions. All material that will be included in the NIS module is included in the syllabus. If changes are made to this exam module, the syllabus will be updated accordingly. IMPORTANT NOTE FOR THE 2025 STUDY GUIDE: A change was recently made on page 35 of the NIS Study Guide from “5 gauss line” to “9 gauss line” to bring the guide up to date with current standards. The following is an explanation of why the change was made. However, please note that this information will not be tested on the 2025 exam, while radiology practices are adjusting to this new standard. The 5 gauss line historically demarcated the threshold of safety for implantable cardiac devices. However, cardiac implantable device manufacturers have been required to demonstrate that their devices are immune to static magnetic fields up to 10 gauss. Thus, the 5 gauss line provided a substantial safety margin. The International Electrotechnical Commission (IEC) recently revised the safety margin to the less stringent 9 gauss line, which allows for 1 gauss tolerance for variability in the device testing methods. This change is recognized by the FDA and endorsed by the ACR MR Safety Committee. Because the 9 gauss line is within the 5 gauss line (closer to the magnet), sites that have been following previous recommendations are already compliant with the new recommendations. The second portion of the Radioisotope Safety Content (RISC) is also integrated into the computerized portion of the exam. For studying, please refer to the RISC Domain Document and RISC Study Guide.  

Oral Portion Study Guide

All candidates for the IR/DR certification, including those who are already certified in diagnostic radiology, will take the oral portion of the IR/DR certifying exam. The following is a study guide for the oral portion of the exam.

1. Exam content: general description

Individual cases may emphasize one area of competency more than the others. At all times, competencies in image-guided procedure, periprocedural patient management, and image interpretation will be assessed by the candidate’s examiner.

• The exam structure is organized into four categories:
  • Arterial diagnosis and intervention
  • Venous and lymphatic diagnosis and intervention
  • Oncology, biliary, and genitourinary diagnosis and intervention
  • Core interventional radiology

• Each section will incorporate both diagnostic imaging related to IR and IR interventions.

• Imaging diagnosis may include CT, CTA, MR, MRA, ultrasound, vascular ultrasound, nuclear medicine, SPECT/PET, angiography/venography/lymphangiography, and plain films. Images may be pre-procedure diagnostic studies, intraprocedural imaging, or follow-up imaging.

• Interventional cases will emphasize periprocedural management and procedures, as well as procedure-related image interpretation.

• Periprocedural management includes pre-procedure or disease-related work-up, consultation, patient selection, imaging, and medical management; and post-procedure medical management, imaging, follow-up, identification and management of complications or inadequate outcomes, and disease-specific management.

• Discussions will include indications and contraindications for procedures, procedural planning, procedural techniques, device selection and utilization, intra-procedural patient management, procedural endpoints, identification and management of intra-procedural complications, and knowledge of expected outcomes.

• The exam has been designed to reflect actual clinical practice.

• The exam is assembled by a 10-member committee and constructed to cover a broad spectrum of IR practice. This format allows updating and revision of the exam content over time. Examples of content for each area are as follows (note that this is not a comprehensive or complete listing):
  • Arterial diagnosis and interventions
    • Peripheral vascular disease, aorta/great vessels, nontumor arterial interventions (e.g., gastrointestinal bleeding), pulmonary and bronchial interventions, interpretation of noninvasive vascular studies (CTA, MRA, vascular ultrasound), vascular malformations
  • Venous and lymphatic diagnosis and interventions
    • Venous thrombolysis/thrombectomy/ablation, venous stenting, venous access, pelvic venous disease, portal hypertension, dialysis access interventions, varicose vein treatment, venous sampling
  • Oncology and biliary/GU interventions
    • Arterially directed therapies for malignancy (TAE, TACE, TARE), ablation, and biliary, gallbladder, and genitourinary interventions
  • Core IR
    • Percutaneous biopsy, fluid drainage, percutaneous enteral access, foreign body removal, management of malignant effusions/ascites, pancreas, pain management, intraprocedural crises, radiation safety

• Pediatric and quality of care/patient safety content is incorporated into the exam. For example, abscess drainage, and renal artery angioplasty in children, may be included in the Core and Arterial sections respectively.

2. Appendix: Topics included in the exam
   This is a general outline and is not all-inclusive.
   • CT and CTA
   • MRI and MRA
   • Noninvasive vascular lab
   • Vascular ultrasonography
   • Venous color flow imaging
   • Arterial color flow imaging
   • Doppler
   • Ankle: brachial indices
   • Segmental limb pressures
   • Pulse volume recordings (PVRs)
   • Arteriography (all)
   • Thoracic aorta and brachiocephalic arteries, including carotids
   • Upper extremity arteries
   • Lower extremity arteries
   • Abdominal and pelvic arteries
   • Collateral pathways
   • Hemodynamics
   • Venography and venous sampling
   • Head and neck
   • Upper extremity veins
   • Lower extremity veins
   • Pelvic veins
   • Portal and mesenteric veins
   • Superior vena cava
   • Inferior vena cava
   • Collateral pathways
   • Hemodynamics
   • Pulmonary angiography
   • Pulmonary arteries
   • Pulmonary veins
   • Hemodynamics
   • Dialysis access evaluations
   • Dialysis access intervention
   • Lymphangiography
   • Venous access (all: tunneled, nontunneled, ports)
   • IVC filter placement and retrieval
   • Foreign body retrieval
   • Venous ablation (varicose veins)
   • TIPS and TIPS evaluation/revision
   • Venous Angioplasty/stents/covered stents, venous (all)
   • Arterial angioplasty/stents/atherectomy/covered stents
   • Thrombolytic therapy, thrombectomy: arterial and venous
   • Aortic endografting (thoracic and/or abdominal)
   • Embolization, emergency (trauma, GI bleed, bronchial bleed, pseudoaneurysm, other)
   • Embolization, including elective, arterial, and venous
   • Chemoembolization (TACE/DEB TACE)
   • Radioembolization
   • Tumor ablation
   • Transcatheter infusion therapy (e.g., vasopressin)
   • Biopsy
   • All organs
   • Abscess drainage
   • Body cavity
   • Organ
   • Tube management
   • Paracentesis, thoracentesis
   • Chest tube placement
   • Tunneled catheter drainage of refractory pleural effusion or ascites
   • Biliary intervention
   • PTC
   • Biliary drainage
   • Biliary stents
   • Biliary biopsy
   • Percutaneous management of retained  bile duct stones
   • Cholecystostomy
   • Urinary intervention
   • Nephrostomy
   • Nephroureterostomy
   • Nephrostolithotomy tract establishment and dilatation
   • Suprapubic cystostomy
   • Percutaneous enteral access
   • Gastrostomy/gastrojejunostomy
   • Jejunostomy
   • Cyst and lymphocele management
   • Gastrointestinal stents
   • Transplant interventions, miscellaneous
   • Pain management
   • Vertebroplasty
   • Fallopian tube recanalization
   • Hospital inpatient care
   • Follow-up post intervention
   • Quality & safety activities
   • Radiation safety
   • Life support principles
   • Principles of image quality
   • Contrast material
   • Conscious sedation
    
   3. Oral Exam Reenactment Video
   An oral exam reenactment has been created to provide guidance to candidates as to how cases are presented and scored. You can view the video here.