Initial Certification for Radiation Oncology

International Medical Graduates Alternate Pathway

Last verified on October 3, 2019
An international medical graduate (IMG) is defined as an individual trained in radiation oncology programs outside the U.S., its territories, or Canada.


To be considered a candidate for certification by the American Board of Radiology, an applicant must demonstrate the following:
  • Satisfy the radiation oncology training requirements of a non-U.S., non-Canadian country
  • Have documentation verifying the applicant’s ability to practice radiation oncology independently in the country of training or board certification (if applicable)
  • Complete a clinical year of non-radiation oncology training in general medicine, surgery, transitional internship, or its equivalent.
  • Complete at least three years of radiation oncology training in a residency program outside the U.S. or Canada.
  • If trained in India, the applicant must have the following degrees to be eligible for the Alternate Pathway: M.B.B.S. + D.N.B. and/or M.D.
The Board will assess the applicant’s status relative to ABR policies and the IMG Alternate Pathways to Board Certification only after receiving the following documents:
  • Current, detailed curriculum vitae with specific dates of all training
  • Verification of the following:
    • Medical school training
    • One year of clinical non-radiation oncology training in general medicine, surgery, transitional internship, or its equivalent. One year of credit for clinical training may be received.
    • Three years of radiation oncology training in a residency program outside the U.S. or Canada
    • Radiation oncology certification (if applicable)
    • Four consecutive years of radiation oncology residency training, fellowship, and/or full-time faculty appointment in one institution with a radiation oncology training program approved by the Accreditation Council for Graduate Medical Education (ACGME) or Royal College of Physicians and Surgeons of Canada (RCPSC). (See Sponsoring Department Agreement below.)
    • Up to three years of radiation oncology residency may count. However, four years of radiation oncology does not qualify for the ABR Alternate Pathway, as that is the standard training pathway.
    • 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, including the applicant’s four-year plan.
    • Credit for research training of up to 12 months will be granted toward radiation oncology certification if the research is completed at the same institution as the remaining clinical training.
    • In addition to the four-year plan, applicants must also submit a letter of commitment for four years of continuous service signed by the host department chair. This letter of commitment may include a statement of condition for termination for cause, although availability of funds should not fall into this category.
    • The applicant’s department chair must complete and submit annual verification forms.
    • 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.
    • Copies of United States Medical Licensing Exam (USMLE) Steps 1 and 2 score reports are required
    • 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 when certification is conferred.
    • Eligibility to sit for the physics and cancer and radiation biology computer-based qualifying exams will begin following 36 months of he approved program.
    All documentation should be mailed to:
    American Board of Radiology
    5441 East Williams Circle
    Tucson, AZ 85711-7412
    or faxed to:
    (520) 790-3200
    Attn: IMG Alternate Pathway


    1. Eligibility to sit for the initial certification qualifying (computer-based) exams in physics, and cancer and radiation biology will begin after completion of 36 months of the approved 4-year program.
    2. Eligibility to sit for the clinical qualifying examination will begin following passing both of the basic science exams and 4 full years of the approved program.
    3. Eligibility to take the certifying (oral) exam will not begin until all three qualifying exams have been successfully passed. See policy.

    More Information

    Recognition of Successful Candidates

    Successful candidates are awarded a continuous ABR specialty certificate in radiation oncology.

    Board Eligibility

    See Board Eligibility Policy for details.


    Radiation Oncology IMG Application Form
    Radiation Oncology IMG Sponsoring Department Agreement

    Annual Program Fees

    Four-Year Plan Appointment Fee
    Administration Fee* $765
    Annual Fee $1165
    *Administration fee is a one-time, nonrefundable fee due at the time of submission of documents for approval to the IMG Alternate Pathway for Initial Certification. Applicants will be sent their annual invoice in July of each year as long as they are in the certification process. The fee amount is subject to adjustment by the ABR each year. All fees are nonrefundable.