Qualifying Exam for Initial Certification

Study Guide for Medical Physics for Radiation Oncology

Last verified on August 31, 2022
Download this study guide in printable .pdf format.
This exam tests your knowledge of the principles of radiation physics underlying the practice of radiation oncology. Included are questions on the general domains listed below. Exam performance will be reported to you based on an overall pass/fail grade, with specific information provided regarding quintile performance in the seven individual domains. Because of the nature of scientific knowledge and subcategories, there may be some overlap of items across domains. Each exam will include items from every domain, but individual subtopics may not be included in every exam and the number of items per domain depends on the domain.
I. Basic physics 11% to 13%
II. Radiation measurements 9% to 11%
III. Treatment planning 19% to 21%
IV. Imaging modalities and applications in radiotherapy 16% to 18%
V. Brachytherapy 12% to 14%
VI. Advanced treatment planning and special procedures 15% to 17%
VII. Safety, QA, and radiation protection 11% to 13%
The ranges above are those generally in effect for the exam to be administered in 2023 and are intended only for guidance in candidate preparation. They do not necessarily represent a precise number of scorable items.

I. Basic physics
  1. Fundamental Physics
  2. Atomic and Nuclear Structure
  3. Production of Kilovoltage X-ray beams
  4. Production of Megavoltage X-ray beams
  5. Radiation Interactions
II. Radiation measurements
  1. Radiation Quantities and Units
  2. Radiation Measurement and Calibration
III. Treatment planning
  1. Photon Beam Characteristics and Dosimetry
  2. Electron Beam Characteristics and Dosimetry
  3. Prescribing, Reporting, and Evaluating Radiotherapy Treatment Plans
  4. Intensity Modulated Radiation Therapy (IMRT)
IV. Imaging modalities and applications in radiotherapy
  1. Imaging Fundamentals
  2. Simulation, Motion Management, Image Guidance, and Treatment Verification
V. Brachytherapy
VI. Advanced treatment planning & special procedures
  1. Special Procedures (e.g., TBI, TSET, IORT, Radiopharmaceutical treatment)
  2. Particle Therapy
  3. Stereotactic Radiosurgery/Stereotactic Body Radiation Therapy
 VII. Safety, QA, and radiation protection
  1. Quality Assurance
  2. Radiation Protection and Shielding
  3. Safety and Incidents
References: References are intended as resources for exam takers and will form the sources for the majority of individual items in the exam. In listing multiple texts, the ABR does not imply or intend that candidates should be fluent in all aspects of every source. Many texts include topics not relevant to radiation oncology, and others include significant duplicative material. Individual items may be sourced from references not cited in this study guide. Primary references are intended to be the source of the majority of exam items. Secondary references are individual smaller categories of items. Additional references may be the source of individual, selected items. In selection of topics for primary consideration, candidates are encouraged to consider details of this study guide and the ASTRO-AAPM curriculum.
Primary References:
  • Ford, E.  Primer on Radiation Oncology Physics: Video Tutorials with Textbook and Problems. Boca Raton, FL: CRC Press; 2020
  • Hendee WR, Ibbott GS, and Hendee EG. Radiation Therapy Physics. Hoboken, NJ: Wiley-Liss; 2005
  • Khan FM and Gibbons JP. The Physics of Radiation Therapy. Philadelphia, Pa: Lippincott Williams & Wilkins; 2014
  • McDermott, P and Orton, C. The Physics and Technology of Radiation Therapy. Madison, WI: Medical Physics Publishing; 2010
  • Podgorsak EB. Radiation Oncology Physics: A Handbook for Teachers and Students. Vienna, Austria: International Atomic Energy Agency; 2005
Secondary References:
  • Dieterich S, Ford E, Pavord D, and Zeng J. Practical Radiation Oncology Physics Philadelphia, PA: Elsevier; 2015
  • Metcalfe P, Kron T, and Hoban P. Physics of Radiotherapy X-Rays and Electrons. 2nd edition. WI: Medical Physics Publishing; 2007
  • Van Dyk J. The Modern Technology of Radiation Oncology. Volume 1. Medical Physics Publishing; 1999
  • Van Dyk J. The Modern Technology of Radiation Oncology. Volume 2. Medical Physics Publishing; 2005
  • Van Dyk J. The Modern Technology of Radiation Oncology. Volume 3. Medical Physics Publishing; 2013
Additional References:
  • Nath, R. , Anderson, L. L., Luxton, G. , Weaver, K. A., Williamson, J. F. and Meigooni, A. S. (1995), Dosimetry of interstitial brachytherapy sources: Recommendations of the AAPM Radiation Therapy Committee Task Group No. 43. Med. Phys., 22: 209-234. doi:10.1118/1.597458
  • Almond, P. R., Biggs, P. J., Coursey, B. M., Hanson, W. F., Huq, M. S., Nath, R. and Rogers, D. W. (1999), AAPM’s TG‐51 protocol for clinical reference dosimetry of high‐energy photon and electron beams. Med. Phys., 26: 1847-1870. doi:10.1118/1.598691
  • Huq, M. S., Fraass, B. A., Dunscombe, P. B., Gibbons, J. P., Ibbott, G. S., Mundt, A. J., Mutic, S. , Palta, J. R., Rath, F. , Thomadsen, B. R., Williamson, J. F. and Yorke, E. D. (2016), The report of Task Group 100 of the AAPM: Application of risk analysis methods to radiation therapy quality management. Med. Phys., 43: 4209-4262. doi:10.1118/1.4947547
  • Benedict, S. H., Yenice, K. M., Followill, D. , Galvin, J. M., Hinson, W. , Kavanagh, B. , Keall, P. , Lovelock, M. , Meeks, S. , Papiez, L. , Purdie, T. , Sadagopan, R. , Schell, M. C., Salter, B. , Schlesinger, D. J., Shiu, A. S., Solberg, T. , Song, D. Y., Stieber, V. , Timmerman, R. , Tomé, W. A., Verellen, D. , Wang, L. and Yin, F. (2010), Stereotactic body radiation therapy: The report of AAPM Task Group 101. Med. Phys., 37: 4078-4101. doi:10.1118/1.3438081
  • Klein, E. E., Hanley, J. , Bayouth, J. , Yin, F. , Simon, W. , Dresser, S. , Serago, C. , Aguirre, F. , Ma, L. , Arjomandy, B. , Liu, C. , Sandin, C. and Holmes, T. (2009), Task Group 142 report: Quality assurance of medical acceleratorsa). Med. Phys., 36: 4197-4212. doi:10.1118/1.3190392
  • United States Code of Federal Regulations, Title 10, Chapter 1 – Nuclear Regulatory Commission, Part 20 – Standards for Protection Against Radiation. https://www.nrc.gov/reading-rm/doc-collections/cfr/part020/
  • United States Code of Federal Regulations, Title 10, Chapter 1 – Nuclear Regulatory Commission, Part 35 – Medical Use of Byproduct Material. https://www.nrc.gov/reading-rm/doc-collections/cfr/part035/