Certifying Exam for Initial Certification

Study Guide: Oral Exam

Last verified on August 2, 2023
Download this study guide in printable .pdf format
Each candidate will be examined for 25 to 30 minutes by a different examiner in each of eight different clinical categories.
The subject matter of the oral exam is the clinical management of malignant and benign disease and is usually presented according to the anatomical site of the primary tumor. Display of images may be used in some categories of the exam.
When included in the oral exam, the items indicated below will relate primarily to management of the cases under discussion. Questions in any category may relate to, but are not necessarily limited to, the following areas:
  • Anatomy
  • Epidemiology
  • Pathology
  • Patterns of local, regional and distant involvement
  • Clinical evaluation, including staging and tumor markers
  • Selection and integration of treatment modalities, including surgery, radiation therapy and systemic therapy, as applicable
  • Radiation therapy planning and technique
  • Results of treatments, including patterns of failure and prognostic factors
  • Complications of treatments with emphasis on the effects of radiation therapy on normal tissues, and how they should be managed
  • Tumor staging: based on the most recent edition of the AJCC Staging Manual (Ed. 8, dated 10/2016), unless the examiner indicates otherwise. If your response is based on previous manuscripts and/or studies using older staging systems, please let the examiner know.
  • Significant previously reported clinical trials
The anatomical sites are divided into the following eight categories:
Gastrointestinal — includes malignancies of the following:
  • Esophagus
  • Stomach
  • Small bowel
  • Colon
  • Rectum
  • Anus
  • Pancreas
  • Adrenal gland
  • Liver
  • Gallbladder
  • Bile ducts
Gynecological — includes malignant lesions of the following:
  • Cervix
  • Vagina
  • Uterus
  • Vulva
Genitourinary — includes malignancies of the following:
  • Prostate
  • Kidney
  • Ureter
  • Urethra
  • Bladder
  • Penis
  • Testis
Hematologic and Benign Diseases — includes the following:
  • Hodgkin lymphoma
  • Non-Hodgkin lymphomas
  • Leukemias – acute and chronic
  • Myeloma and plasmacytoma
  • Cutaneous lymphomas
Head, Neck, and Skin — includes malignancies of the following:
  • Oral cavity
  • Paranasal sinuses
  • Salivary glands
  • Nasopharynx
  • Hypopharynx
  • Thyroid
  • Larynx
  • Oropharynx
  • Skin – basal cell, squamous cell, melanoma, Merkel cell, and Kaposi sarcoma
Breast — includes the following:
  • Non-invasive and invasive malignancies of the breast
  • In situ carcinomas of the breast
Pediatric and Central Nervous System — includes benign and malignant diseases of the following:
  • Central nervous system
  • Neoplasms of the pediatric age group
  • Histiocytosis
Lung, Mediastinum, and Sarcoma — includes malignancies of the following:
  • Lung and mediastinum
  • Pleura
  • Soft tissues
  • Bone

American Joint Commission on Cancer (AJCC) Staging

In all instances where questions relate to disease staging of contemporaneous cases or hypothetical situations, the correct staging system will be the most current as published by the AJCC (at this time, Ed. 8, dated 10/2016). In instances where questions refer to previously reported clinical trials, staging will relate to the system in place at the time of the specific report.