Qualifying Exam for Initial Certification

Study Guide for Clinical (General and Radiation Oncology)

Last verified on November 14, 2024
Download this study guide in printable .pdf format
This exam is designed to assess your understanding of the entire field of oncology and radiation oncology. Included are questions on the following topics related to cancer and cancer therapies of every type, as well as appropriate benign entities:
  1. Epidemiology and pathology
  2. Normal and pathologic anatomy
  3. Elements of cancer diagnosis, staging, treatment (including the utilization of modalities other than radiation), and follow-up
  4. Tumor markers for diagnosis and follow-up
  5. Natural history and routes of local, regional, and distant spread
  6. Selection of treatment modality (specific details of multimodality therapies including sequencing, interactions, and specific agents)
  7. Management of both local and metastatic disease
  8. Optimum radiation simulation, field design, and radiation techniques (including external beam, radiosurgery, brachytherapy employing HDR and LDR sources, and unsealed radioactive agents) for various clinical situations
  9. Tumor localization and respiratory management
  10. Radiation target and organs at risk dose distribution
  11. Selection of optimum radiation volume, dose, and fractionation
  12. Radiation dose constraints
  13. Interpreting a dose-volume histogram
  14. Understanding of how radiation affects normal tissues
  15. Side effects of radiation and other modalities, and how to manage them
  16. Evidence-based treatment results (e.g., with surgery, radiation therapy, chemotherapy, biological therapy, or other emerging interventions)
  17. Patterns of failure
  18. Palliative care
  19. Precision and errors in treatment planning
  20. Quality assurance
  21. Patient and personnel safety
  22. Bioethics
  23. Biostatistics
Categories for General and Radiation Oncology
May include, but are not necessarily limited to:
Benign Diseases 2% to 5%
Breast 9% to 15%
Central Nervous System 5% to 11%
Gastrointestinal 9% to 15%
Genitourinary 9% to 15%
Gynecological 7% to 13%
Head and Neck 7% to 13%
Hematologic 5% to 11%
Lung and Mediastinum 9% to 15%
Non-Clinical Skills (NCS) 1% to 6%
Pediatric 4% to 10%
Sarcoma 2% to 8%
Skin Histologies 7% to 13%
The ranges above are those generally in effect for the exam to be administered in 2025 and are intended only for guidance in candidate preparation. They do not necessarily represent a precise number of scorable items.

Benign Diseases
  1. Keloid
  2. Heterotopic Bone
  3. Dupuytrens/Ledderhose disease
  4. Osteoarthritis
  5. Graves Ophthalmopathy
  6. Other
Breast
  1. Early-stage
  2. Locally advanced
  3. Inflammatory
  4. Carcinoma in situ
  5. Locally recurrent
  6. Metastatic carcinoma
Central Nervous System
  1. Astrocytoma, low grade
  2. Astrocytoma, high grade
  3. Medulloblastoma
  4. Brainstem glioma
  5. Ependymoma and ependymoblastoma
  6. Pineal
  7. Lymphoma
  8. Optic tract glioma
  9. Oligodendroglioma
  10. Meningioma (benign and malignant)
  11. Pituitary
  12. Spinal cord
  13. Craniopharyngioma
  14. Arteriovenous malformation (AVM)
  15. Acoustic neuroma
Gastrointestinal
  1. Esophagus
  2. Stomach
  3. Small bowel
  4. Colon/rectum
  5. Anus
  6. Pancreas
  7. Biliary tract
  8. Liver
Genitourinary
  1. Prostate
  2. Bladder
  3. Testes
  4. Kidneys
  5. Ureter
  6. Urethra
  7. Penis
Gynecological
  1. Cervix
  2. Endometrium/uterus
  3. Ovaries and fallopian tubes
  4. Vagina/urethra
  5. Vulva
Head and Neck
  1. Orbits/eye
  2. Oral cavity
  3. Lips
  4. Nasal ala
  5. Nasal cavity
  6. Nasopharynx
  7. Paranasal sinuses
  8. Oropharynx
  9. Hypopharynx
  10. Larynx
  11. Salivary glands (major and minor)
  12. Thyroid gland
Hematologic
  1. Hodgkin lymphoma
  2. Non-Hodgkin lymphoma
  3. Leukemia, chronic and acute
  4. Multiple myeloma/plasmacytoma
  5. NK/T cell lymphoma
  6. Cutaneous lymphomas
Lung and Mediastinum
  1. Non-small cell
  2. Small cell
  3. Superior sulcus tumor
  4. Thymomas, thymic, and/or other mediastinal tumors
  5. Mesothelial/pleural tumors
Non-Clinical Skills A link to a detailed non-clinical skills syllabus has been provided for preparation of topics in this category: Non-Clinical Skills (NCS) Syllabus

Bioethics

  1. Consent in the impaired patient
  2. HIPAA issues
  3. Research issues
  4. General consideration

  Patient and personnel radiation safety and source handling

  1. Human factors related to error
  2. Communication of error
  3. Frequency/necessity of repeat calculations
  4. General considerations

Biostatistics

  1. Pvalue and significance
  2. Risk ratio
  3. True positive/negative
  4. Meta-analysis
  5. General considerations

Quality assurance (QA)

  1. Routine vs exceptional QA
  2. QA after linac service
  3. Value of peer review
  4. Root cause analysis
  5. General considerations
Pediatric
  1. Retinoblastoma
  2. Wilms tumor
  3. Neuroblastoma
  4. Rhabdomyosarcoma
  5. Lymphomas
  6. Leukemias
  7. Histocytosis X
  8. Ewing sarcoma and other bone and cartilage tumors
  9. Pediatric solid tumors
  10. Soft-tissue sarcoma
  11. Germ cell tumor
  12. Hepatic tumor
  13. Osteosarcoma
  14. Hodgkin lymphoma
  15. Medulloblastoma
  16. Astrocytoma (glioma), low grade
  17. Astrocytoma, high grade
  18. Brain stem glioma
  19. Ependymoma
  20. Pineal/germ cell
  21. Craniopharyngioma
  22. Optic tract
Sarcoma
  1. Soft tissue sarcomas
  2. Ewing sarcoma
  3. Desmoid tumor
  4. Osteosarcoma and/or chondrosarcoma
  5. Other benign and malignant bone and joint tumors
Skin Histologies
  1. Basal
  2. Squamous
  3. Melanoma
  4. Merkel