One year ago today, I was waiting anxiously to take my oral exam to become board certified by the American Board of Radiology in radiation therapy physics. By the end of my exam, I was already making plans to return to Louisville, KY to retake them next year. Somehow, against all odds, I passed. It was one of the most grueling experiences of my life. There’s nothing quite so soul crushing as devoting your life to a field of study and then being shown in excruciating detail how little you actually know about it. So I salute those that are going through it now, as this year’s exams begin.
The oral exam consists of 25 questions on five topics: radiation protection and patient safety, patient-related measurements, image acquisition and processing, calibration and quality assurance, and equipment. There are five examiners; each one asks one question from each topic. The exam takes place in a hotel. Each examiner is in a different room, and you go room to room to meet with each one in turn. You have 30 minutes with each examiner before you have to move on to the next one.
Having never been an examiner, I don’t know for sure, but the common wisdom on the oral exam is that the ABR is not looking to see how much you know. Instead, they want to see that it is safe to let you work clinically. “I don’t know” is therefore a good answer. (Although, on my exam, in my anxiousness I forgot the necessary addition “But here is where I would look to find out.” This omission got me berated, and justifiably so, by one of the examiners.) The examiners want to see that you know your limitations and will seek help (and know where to seek it) rather than treat patients in an unsafe manner. Of course, they expect to see that you have enough knowledge to indicate that you have some clinical experience. At least two years of clinical experience is needed to sit for the exam, but the ABR has no way of knowing how much you have actually learned in that time.
So to those about to take the exam, I wish you good luck. It will seem like you are doing much worse than you actually are. Don’t let yourself get rattled. Remember, part of the test is to see how well you perform under pressure, and the examiners will do everything they can to press you. To test the limits of your knowledge, they will continue to ask questions on a topic until you don’t know the answer. Don’t pretend to know more than you actually do. Just keep in mind that in the exam, just as in the clinic, the point is to make decisions that promote the safety of the patient. Just keep the patient as the first priority, and you will do fine. Remember, you don’t have to be the best examinee, only in the top 50%.
I would also like to thank the examiners. They have an enormous responsibility. They have to choose between perhaps letting an unqualified physicist treat patients or maybe unnecessarily crippling someone’s career. I can’t imagine how hard it must be to make such a judgment in only 30 minutes. These volunteers truly have a thankless job. (There is no truth to the rumor that I’m saying this because of a fear that someday I’ll get a call from the ABR saying that a mistake has been made and I’ll need to retake the exam.)
