ABR Certifying Exam preparation

(updated 2/16/2021)

The ABR Certifying Exam is the second step in board examinations for radiology residents, taken 15 months after completion of radiology residency. In this exam, test takers are allowed to choose areas of concentration that they would like to take their sections in, or clinical practice modules. It is a total of 5 sections, 2 are mandatory: Essentials of Diagnostic Radiology and Non-Interpretive Skills (on the ABR web site these are simply described as one. Radioisotope questions (RISE) are built in. The other three you can choose your area of specialization. You can choose the same area 3 times.

The exam is shorter than the Core exam at only 5 hours (essentially 5 hour long sections), but still can only be taken in Chicago or Tuscon. As on the other exams, it is still not explicitly divided into sections but they do seem to go in order with general first and then your areas that you selected.

Areas that you can choose are called “Clinical Practice Modules”. There are study guides for each option, but don’t expect them to be much more useful than those for the other ABR exams. There is more information about how I recommend you choose your modules below.

I know it’s not saying much, but the certifying exam is probably the most fair of the ABR exams

It may be controversial to say this, and I know it’s not saying much, but the certifying exam is probably the most fair of the ABR exams. I’ve heard few complaints about the topic coverage and the ability to choose your modules makes it more appropriate to your practice.

Scoring is equally mysterious to the other ABR exams. I don’t believe you can condition anything.

Choosing your clinical practice modules

Choosing your modules that you want to take is going to seem like a dilemma, but it’s not. Choose whatever you did your fellowship in!

You get to choose up to 3 topics from the list here: general radiology, breast, cardiac, gastrointestinal, musculoskeletal, neuroradiology, nuclear, pediatric, thoracic, ultrasound, genitourinary, and vascular and interventional radiology.

If you choose a second module in the same topic, it will be slightly harder. Emphasis on the word slight. ABR is calling it advanced, but for the fellowship level, you should be picking your fellowship. Most of the people I’ve heard of having problems with this exam took more than one area because they were afraid of moving into the “advanced” level. I don’t think it’s that big of a deal.

There are only 2 levels of difficulty. That is, the 3rd module just gives you more second level difficulty questions. This is the key! There is no “master” level or anything.

Question Type/Quality

Questions follow the same format as the Core exam. The bread and butter of this exam is the multipart image based question, where an initial question is shown with a series of images. This initial question may be about the findings or the most likely diagnosis.

Subsequent questions may continue to be about that case. Sometimes, it may lock your first answer before allowing you to progress. The follow-up may give you the answer to the first question, or simply throw you off. It’s hard to tell but you should be prepared for minor frustrations.

Image quality has overall been poor. Images are known to be too small, not scrollable when they should be, and often widowed inappropriately.

Further quick tips are found in the introduction to board review videos, such as Intro to Board Review 1.

Web resources

There are number of online question banks which address the radiology certifying exam. I did an inexpensive question bank called Rocktheboards, which is now defunct. It was totally fine and didn’t cost that much, so it was worth it at the time. The cost was fair and the questions were very similar to the exam. In fact, once I finished the exam I had trouble remembering which ones were on the practice exam versus the real exam

Now that this option is gone, I don’t really have a specific recommendation. There are a couple of other options, such as:

It’s not that I don’t recommend these, I just have no experience with them. It’s probably best to ask around before the exam.

Ben White has written a pretty decent explainer of what the exam is like on his website. He also has a description of some of the resources that are available for the Core Exam, which probably also applies here. 



Your probably not going to be reading a lot of books for this exam, as you are either in a 2nd fellowship year or just started a job when taking this exam. I would stick to case based reviews, and use the ones you used when you were a resident. Relevant examples for neuroradiology:

There are others and they are probably equally fine.

I wouldn’t bother getting too much into high level books. Neuroradiology fellows sometimes read books such as Osborn’s Brain while fellows. If you have been doing this while going along, then great, but no time to worry about that now. A full description of these books (as well as others) is found below:

Detailed Book Recommendations

Study Plan

Most people can succeed on this test without too much dedicated study time. I would plan on doing some case based reviews, either though books or one of the online question banks in the 1-2 months prior to the exam. If you choose what you did in your fellowship and got adequate exposure to the range of topics in you area, in this case neuroradiology, then I think you should be ok.

Video reviews can be a useful supplement, including the board review videos on this site or other video series such as UCSF. I haven’t specifically heard of people traveling to review courses for this exam, but if your job will pay for it and give you the time off, it might be worth it.


Video review

UCSF board review DVDs, if you have access to them, are high quality and comprehensive, although the versions circulating can be somewhat dated. They are somewhat basic for a fellow-level trainee, but can be a good review.

From this website, your highest yield is going to be the board review case style videos

It may also be of benefit to review any posts labeled with the Fellow tag.

Overall Advice

The ABR certifying exam is the most straightforward of the ABR radiology exams. Because of the ability to choose your modules, it is likely the most fair and most well suited to your abilities. Be sure to choose wisely though. Because you probably have limited time prior to taking in to prepare, focus on case based reviews and short review videos. 

Good luck and let me know if you have any feedback after taking the exam.

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