The dreaded ABR Part 1 Exam

Now that I’ve taken the exam, I have found that it’s one of the last things I want to immortalize through repeated Q&A sessions with my fellow grad students. Still… wouldn’t it be great if I could actually immortalize my thoughts on this exam once and for all?

There comes a time in every young medical physicist’s life when they learn about the ABR exams. A three-part series of exams- the first of which is designed to test if a physicist is at least one-thirds-fully-capable of making sure patients aren’t getting unwarranted radiation carcinogenesis from a CT/LINAC/FDG procedure. For me, this was a moment of shock, since it involved the realization that I would be required to fork over $890 (USD, 2022).

How to Study

Studying techniques will vary widely from person to person, so I will explain how I studied for the exam with the disclaimer that, while this is the particular method that worked for me, it may not be the best for everyone.

Timing

Start early, especially if it has been a while since you’ve taken your core medical physics classes. I started studying about five months out, however the first two months of studying were mostly casual review of course materials. I got progressively more serious about studying the closer I got to the exam, and by the time the exam was a month out, studying was basically my entire personality.

• 3 months out: I was studying an hour or two every other night on average. Mostly reviewing or self-teaching new material
• 2 months out: I added flash cards into the mix. I was doing practice exams and putting concepts I missed onto flash cards. I spent about 15 mins - 1 hour a day reviewing flash cards.
• 1 month out: Full length exams several times a week. Put concepts I missed onto flash cards.
• 2 weeks out: Full length exams every day
• I started relaxing a couple days out from the exam because I didn’t think I’d retain much more so close to the exam. I was focusing on mental health and keeping my anxiety in check.

Flash Cards

I decided early on to rely on flash cards as a main part of my studying regimen, alongside practice tests. I used a combination of virtual flash cards (Quizlet, etc.) and physical flash cards. I like to have physical flash cards handy because, when I’m on the go, they’re less distracting to pull out than my phone. For spaced repetition, I created separate piles for cards I had mastered and cards that I needed to drill again.
I have heard good things about anki flash cards, but I never got around to learning how to configure them. One of the features of anki is that you can format equations using LaTeX, which is useful for stuff like Bateman equations or interaction cross sections.

Here’s a link to a digitized version of my ABR flashcards: Quizlet for ABR Part 1

Practice Exams

There are many (paid) resources available online that provide practice exams. This was one of my overarching frustrations with the ABR exam in general- that it felt like it was pay to win. Some of these websites were asking for over a thousand dollars for a membership, which was pretty appalling for a broke grad student. I have heard the argument that these types of resources are an investment towards a well-paying career in medical physics, however, as someone who believes information should be freely available, I can’t get on board with that. With that said, I went with the cheapest option, which was OncologyMedicalPhysics. I also had access to ABRphysicshelp through a classmate. Comparing the two websites, ABRphysicshelp was good, but some of the problems were much more complex than necessary. OMP offered a large test bank of questions that were less problem solving and more knowledge-based.

The Raphex exams were a wonderful resource for brushing up on multiple-choice questions. I was lucky enough to find a stack of old Raphex exams in my lab room. Ask around and you might know someone who has digital copies! Keep in mind that these practice exams were written with radiology residents preparing for their Core exams in mind. I found the general physics portions that were at the beginning of both the diagnostic and therapeutic versions to be very useful in making sure I had my basics down to pat. I also completed several diagnostic exams in their entirety, but thought that a lot of the therapy questions were overkill for the ABR Part 1 exam.

Books

My master’s program at San Diego State University used the following textbooks:

• Hall, E.J. and Giaccia, A. (2011) Radiobiology for the Radiologist. 7th Edition, Lippincott Williams & Wilkins, Philadelphia.
• Cherry, S.R., Sorenson, J.A. and Phelps, M.E. (2012) Physics in Nuclear Medicine. 4th Edition, Elsevier Inc., Philadelphia.
• Bushberg, J.T., Seibert, J.A., Leidholdt, E.M. and Boone, J.M. (2012) The Essential Physics of Medical Imaging. 3rd Edition, Lippincott Williams and Wilkins, Philadelphia.
• Attix, F.H. (1986) Introduction to Radiological Physics and Radiation Dosimetry. J. Wiley and Son, New York.
• Khan, F.M. and Gibbons, J.P. (2014) The Physics of Radiation Therapy. 5th Edition, Lippincott Williams & Wilkins, Philadelphia

When I began studying for the exam, I started with a cumulative review using the textbooks listed above. While I saw virtue in this technique as being more comprehensive and giving me the theoretical knowledge to problem-solve my way through anything that could be thrown at me, I now think spending more time actually solving problems is more valuable than just reading textbooks.

The following are a couple of books that I used religiously for practice problems and concise information:

• Khan, Faiz M. (2012) Khan’s Lectures: Handbook of the Physics of Radiation Therapy. Wolters Kluwer/Lippincott Williams & Wilkins Health, Philadelphia.
• Huda, W., Abrahams, R. B. (2016). Review of Radiologic Physics. Wolters Kluwer.

The ABR Website

Check out the Content Guide on the ABR website. Make sure you are able to answer all the questions at the bottom of that page. Further, seek out questions that are in a similar style to those on the content guide.

Another useful resource on the ABR website is the list of constants and physical values, found here. Have this list available whenever you are doing a practice exam. Study the list itself and make sure you can solve problems based off of the information given on this page. For example, the list contains a table of dose rate constants and TVLs of various nuclides. This would suggest that you are expected to know how to solve a shielding type problem or know how to work with TVL equations.

Videos

I referred to Kurt Van Delinder’s videos series on YouTube to help me figure out how to do some problem types I was really stuck on. Each of his problem solving videos starts off with really basic questions and eventually progresses to more difficult questions. He does a lot of problems from Attix’s book. I also recall him even solving some problems from the ABR Content Guide mentioned above.

Materials

• 8.5” x 11” whiteboard
  • I suggest doing all of your practice problems on the whiteboard so you can get a feel for your space limitations during the exam. This might be a little overboard, but I modded one of the magnets that came with my whiteboard to be an eraser by hot gluing some felt to the surface.
• Ultra fine EXPO markers
  • You might run out of space after writing down 1/16th of an equation if you use the classic chisel-point markers. This is a personal choice, but I like to keep things compact.
• TI-30XS Multiview Calculator
  • It’s either this specific calculator, or the online version that is built into the exam software. I knew I’d be quicker to the draw with the real deal.
• Side-view webcam. I mounted a webcam on a phone tripod that I already had lying around.