IR/DR Cheat Sheet 2026: One-Page Review of Must-Know Facts

The Credential at a Glance

IR/DR here means Interventional Radiology/Diagnostic Radiology, the American Board of Radiology (ABR) credential for physicians who complete integrated or independent interventional radiology training. This page is a compression exercise: the facts you should be able to recite without notes before test day. If you want the broader strategy behind them, pair this sheet with our IR/DR study guide, and for a definitional primer start with what IR/DR certification is.

The credential is not a single sitting. It is a sequence:

1. Qualifying (Core) Exam, the prerequisite gate taken after training progresses.
2. Certifying Exam, computer-based component, which a candidate with an existing DR certification is exempt from.
3. Certifying Exam, oral component, examiner-led and remotely monitored.

Each certifying component is scored as a whole and separately. When both are required, both must be passed.

Three Exams, One Pathway: What Each Stage Tests

Core: breadth across diagnostic radiology

ABR's certification page lists these Core practice topics: Breast imaging; Cardiovascular imaging; Computed tomography; Gastrointestinal imaging; Genitourinary imaging; Interventional radiology; Magnetic resonance imaging; Musculoskeletal radiology; Neuroradiology; Noninterpretive skills; Nuclear radiology; Pediatric radiology; Physics; Radiography/fluoroscopy; Thoracic radiology; Ultrasound; and Radioisotope Safety Content. These are the page's listed topics, not a verified exhaustive weighted blueprint. Individual domain blueprints live in ABR's Qualifying (Core) Exam Domains document, and its within-domain percentages should never be treated as percentages of the Certifying Exam.

Certifying computer-based: modules and IR depth

Preparation for this component centers on the required Essentials of Diagnostic Radiology module plus ABR's computer-based study guide headings (arterial, venous, lymphatic, nonvascular, and patient care). Multiple-choice questions predominate, and ABR also describes image-location and drag-and-drop formats.

Certifying oral: judgment under examiner pressure

The oral component assesses image interpretation, image-guided procedures, and periprocedural management. It tests whether you can think like a practicing interventionalist: recognize the finding, choose the procedure, anticipate the complication, and manage the patient.

Numbers to Memorize: Format and Timing

Test-day rules worth knowing cold

• Closed book, one monitor, and a side-view webcam for the computer-based exam, with live and recorded monitoring.
• A software calculator is supplied; personal calculators are prohibited on both certifying components.
• Previously viewed questions are locked after a break, so decide before you step away rather than planning to revisit.
• No Pearson VUE or PSI testing-center arrangement is established by the current guides; delivery is through ABR remote exam delivery and monitoring.

For how these formats translate into difficulty, see how hard the IR/DR exam is.

Fees and Registration Mechanics

All fees below are in USD and come from ABR's initial certification fee schedule. No member/nonmember split is published, and fees are nonrefundable, though published rescheduling credit rules apply.

A DR-certified candidate skips the computer-based component and its $640 fee, but the application, Core, and oral costs still apply. Our IR/DR certification cost breakdown walks through total-path scenarios, and IR/DR exam dates covers scheduling windows and deadlines.

The 10-Heading Content Map

Here is the first thing to understand about "10 domains": ABR does not publish ten unified, percentage-weighted exam domains for IR/DR. The count of ten is an organizing device that combines the required Essentials module, the five preparation headings in the computer-based study guide, and the four oral-exam categories. No highest-weighted category can be established, and equal-length oral periods do not imply equal percentage weights. For the full walkthrough, see our complete guide to all 10 content areas.

Oral Exam Quick Reference

The oral component is where many candidates feel the most uncertainty, because there is no fixed published count of cases or questions. What is established: four separate examiner-led periods of 30 minutes each, two hours of active assessment, closed book, remote webcam monitoring, and no conditional pass for IR oral.

A repeatable case framework

Because the oral assesses image interpretation, image-guided procedures, and periprocedural management, a consistent verbal structure keeps you from skipping a layer. Rehearse something like this until it is automatic:

1. Describe the findings on the images in a systematic order, naming the key abnormality early.
2. Give a focused differential and say what clinical information would discriminate between entries.
3. State the indication and contraindications for the proposed procedure, including laboratory and anticoagulation considerations.
4. Walk through the technique: access, imaging guidance, device or agent choice, and endpoints.
5. Anticipate complications and say how you would recognize and manage each one.
6. Close with follow-up: periprocedural orders, monitoring, and the plan if the result is inadequate.

Reading the Pass Rate Numbers Correctly

ABR's current certification page reports the following figures, and it is easy to misread them:

• 2026 IR oral, first-time: 88% among 219 examinees.
• 2025 IR oral, first-time: 88% among 190 examinees.
• 2026 Core, first-time resident: 93% among 1,598.

These are different cohorts and different components. They are not an overall credential pass rate, and you cannot multiply or average them into one. A separate IR/DR computer-based certifying pass rate was not found in the retrieved sources, so any figure you see quoted for that component deserves skepticism. Our IR/DR pass rate analysis covers how to interpret first-time versus repeat cohorts.

Passing standard

ABR uses criterion-referenced standards, meaning your result depends on meeting a defined standard rather than on outperforming other candidates. A current numerical IR/DR-specific pass mark is not established by the retrieved sources. The 350 figure on ABR's general scoring page is an illustrative example, not a verified IR/DR cutoff, so do not treat it as your target. See what the IR/DR passing score means for more detail.

Eligibility, the 2029 Transition, and Continuing Certification

Who can sit

• Integrated pathway: a clinical year plus a five-year accredited IR residency.
• Independent pathway: DR residency followed by two years of IR training, potentially one with approved ESIR.
• Passing Core, verified training, medical licensure, and professional standing are required.
• Alternative and IMG pathways have separate published rules.

Certification eligibility lasts six full calendar years after training. That is an eligibility window, not the validity period of the certificate. The details are in our IR/DR requirements guide.

The 2029 change

ABR's IR/DR Certifying Exam Process Update announces a DR Oral plus IR Oral process beginning in 2029 and an end to the current IR/DR computer-based component after 2028. This entry applies to 2026 guidance, so the future structure should not be applied to 2026 candidates. The update's sections dated March 10 and December 12, 2025 should be read together, because the later one changes timing discussed in the earlier announcement.

After you pass

Certification is continuous and subject to ABR Continuing Certification, not a fixed five- or ten-year initial certificate. Requirements per ABR's Stay Certified page:

• Unrestricted medical licensure.
• At least 75 Category 1 CME credits per rolling three years.
• The five-year assessment requirement, met through OLA or a Continuing Certification exam.
• One PQI project or qualifying activity per rolling three years.
• Newly certified diplomates first meet the CME/PQI requirements in year four.
• Annual IR/DR Continuing Certification fee of $340.

A Domain-Ordered Review Sequence

The one planning idea worth keeping is sequencing by dependency: build the shared foundation first, then the procedure-heavy headings, then convert to spoken answers. The timeline below is an illustration to adapt, not an ABR-prescribed schedule.

If you are asking whether the effort is justified, read whether IR/DR certification is worth it. To test your recall against exam-style items, use our IR/DR practice tests.

Who Hires and What the Pay Evidence Shows

Board certification in interventional radiology matters most to employers that credential and privilege proceduralists: academic medical centers, hospital systems, and radiology groups. One concrete data point: a UC Davis Interventional Radiologist posting (JPF07749), opened September 21, 2026, lists a range of $525,000 to $575,000.

Frequently Asked Questions