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Hi all, I'm not a frequent poster, but I thought I would start a thread about the California Fluoroscopy exam. This might be relevant to other fields that use fluoro, but I'll post to Cardiology since that is my field. There is a separate radiography exam, which most people (at least in cardiology) won't need. Ask your employer which exams you need before you sign up.
Obtaining the license is a pain and took longer than I anticipated. If you're planning on taking a job in California that requires it, get started early! In order to apply you need a California medical license, which is a chore by itself. You need to send a form via mail (no electronic applications) to the California Department of Public Health, which takes about 6 weeks to review your application. You will be notified via mail with instructions on how to register for the exam. You will pay the ARRT online, which now administers the exam on behalf of the state. They will then send you a testing permit via mail (this takes about 2 weeks) to schedule the exam with Pearson. Once you have scheduled and taken the exam, the state will report back to you in 45 days. So, as you can see, the process is quite slow. Getting any response from the Department of Public Health is a fool's errand.
The exam itself is actually pretty reasonable, in my opinion. Apparently, the ARRT took over the exam a few years ago, so information on the old exam may be out-of-date. So be wary of any old questions you see floating around the internet. For obvious reasons, I can't disclose test questions or specific topics, but I think I can provide some general guidance on how to prepare. In general, the exam emphasizes radiation safety more than anything else, so make sure you know all aspects of radiation safety. Everything from occupational limits, radiation protection, and physics is fair game. They especially want to know about what the operator can do to limit risk, so know how your settings at the table can affect radiation dose. They also devote a significant number of questions to the technical aspects of fluoroscopy, so you'll have to know the basics about how the device works, including the x-ray generator, the image intensifier and the flat panel detector. Radiation units are also fair game, and you can pick up some easy points by knowing these. There are other topics, which are covered in the blueprint (e.g., regulations, information technology, consent/ethics, etc).
I think most questions were pretty fair, without too many esoteric questions. Most are single-best answer questions, but they do have some other formats, so be prepared for that. They try to ask questions with a single correct answer, where the other options are unambiguously wrong. Question stems are short enough that most people won't have to worry about the time limit. There are also experimental questions, so don't let tricky questions throw you. I believe 90 of the questions are scored and 30 are experimental. I don't think I disclosed anything protected here. This information just confirms what is available on the exam blueprint.
So, how to review? Most people use the ASRT modules and practice questions. In general, I thought the quality of these was poor. They often focused on unnecessary details about history and legislation. The authors showed a poor understanding of the technical aspects of fluoroscopy, so I found it impossible to learn about certain topics (like how a flat panel detector works) from them. They also devote separate chapters to portable vs fixed fluoroscopy units, which is a strange decision. The longest chapter was devoted to radiation to the eye (sigh). The readings are very dry. The questions are marginally better, but often focus on unnecessary granular detail. They also don't provide any feedback on the option choices, so it's hard to learn from them.
The old manual written by the state of California is still out there on the internet. It's actually pretty good, though also very dry. When you take away the appendices and index, it isn't terribly long and provides a lot of useful information. Just be aware that certain things may be out of date. The old manual also focuses on image intensifiers, while for the exam you also need to be familiar with flat-panel detectors. As a result, you can ignore some information on out-of-date equipment. Just be aware that both image intensifiers and flat panels are covered by the exam.
I think online practice questions, such as FluoroPrep can be helpful and you can pick up some easy points by doing them. Some of their questions are inaccurate, so be aware. They will ask about the same topic multiple times in an effort to force you to remember. I think this can be a useful way to shore up weaknesses.
How much time to devote will depend on your study habits, but I thought this was easier than most of the exams I have taken so far. It was certainly easier than the various USMLE steps, ABIM exams, and Echocardiology exam. It was perhaps comparable to the Nuclear Cardiology exam for those of you who have taken it. Still, the exam should be taken seriously. Smart people have failed, and nobody wants to delay the start of their career because they bombed the fluoro exam. I would review the ASRT modules/questions, read over the old California manual (it goes pretty quickly), and then practice with the Fluoroprep questions.
I hope that helps. Again, I did my best to be helpful without crossing any legal/ethical lines. Good luck.
Obtaining the license is a pain and took longer than I anticipated. If you're planning on taking a job in California that requires it, get started early! In order to apply you need a California medical license, which is a chore by itself. You need to send a form via mail (no electronic applications) to the California Department of Public Health, which takes about 6 weeks to review your application. You will be notified via mail with instructions on how to register for the exam. You will pay the ARRT online, which now administers the exam on behalf of the state. They will then send you a testing permit via mail (this takes about 2 weeks) to schedule the exam with Pearson. Once you have scheduled and taken the exam, the state will report back to you in 45 days. So, as you can see, the process is quite slow. Getting any response from the Department of Public Health is a fool's errand.
The exam itself is actually pretty reasonable, in my opinion. Apparently, the ARRT took over the exam a few years ago, so information on the old exam may be out-of-date. So be wary of any old questions you see floating around the internet. For obvious reasons, I can't disclose test questions or specific topics, but I think I can provide some general guidance on how to prepare. In general, the exam emphasizes radiation safety more than anything else, so make sure you know all aspects of radiation safety. Everything from occupational limits, radiation protection, and physics is fair game. They especially want to know about what the operator can do to limit risk, so know how your settings at the table can affect radiation dose. They also devote a significant number of questions to the technical aspects of fluoroscopy, so you'll have to know the basics about how the device works, including the x-ray generator, the image intensifier and the flat panel detector. Radiation units are also fair game, and you can pick up some easy points by knowing these. There are other topics, which are covered in the blueprint (e.g., regulations, information technology, consent/ethics, etc).
I think most questions were pretty fair, without too many esoteric questions. Most are single-best answer questions, but they do have some other formats, so be prepared for that. They try to ask questions with a single correct answer, where the other options are unambiguously wrong. Question stems are short enough that most people won't have to worry about the time limit. There are also experimental questions, so don't let tricky questions throw you. I believe 90 of the questions are scored and 30 are experimental. I don't think I disclosed anything protected here. This information just confirms what is available on the exam blueprint.
So, how to review? Most people use the ASRT modules and practice questions. In general, I thought the quality of these was poor. They often focused on unnecessary details about history and legislation. The authors showed a poor understanding of the technical aspects of fluoroscopy, so I found it impossible to learn about certain topics (like how a flat panel detector works) from them. They also devote separate chapters to portable vs fixed fluoroscopy units, which is a strange decision. The longest chapter was devoted to radiation to the eye (sigh). The readings are very dry. The questions are marginally better, but often focus on unnecessary granular detail. They also don't provide any feedback on the option choices, so it's hard to learn from them.
The old manual written by the state of California is still out there on the internet. It's actually pretty good, though also very dry. When you take away the appendices and index, it isn't terribly long and provides a lot of useful information. Just be aware that certain things may be out of date. The old manual also focuses on image intensifiers, while for the exam you also need to be familiar with flat-panel detectors. As a result, you can ignore some information on out-of-date equipment. Just be aware that both image intensifiers and flat panels are covered by the exam.
I think online practice questions, such as FluoroPrep can be helpful and you can pick up some easy points by doing them. Some of their questions are inaccurate, so be aware. They will ask about the same topic multiple times in an effort to force you to remember. I think this can be a useful way to shore up weaknesses.
How much time to devote will depend on your study habits, but I thought this was easier than most of the exams I have taken so far. It was certainly easier than the various USMLE steps, ABIM exams, and Echocardiology exam. It was perhaps comparable to the Nuclear Cardiology exam for those of you who have taken it. Still, the exam should be taken seriously. Smart people have failed, and nobody wants to delay the start of their career because they bombed the fluoro exam. I would review the ASRT modules/questions, read over the old California manual (it goes pretty quickly), and then practice with the Fluoroprep questions.
I hope that helps. Again, I did my best to be helpful without crossing any legal/ethical lines. Good luck.