Free ARRT Radiation Therapy Exam Flashcards

Radiation Therapy is a primary eligibility pathway credential, alongside Radiography, Nuclear Medicine Technology, MRI, Sonography, and Vascular Sonography. You do not need to hold an existing ARRT credential first. You qualify by completing an accredited radiation therapy educational program and meeting the ethics and examination requirements. This differs from postprimary credentials such as CT, Mammography, and Bone Densitometry, which do require an existing ARRT certification in a supporting category.

The exam has 230 total items: 200 scored questions plus 30 unscored pilot questions that ARRT is evaluating for future exams. Pilot items are not identified during the exam and do not affect your score, so answer every question as though it counts. The 200 scored items are distributed across Patient Care (46), Safety (51), and Procedures (103).

You need a total scaled score of 75. ARRT scaled scores range from 1 to 99 and are not percentages, so 75 does not mean 75% correct. ARRT reported that in 2025 it took approximately 68% of items answered correctly to reach a scaled score of 75. The exact number of correct answers needed varies slightly by exam version, which is the reason ARRT scales scores at all.

77% of first-attempt candidates passed in 2025, according to ARRT's Annual Exam Report. That year 958 first-time candidates tested, along with 276 repeat candidates, for 1,253 total exams. The mean scaled score among first-attempt candidates was 79.8. ARRT bases its published statistics on each candidate's first attempt.

You get 230 minutes of test time for the 230 items, roughly one minute per question. The full appointment is 250 minutes (4 hours, 10 minutes), which adds 8 minutes for the tutorial, 2 minutes to sign the nondisclosure agreement, and 10 minutes for a post-exam survey. The tutorial also introduces the on-screen calculator you will use for dose and MU questions.

You get three attempts, and they must all fall within three years of the date your first exam window opens. ARRT does not impose a fixed waiting period between attempts: after a first or second failure a Reapply button appears on your dashboard, and each attempt requires a new application and fee. After a third failure you cannot simply retake it. You lose eligibility and must requalify by re-establishing the education requirements, so the barrier is eligibility rather than a waiting period.

Procedures is by far the largest area at 103 of 200 scored items. It breaks down into Treatments (35), Treatment Sites and Tumors (26), Prescription and Dose Calculation (24), and Treatment Volume Localization (18). Safety accounts for 51 items, split between Radiation Protection, Equipment Operation, and Quality Assurance (30) and Radiation Physics and Radiobiology (21). Patient Care accounts for 46 items.

ARRT's content specifications state that SI units are the primary units of radiation measurement on the radiation therapy exam. Expect gray (Gy) and centigray (cGy) for absorbed dose and sievert (Sv) for dose equivalent and effective dose. Know the conversions anyway, since clinical references still use the old units: 1 Gy = 100 rad and 1 Sv = 100 rem.

Renew your certification and registration every year, with the deadline falling on the last day of your birth month. Complete and report 24 approved continuing education credits every two years. If you earned the credential on or after January 1, 2011, you also complete Continuing Qualifications Requirements every 10 years, which involves a professional profile, a Structured Self-Assessment, and any continuing education prescribed by your assessment results.