1.1 ODS Exam Structure, Timing, Scoring & 2026 Testing Windows

Why the exam format matters

The National Cancer Registrars Association (NCRA) Council on Certification awards the Oncology Data Specialist (ODS) credential, formerly called the Certified Tumor Registrar (CTR). NCRA's Code of Ethics lets credential holders write the letters ODS, or alternatively ODS-C or ODS-Certified, so you will see both labels in job postings and study materials. Knowing how the exam is built changes how you study. Three-quarters of your preparation time should go to the closed-book knowledge you must carry in your head. The open-book section rewards fast, accurate navigation of a small set of official PDFs, not memorization of code tables.

Content outline and item counts

The current content outline was built from NCRA's 2022 role delineation study and has been used since the 2023 exam. NCRA's 2026 exam page and 2026 Candidate Handbook list these domains:

NCRA's score report guide adds that the item count "may vary slightly after the post-exam analysis." The handbook also warns that every domain appears on every form, but not every sub-area is tested on every form.

Items are written at three cognitive levels: recall, application, and analysis. The handbook says the emphasis is on application and analysis. Expect short case vignettes that make you decide what to do, not definitions to recognize.

Timing: two separately timed sections

Three timing rules catch unprepared candidates:

1. Time does not carry over. Finishing Part 1 in 90 minutes does not give you 150 minutes for Part 2. Use spare closed-book time to review flagged items.
2. You cannot return to Part 1 after you submit it.
3. The clock keeps running during restroom breaks. Remote testers must also have their space re-secured by the proctor before they continue.

The testing platform lets you flag items for review, shows the time remaining, and offers an on-screen notepad and calculator. Time alerts appear with 30 and 15 minutes remaining. Unanswered and flagged items are scored as they stand when time expires, so never leave an item blank.

The open-book references

Since 2024, printed references have been prohibited for everyone. The open-book PDFs are opened through the External Resources button, and each PDF is bookmarked and searchable with Ctrl+F (Command+F on a Mac). NCRA's list of references for 2026 exams, updated December 16, 2025, gives these open-book resources:

• AJCC Cancer Staging Manual, 8th edition (4th printing): Part XI Breast, Part XIII Male Genital Organs and Part XIV Urinary Tract, plus Lung from AJCC Version 9. Access is limited to the listed sites.
• STORE 2025 Appendix A: site-specific surgery codes.
• STORE 2025 Radiation chapter.
• Grade Manual v3.2 (NAACCR, September 2024).
• Solid Tumor Rules (NCI SEER, 2025 update, dated November/December 2024).
• Summary Stage 2018 Coding Manual v3.3 (NCI SEER, November 2025).

The handbook adds that "the open-book section may test on any primary site." Notice what is not on the list: ICD-O-3.2, the Hematopoietic Database, the SSDI Manual and the full STORE manual. You must know those rules without a PDF. The same reference list also names four testable resources for the whole exam: the NCRA Cancer Registry Management: Principles & Practice (4th edition), STORE 2025, the CoC Optimal Resources for Cancer Care 2020 Standards (updated October 2025), and the NCRA Professional Practice Code of Ethics (revised 2023).

Scoring and pass rates

• Each correct answer earns 1 point; wrong or blank answers earn 0.
• Pass/fail is decided on the total examination (closed-book and open-book scores combined).
• The passing point is set with the Modified-Angoff criterion-referenced method, and NCRA may adjust it through statistical equating when one form is harder than another. NCRA does not publish a fixed percentage.
• Your score report shows percent correct for each domain, but those domain results are not assigned a pass or fail status. Use them to plan a retake.

NCRA's Summary of the 2025 ODS Certification Exam reports that nearly 800 candidates tested in 2025. The overall pass rate was 51.4% (410 candidates passed), and the 506 first-time candidates passed at about 59%. Pass rates were 51.9% for Routes 1 and 2 and 50.0% for Route 3.

2026 windows, fees and policies

• Registration fee: $435, or $335 for NCRA members. Non-US candidates pay an extra $150 to test at an international test center; there is no extra fee for remote online testing.
• Scheduling: approved candidates receive a notice to schedule from Meazure Learning about 45 days before the window. You can test at a Meazure Learning center or through live remote proctoring. Remote testing uses the Guardian browser, a webcam and microphone, a room scan, and a mirror check of your monitor.
• Changes: you can reschedule within the same window at least three business days (72 hours) before your appointment. Moving to a different window costs a $125 transfer fee, and after a transfer the exam fee can no longer be refunded. A withdrawal is refunded less a $125 processing fee. A no-show forfeits the fees.
• Retakes: you may test only once per window. To retake, submit a new application and pay the full fee for a later window. You must meet the eligibility requirements in effect that year.
• Results: scores are posted about 6–8 weeks after the window closes, with no immediate result at the test center.
• Accommodations: request them through NCRA with documentation. The 2026 handbook says to do this when you apply or at least 30 days before your test date.

Pacing strategy that fits the real rules

In Part 1, aim for about 50 seconds per item on the first pass, flag anything uncertain, and use the leftover time to revisit flags. In Part 2, read the stem and decide which manual answers it before you search: the Solid Tumor Rules, Summary Stage, an AJCC chapter, Appendix A, the Radiation chapter or the Grade Manual. Use the PDF bookmarks to jump straight to the site chapter rather than searching a common word such as "carcinoma."