The Holman Pathway presents an alternative residency structure for selected residents in radiation oncology. In this pathway, residents are eligible to be board certified after 21 months of research and 27 months of clinical training. The traditional pathway requires 48 total months of residency in radiation oncology with a minimum of 36 months in clinical radiation oncology. The Holman Pathway is primarily designed for residents with an MD/PhD, or with an MD with a strong research background and who have excellent clinical skills such that clinical competence can be achieved in this abbreviated time period. Prospective candidates should have a documented history of research, i.e., a specific research plan with a suitable research mentor and environment. More information, including application requirements, is available on the American Board of Radiology website at

In response to inquiries in 2004 from the Association of Directors of Radiation Oncology Programs (ADROP), the Review Committee compiled a consensus summary regarding the Holman Pathway in 2005, an updated summary of which is presented below. The information is also included as part of the Review Committee's Frequently Asked Questions (FAQs).

Resident Complement

The Review Committee believes that Holman Pathway residents should be included in the program's approved complement of residents throughout their four-year programs, during both clinical and laboratory educational experiences. The Review Committee has acknowledged that some programs, depending on their structure and schedule, may have difficulty in maintaining an appropriate clinical training program for the remainder of the residents during a portion of the time a Holman Pathway resident is in the laboratory. If the program director determines it is in the best interest of the program to increase the resident complement during this time, the program director may request a temporary increase in the resident complement from the Review Committee. In this situation, the program director should follow the usual procedures for requesting a temporary increase—providing the Review Committee with a written request (via the Accreditation Data System (ADS)), justification, and necessary medical data as specified. This information should be submitted at least six months in advance of the anticipated increase. As with other temporary increases, the period of time should not exceed two years. It is the responsibility of the program director to state the length of time for the increase, and to outline a plan for returning to the original approved complement. Such requests must be endorsed by the designated institutional official (DIO) of the program’s Sponsoring Institution prior to submission.

Procedure and Case Load Requirements

For the traditional resident, the Program Requirements for Radiation Oncology currently in effect mandate a maximum of 250 cases per year for each resident, with a total minimum of 450 external beam cases simulated over four years of the educational program. The minimum number of intracavitary cases required is 15, to be performed over the four years of the program. The minimum number of interstitial cases is five, performed over the four years of the program. The resident must treat at least 12 pediatric cases. Each resident must participate in a minimum of six cases of radiopharmaceuticals, radioimmunotherapy, or unsealed sources over the four years of the program, a minimum of 20 cases of intracranial stereotactic radiosurgery, and at least 10 cases of stereotactic body radiation therapy to the liver, lung, spine, or other extracranial sites.

The Committee believes that all residents, including Holman Pathway residents, should be required to meet the minimum numbers of specified procedures (interstitial, intracavitary, stereotactic radiosurgery and stereotactic body radiotherapy, unsealed sources, and pediatric cases).

For external beam cases over the course of the 27 months of clinical training, the Committee has modified the minimum total number for Holman Pathway residents to 350, with the same annual maximum of 250 cases.