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Radiation Oncology In-Training (TXIT™) Exam

The TXIT™ exam is scheduled annually in February for first- through fourth-year residents, as well as those in fellowships.

Exam Timeline and Registration

The 2026 ACR TXIT Exam will take place Feb. 10, 2026.

Registration is open Mar. 10 – Nov. 14, 2025.
Late registration is Nov. 15–Dec. 12, 2025.
TXIT exam is Feb. 10, 2026.
TXIT review period is Feb. 16–June 30, 2026.
Score reports will be available approximately eight weeks after the exam closes.

Existing residency programs will update their resident rosters in the Program and Practice Management Application (PPM) (log-in required, for residency program directors and coordinators only). For new programs or questions regarding entering or updating residents in the PPM, please contact traineeupdate@acr.org.

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Get support during the exam testing window

If you experience technical difficulty, email intrainingexam@acr.org with a screenshot and detailed explanation of the issue. Messages are answered in a queue. Do not phone the ACR or request support through multiple methods. This may delay a response to your issue.

Utilize In-Training Exams toFulfill your training program ACGME requirements

Evaluate your program and residents

Evaluate your program using national benchmarking and scale individual resident scores for all residency levels.

Identify areas of deficiency

Offer residents an opportunity to evaluate their knowledge and to identify areas of deficiency relative to peers at the same level of training.

Provide secure and accurate evaluations

Use third-party psychometric evaluation of data for accurate benchmarking. Ensure secure test data via proctored testing and prevent question sharing with new exams created each year through the use of multiple equalized forms.

Prepare for exam and remediation

Offer residents an opportunity for maximizing testing prep with TXIT item questions, including annotated references and rationales.

Count on over 40 years of experience

Trust in an exam existing for over 40 years and created by esteemed experts in radiology subspecialties.

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Additional Resources

Program and Resident Management
A new application that allows you to manage your resident information throughout the year, including resident levels.
PPM Application
Virtual Testing
ACR is now offering residents the option for remote in-training testing.
Learn more
Study Guide
The new TXIT study guide replicates the In-Training Exam format and replaces the PDF files used previously.
Get started

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Exam Pricing

U.S.	USD $275
All other regions	USD $550
Late fee	USD $150 per resident
Cancellation/refund fee*	USD $100 per resident

*Cancellation and refund determined on a case-by-case basis.

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Get StartedMake your payment and understand next steps

Access to the exam is not provided until the registration is paid in full.

The recommended payment method is by e-check, which will take around five days. Credit cards will provide immediate payment. When paying by credit card, limit the registrations on the order to the amount that your credit card will cover. Multiple orders may be needed. Both e-check and credit cards payments are available through the PPM. See below for a guide on setting up e-check and credit card payments.

To pay by mail, make your check payable to ACR and mail it to:

ACR
Attn: TXIT
1892 Preston White Drive
Reston, VA 20191

Checks provided by mail may take two to three weeks to process once received by the ACR. Exams will not be provided to residents if the check payment is in the mail or being processed.

Alternate payment options (ACH or Wire Transfer) are available in the Program Guide.

Payment Setup

Before the Exam:

Review the Program Guide, Proctoring Guide and Program FAQ.
Register your residents and verify your order has been paid in full prior to the Exam start.
Verify your resident levels in the PPM after the start of the new academic year. Score reports will not be rescored for incorrect resident levels.
Notify InTrainingExam@acr.org with any special accommodations. These are due by the registration deadline.
Schedule the Exam time on the day of the provided Exam window. It is recommended the Exam be completed during ACR working hours.
Assign a proctor for the Exam. Review the proctoring information provided with the assigned proctor.
IMPORTANT: Remind your residents to check their login information prior to the exam by accessing the Exam Dashboard.

During the Exam:

Complete and submit the proctoring Roster.
Have residents start the Exam.
If experiencing technical difficulty, contact cortexsupport@acr.org, or during ACR working hours, email InTrainingExam@acr.org with a screen shot and detailed explanation of the issue. Messages are answered in a queue. Do not phone the ACR or request support through multiple methods. This may delay a response to your issue.

After the Exam:

Schedule the Exam review with the residents during the Exam Review window.
Have residents complete their Exam review.
You will be notified when the score reports are available, usually 8 weeks after the Exam.

Before the Exam:

Review the Residents Guide and Resident FAQ documentation.
The Exam is administered online.
At least 72 hours before the Exam, confirm your login and verify your resident level which can be located by your name top right of the Exam dashboard. If the level is incorrect, notify your Program Administrator. DO NOT contact the ACR. We are unable to change this information.

During the Exam testing window:

If experiencing technical difficulty, contact cortexsupport@acr.org, or during ACR working hours, email intrainingexam@acr.org with a screen shot and detailed explanation of the issue. Messages are answered in a queue. Do not phone the ACR or request support through multiple methods. This may delay a response to your issue. Do not phone the ACR or request support through multiple methods. This may delay a response to your issue.

After the Exam:

Set up or confirm your Exam Review time with your Program Administrator.
Relax and wait for your score report. Take advantage of this time to use the TXIT Study Guide for topics you struggled with.

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Questions about ACR In-Training Exams?

Email us

Radiation Oncology In-Training (TXIT™) Exam

Exam Timeline and Registration

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Get support during the exam testing window

Utilize In-Training Exams toFulfill your training program ACGME requirements

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Additional Resources

Program and Resident Management

Virtual Testing

Study Guide

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Exam Pricing

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Get StartedMake your payment and understand next steps

Payment and registration

Important Information for Programs

Important Information for Residents

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Questions about ACR In-Training Exams?

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Utilize In-Training Exams toFulfill your training program ACGME requirements

Additional Resources

Program and Resident Management

Virtual Testing

Study Guide

Exam Pricing

Get StartedMake your payment and understand next steps

Payment and registration

Important Information for Programs

Important Information for Residents

Questions about ACR In-Training Exams?

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