What is ABSITE?

ABSITE is an annual exam — 250 multiple-choice question, five-hours — that is offered by the American Board of Surgery. It primary objective is the testing of surgical knowledge. Its content is aligned with the SCORE Curriculum Outline for General Surgery Residency (PDF).

Additional Details:

  • Testing takes place during the final two weeks of January, and results are provided by early March.
  • The same exam is provided to all residents; however, percentile score is generated by comparing the raw score to your peers within the same PGY level.
  • A sample test of the format is available for review.

Why is It Important?

The ABSITE reflects how well you are learning the requisite information needed to become a safe and successful general surgeon and serves as a component of your performance evaluation in the Clinical Competency Committee. That committee meets twice every year, and your performance on the exam may affect your PGY advancement. In addition, the text is a strong predictor for passing the General Surgery Qualifying Examination and may also be used by fellowships when evaluating residents for positions.

Study Strategies

  • Develop a structured reading program for the entire year — daily or weekly — and stick to it. This may include:
    • Textbook, the This Week in SCORE weekly topic, etc.
    • Use a mixture of general topics with current rotation specific topics.
    • The preparation for Thursday morning didactics.
  • Create flashcards for high yield topics and topics that you find difficult to master.
  • Utilize question banks to test yourself, increasing the number of questions as ABSITE gets closer.
  • ACS Tips.

Resources

Supporting Literature

  1. Flentje AO, Caturegli I, Kavic SM. Practice Makes Perfect: Introducing a Question Bank for ABSITE Preparation Improves Program Performance. J Surg Educ. 2020 Jan-Feb;77(1):54-60. doi: 10.1016/j.jsurg.2019.09.005. Epub 2019 Sep 14. PMID: 31526642.
    • Qbanks improved overall ABSITE scores with more questions answered leading to larger improvement — three percent for every 100 questions completed.
       
  2. Winer LK, Cortez AR, Kassam AF, Quillin RC, Goodman MD, Makley AT, Sussman JJ, Kuethe JW. The Impact of a Comprehensive Resident Curriculum and Required Participation in "This Week in SCORE" on General Surgery ABSITE Performance and Well-Being. J Surg Educ. 2019 Nov-Dec;76(6):e102-e109. doi: 10.1016/j.jsurg.2019.08.015. Epub 2019 Sep 3. PMID: 31492638.
    1. Required “This week in SCORE” participation lead to increased weekly study time and median ABSITE percentile improvement of 12 percent.
       
  3. de Virgilio C, Chan T, Kaji A, Miller K. Weekly Assigned Reading and Examinations during Residency, ABSITE Performance and Improved Pass Rates on the American Board of Surgery Examinations. J Surg Educ. 2008 Nov-Dec;65(6):499-503. doi: 10.1016/j.jsurg.2008.05.007. PMID: 19059184.
    • Weekly assigned readings and quizzes resulting in increased first time ABS Qualifying Exam pass rates.
    • ABSITE score less than the 30th percentile at any time or scoring less than 35th percentile more than once during residency significantly increased the chance of failing the ABS Qualifying Exam.
    • ABSITE score less than the 25th percentile also predicted failure of both the ABS Qualifying and Certifying Exams.
       
  4. Kim JJ, Kim DY, Kaji AH, Gifford ED, Reid C, Sidwell RA, Reeves ME, Hartranft TH, Inaba K, Jarman BT, Are C, Galante JM, Amersi F, Smith BR, Melcher ML, Nelson MT, Donahue T, Jacobsen G, Arnell TD, de Virgilio C. Reading Habits of General Surgery Residents and Association With American Board of Surgery In-Training Examination Performance. JAMA Surg. 2015 Sep;150(9):882-9. doi: 10.1001/jamasurg.2015.1698. PMID: 26176352.
    • Resident attitude regarding the importance of ABSITE results was among the independent predictors of ABSITE performance.
       
  5. Kim RH, Tan TW. Interventions that Affect Resident Performance on the American Board of Surgery In-Training Examination: A Systematic Review. J Surg Educ. 2015 May-Jun;72(3):418-29. doi: 10.1016/j.jsurg.2014.09.012. Epub 2014 Oct 31. PMID: 25456409.
    • Systematic review of 26 published articles concluding that structured reading programs and mandatory remedial programs were the consistently most effective measure that can improve ABSITE performance.
       
  6. Miller AT, Swain GW, Widmar M, Divino CM. How Important are American Board of Surgery In-Training Examination Scores When Applying for Fellowships? J Surg Educ. 2010 May-Jun;67(3):149-51. doi: 10.1016/j.jsurg.2010.02.007. PMID: 20630424.
    • Surgical fellowship directors ranked importance of ABSITE scores as three- or four- out of five-point scale.
    • Only factors given more weight than ABSITE scores were letters of recommendation and candidate’s residency program.
    • To be most competitive, applicants should aim to score >50th percentile.
       
  7. Marcadis AR, Spencer T, Sleeman D, Velazquez OC, Lew JI. Better ABSITE Performance with Increased Operative Case Load during Surgical Residency. Surgery. 2018 Dec;164(6):1341-1346. doi: 10.1016/j.surg.2018.06.004. Epub 2018 Jul 29. PMID: 30068483.
    • Residents who perform more operative cases do better on ABSITE.