ABSITE

The American Board of Surgery In-Training Examination (ABSITE)

The American Board of Surgery In-Training Examination (ABSITE) is an annual exam given to general surgery residents to measure their progress in knowledge of applied science and management of clinical problems related to surgery to guide education and identify areas of weakness.

How to Prepare

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How to Prepare

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Resources

ABSITE Format

The American Board of Surgery In-Training Examination (ABSITE) is an annual exam given to general surgery residents. It is administered toward the end of January or early February. ABSITE consists of approximately 250 multiple-choice questions.  Residents are given 5-Hours to complete the exam. There are no “scheduled” breaks. Residents are allowed to take a break whenever they want, although exam time will continue to elapse.

How is ABSITE Graded?

ABSITE results will show two different scores: standard score and percent correct score. The standard score is a calculated number from the entire examinee group (not specific to training level) that transforms scores to arbitrarily have a total group mean of 500 and standard deviation of 100. Therefore, a standard score of 600 would indicate performing one standard deviation above average. The percent correct score is simply the percentage of questions answered correctly. As of 2025, ABS has stopped reporting the percentile which indicated the percentile performance within a resident’s own postgraduate year (score amongst all PGY-3’s, etc).

ABSITE results are given directly to the surgery program, not to the individual residents. The ABS does not retain these records.

Why is ABSITE important?

The ABSITE is not a requirement of the ABS board certification process. Originally ABSITE was designed to simply measure the progress attained by residents in their knowledge of applied science and management of clinical problems related to surgery.  The exam was and is intended to serve as a formative, not summative, evaluation to help guide education and identify areas of weakness.  It, however, has been shown that residents who scored below the 30-35th-percentile were at an increased risk for failing both the American Board of Surgery (ABS) Qualifying Exam (QE) and Certifying Exam (CE), otherwise known as the “Written and Oral Boards”.  It is therefore used outside of its originally intended purpose by some programs in deciding resident promotion and graduation.  It is also used as a critical factor during fellowship application if subspecialty training is desired.

ABSITE Content and Category Weights

The content of the ABSITE is aligned with the SCORE Curriculum Outline for General Surgery.
*Note – approximately 80% of items will address Clinical Management topics and 20% Applied Science topics.

Patient Care Category (72%)

Abdomen (17%)

  1. General – 3%
  2. Hernia – 2.5%
  3. Biliary – 3.5%
  4. Liver – 3.5%
  5. Pancreas – 3.5%
  6. Spleen – 1%

Alimentary Tract (14.5%)

  1. Esophagus – 2.5%
  2. Stomach – 3.5%
  3. Small Intestine – 3%
  4. Large Intestine – 3.5%
  5. Anorectal – 2%

Other General Surgery (13.5%)

  1. Endoscopy – 2%
  2. Breast – 4%
  3. Endocrine – 4%
  4. Skin & Soft Tissue – 3.5%

Trauma & Critical Care (11%)

  1. Surgical Critical Care – 5%
  2. Trauma – 6%

Vascular & Subspecialty Surgery (16%)

  1. Arterial Disease – 2%
  2. Venous – 1%
  3. Access – 1%
  4. Transplantation – 2%
  5. Thoracic Surgery – 2%
  6. Pediatric Surgery – 2%
  7. Plastic Surgery – 2%
  8. Genitourinary – 1%
  9. Gynecology – 1%
  10. Head & Neck – 1%
  11. Nervous System – 1%

Medical Knowledge Category (24%)

  1. Anesthesia – 1%
  2. Biostatistics & Evaluation of Evidence – 1%
  3. Fluids, Electrolytes & Acid-Base Balance – 3.5%
  4. Geriatric Surgery & End of Life Care – 1.5%
  5. Immunology – 1%
  6. Infection & Antimicrobial Therapy – 3%
  7. Minimally Invasive Surgery – Principles – 1%
  8. Nutrition & Metabolism – 2%
  9. Oncology & Tumor Basics – 2%
  10. Pharmacology – 1%
  11. Preoperative Evaluation and Perioperative Care – 4%
  12. Transfusion and Disorders of Coagulation – 2%
  13. Wound Healing – 1%

Other Category (4%)

  1. Radiology – 1%
  2. Outcomes – 2%
  3. Ethics – 1%

We will review the format, available resources, and provide guidance in how to best prepare so that you can enter with confidence and succeed.