There are time-tested, proven approaches to studying for the ABSITE effectively. It is important to use the right study resources and give yourself enough time to not only digest the material, but to develop a strong command of it. TrueLearn (along with other appropriate resources) can go a long way to getting you top scores. In fact, a study found that completing TrueLearn’s entire ABSITE question bank increased residents’ overall percentile on the exam by 20%.1
Where to Focus Effort
According to the American Board of Surgery, the ABSITE is closely aligned with the SCORE Curriculum Outline for General Surgery. The ABSITE Content Outline shares which patient care and medical knowledge topics are covered and how heavily each topic is tested. As such, you should take a weighted approach to your studies. More information on that below.
Example Study Plan/Schedule
Knowing that the ABSITE applies the following percentage weights (with some variation from year to year), it is best to study accordingly:
- Patient Care – 72%
- Medical Knowledge – 24%
- Other (Radiology, Outcomes, and Ethics) – 4%
The above categories are further broken down into topics with their own percentage weights, as indicated in the ABSITE Content Outline. Thus, if your ABSITE is three months away, you could consider the following study plan/schedule:
- Start time: Last week of November.
- Stop time: Rest the day before the ABSITE (which is typically in late January or early February).
- # of practice questions: As many as possible, depending on learning style. Some trainees will complete an entire question bank or two prior to the exam.
- How to take the questions: Tutor mode is useful for formative practice, since the explanations are provided immediately after answering the questions. However, it is helpful to mix in timed mode, especially as you get closer to your exam date, to better simulate the actual test-taking experience.
It is best to mix questions from different categories, as this allows you to test yourself on a diverse range of topics in each sitting. However, if you have a particular area of weakness, taking repeated, focused questions on that topic can help improve your understanding. Weak areas will likely need to be supplemented with additional readings.
General note: Try to review surgery materials daily. According to a study by Kim and others, reading habits are an essential predictor of ABSITE scores.2 In addition to practice questions, nontraditional materials such as YouTube tutorials, as well as traditional resources like textbooks, review books such as The ABSITE Review by Fiser, and for more advanced residents, SESAP, are all great study tools.
- Fiser is an old standby. This book still has the big picture, high-yield topics represented in the exam, but it is important to note that the ABSITE has changed over the years. In its earlier iterations, the ABSITE leaned more toward basic science questions. It was during this time, around 2006, that Fiser’s The ABSITE Review earned its reputation as a stand-alone study text. This book is effective for learning from moderately difficult questions or refreshing yourself on forgotten facts. In more recent years, the ABSITE has become more problem-based, with fewer basic science questions. Fiser remains an important text with high-yield facts; however, effective test-prep mandates supplementation with additional sources.
- Use a question bank. As of 2020 and in the past few years, the ABSITE has focused primarily on management, with fewer basic science questions. Thus, one of the best ways to succeed on the test is to answer clinically relevant practice questions.1 Studies have shown that trainees should answer questions to best prepare for the ABSITE, and that electronic testing services have improved test scores.3
- Determine what materials to use. Making use of question banks is critical, and there are a number of options to choose from. The most established of these are offered by SCORE, TrueLearn, and SESAP. The SCORE questions include a “This Week in Score” component that trainees may find useful. Numerous studies have identified the utility of TrueLearn in improving ABSITE scores. SESAP may be inappropriate for interns, given the advanced level of complexity seen in its question bank. It is aimed for senior residents preparing for the ABS Qualifying Exam. However, as early as the second year of training, SESAP may be useful.
- Consider the curve. Given that the percentile score on the ABSITE is much more important than the raw number of questions answered correctly, this is an area of great interest. The ABSITE curve is shrouded in mystery, with little data provided online. The only glimpses offered are in the form of the post-test score reports provided to individual trainees. From those, we know that the curve gets tougher and narrower every year. The PGY1 curve has historically been the most forgiving, while many test-takers experience a drop in percentile in the PGY2/PGY3 years, despite consistency in study effort. This demonstrates the importance of adapting exam prep to a demanding surgical lifestyle in a dynamic way. If you don’t study smart and consistently build on what you have already learned, you might find yourself slipping down the wrong end of the curve.
- Imran JB, Madni TD, Taveras LR, et al. Assessment of general surgery resident study habits and use of the TrueLearn question bank for American Board of Surgery In-Training exam preparation. Am J Surg. 2019;218(3):653‐657. doi:10.1016/j.amjsurg.2019.02.031
- Kim JJ, Kim DY, Kaji AH, et al. Reading Habits of General Surgery Residents and Association With American Board of Surgery In-Training Examination Performance. JAMA Surg. 2015;150(9):882‐889. doi:10.1001/jamasurg.2015.1698
- Hancock KJ, Klimberg VS, Williams TP, et al. General Surgery Resident Use of Electronic Resources: 15 Minutes a Day. J Am Coll Surg. 2020;230(4):442‐448.
Author: Nicole Ilonzo, MD, graduated from general surgery residency at Mount Sinai St. Luke’s-West in 2019 and is currently completing a vascular surgery fellowship. She is passing along insight from a previous chief resident, Michael Passeri, MD, who founded the ABSITE review club at their residency.