AAN RITE: Everything You Need To Know

The American Academy of Neurology (AAN) Resident In-Service Training Examination (RITE) exam is an annual, comprehensive examination covering topics within the specialty of neurology. The purpose of the examination is to identify knowledge areas of strength and weakness, and to gauge preparedness for the Neurology Board Examination taken at the conclusion of residency training.

The RITE exam is taken by neurology residents in their PGY-2 through PGY-4 years, usually around February. Scores are released a few months following the examination. Upon release of results, you will receive a personalized spreadsheet with percentage correct in each tested category, as well as a packet with question explanations. There is no minimum score required on the RITE examination necessary to complete residency training; it is merely a tool that resident physicians and their program directors can use to guide learning throughout training. The higher your score, the more likely you are to pass the Board Examination required to become an attending physician on your first attempt.   

AAN RITE Exam Content and Structure

Content that is tested on the examination includes questions from neuroanatomy, behavioral medicine/psychiatry, clinical adult neurology, clinical pediatric neurology, contemporary issues in neurology, neuroimaging, neuro-pathology, neuro-pharmacology, and neurophysiology. 

The examination is currently computerized, and consists of 800 questions, which are broken down into several smaller sections that you complete throughout the day. There is typically a one-week time span within which all neurology residents complete the examination; the exact procedure may vary slightly from program to program.   

Question Format 

The question format is multiple choice. The first half of the examination typically consists of multiple choice questions that test the categories within neurology listed above. In addition to traditional multiple choice questions, there are usually a handful of matching questions. An example of the matching type question would be: choices A-J of headache medications, with 5-10 accompanying questions that describe various headache syndromes – the examiner will need to match the correct treatment with the described headache disorder. Other popular items within this section include pediatric syndromes, neuro-cutaneous disorders, movement disorders, and pharmacology. 

The second half of the examination includes photographs that accompany multiple choice questions. The photographs can include neuropathology/histology slides, neuro-radiology images (CT, CT angiogram, MRI, etc), EEG tracings, physical examination findings, or EMG data.  

How Long You Should Study

Throughout your residency training, you will be studying daily while working on the wards and in the neurology clinics. This “active learning” will teach you a surprising amount! In addition, most residents will begin dedicated study several weeks to several months before the RITE examination. 

There are several popular resources including practice RITE question banks like TrueLearn, question books, and review texts. The American Academy of Neurology also has wonderful resources for members including journals, podcasts, practice questions, and videos.

Top Three Tips for Taking the RITE Exam

1. Don’t Stress. This examination is a tool provided by the American Academy of Neurology to help you identify your individual strengths and weaknesses; it is not meant to be a stressful exercise. Use it as a learning opportunity and tool. Don’t feel pressured to compare your results to those of your colleagues – everyone progresses through residency at their own pace.
2. Stick with What Works for You. At this stage of advanced education, most learners have a preferred strategy – use what has historically worked for you to prepare for this exam. If you learn best by doing questions, use a question book or bank. If you prefer to read text, purchase a review textbook. There is no incorrect way to prepare, as long as you pick a comprehensive resource and stick with it.
3. Don’t Cram. Each day as a resident physician is exhausting, and at the end of the day it is difficult to find motivation to hit the books. In an effort to decrease stress and cramming, choose a study resource and spend 10-30 minutes per day reviewing the resource. That way, you slowly gain knowledge over time, and decrease burnout. If you can study for 10 minutes per day, you will be well ahead of your peers.

Written By: Lauren Peruski, DO, Sparrow and MSU Neurology Resident
For additional information on the AAN RITE, visit aan.com.