ABA BASIC Exam: Everything You Need to Know

The ABA BASIC Exam is part of a staged exam series that starts with the BASIC Exam at the end of CA-1 year anesthesia training. This is followed by the ADVANCED and APPLIED Exams after graduation from anesthesia residency. These staged exams are mandatory as part of the anesthesiology board certification process. Residency programs also set their own requirements for how BASIC Exam results factor into training and graduation.

The main focus of the BASIC exam is to test basic principles in pharmacology, physiology, anatomy, anesthesia equipment and monitoring. Each year, the American Board of Anesthesiology (ABA) releases a “Gaps in Knowledge Report” after the BASIC exam is completed that states the most common topics that were answered as incorrect by examinees or proved to be difficult; these concepts are usually e-mailed directly by the ABA to anesthesiology program directors and may be available upon request.

What is the BASIC Exam

The BASIC Exam is designed to evaluate a CA-1 resident’s mastery of anesthesia learning objectives that are typically covered during the clinical base year and CA-1 year. This is a secure, proctored, computer-based exam administered twice each year through Pearson VUE testing centers nationwide. The exam takes place during two days in the summer (usually June) and during two days in the fall (usually November).

Upcoming BASIC Exam dates:

• November 6-7 2026 (late registration through Sept. 24, 2026)
• June 4-5, 2027 (standard registration Feb. 10-April 7, 2027; late registration April 8-22, 2027)
• November 12-13, 2027 (standard registration July 21-Sept. 15, 2027; late registration Sept. 16-30, 2027)

Once you register, the ABA assigns your exam date, and it can only be changed for religious observance, military commitments, or medical accommodations. Find the latest dates on the ABA’s BASIC Exam page.

BASIC Exam Content and Structure

There are four main content categories in the BASIC Exam including “Basic Sciences”, “Clinical Sciences”, “Organ-based Basic and Clinical Sciences”, and “Special Problems or Issues in Anesthesiology”. The questions that comprise these content areas are constructed to cover certain specifications as outlined in the Anesthesia BASIC Exam Blueprint. A typical format will comprise the following:

• “Basic Sciences”: 44-52 questions (24% of exam)
• “Clinical Sciences”: 65-79 questions (36% of exam)
• “Organ-Based Basic and Clinical Sciences”: 66-82 questions (37% of exam)
• “Special Problems Or Issues in Anesthesiology”: 4-8 questions (3% of exam)

There are a total of 200 questions on the exam and residents have four hours to complete this exam. The answer choices are type A question items only. This means that there is only a single-best answer choice on multiple-choice questions and these question stems will not contain negative/exception phrases  (e.g. “Which of the following is not true”, “All of the following are correct except for”, etc.). According to the ABA, BASIC questions require the application of knowledge rather than simple recall, so many will involve second- or third-order thinking. Clinical vignettes accompanied by laboratory data and static images may also be presented in questions.

How Long Do I Need to Study for the Exam

It is recommended that residents study long-term over the course of the CA-1 year. Studying an average of one hour daily over the course of a year is likely better than cramming 6 hours daily over one month.

Spaced repetition of learning important basic anesthesia concepts is key. There have been numerous published studies that demonstrate the efficacy of spaced repetition in learning and obtaining high board scores across a variety of both medical and non-medical fields. The long-term learning model also allows the resident to practice newly-learned skills from their reading/studying and apply it to their clinical practice earlier on in training. This allows the resident to determine what works best and what does not; this is a form of active learning.

What Type of Results will be Generated

The BASIC Exam is a pass/fail exam so you won’t receive a scaled score or percentile. According to ABA research, more than 99% of candidates pass the BASIC Exam by their third attempt. However, residents who score in the top 10% nationally receive recognition from the ABA for their performance.

Evidence from Published Studies

A study by Zhou and colleagues analyzed resident performance on the ITE (in-training examination) during implementation of the staged exam system (BASIC, ADVANCED, and APPLIED exams) and compared it to resident performance on the ITE in previous cohorts utilizing the traditional examination system (without the staged BASIC, ADVANCED, and APPLIED exams). This study demonstrated that the new staged system with the BASIC exam had a greater improvement in ITE scores between the first and second years of clinical anesthesiology training. Impressively, the residents in the staged exam cohort achieved a similar score in their second year to that of third-year clinical anesthesiology residents in the previous traditional cohort. This highlights that the new staged system that incorporates the BASIC exam is important for knowledge growth in anesthesiology. Importantly, even though this is a pass/fail examination, residents should view it as an opportunity to prepare to the best of their ability as it is a predictor of ITE performance.

Top 3 Things You Need to Know If You’re Taking the BASIC Exam

1. Long-term preparation is key

You have been preparing for this exam all of CA-1 year. However, it is crucial that the resident employs the proper preparation strategy. Instead of cramming, it is recommended that spaced repetition of study concepts over a long period of time works better. Furthermore, more “active” learning approaches rather than “passive” learning approaches are better. For example, doing questions from a qbank or question book is better than listening to video lectures. Engaging in boards-style questions with your attending is also a useful active learning approach that makes key concepts stick. Another quick tip: it is the opinion of the author of this post that when learning from question banks, it is preferable to do questions in “random” mode than study within one subject at a time. This is how questions will be presented on the actual exam (in random order of subject). In addition, the random order allows for spaced repetition of similar concepts, instead of exposing the resident to the same concepts all at once. 

2. Use the appropriate resources:

The resident should focus their efforts on utilizing study tools geared towards basic anesthesia concepts. For example, while studying standard transesophageal echocardiogram views may be useful for the ITE, these advanced topics won’t be tested on the BASIC exam. Utilize the published blueprint on the ABA website to study the pertinent concepts. You will also likely experience resource overload. There are too many anesthesia resources available, try to pick a few reputable sources to focus on. One qbank (e.g. TrueLearn BASIC anesthesiology qbank) and one textbook resource (e.g. Morgan and Mikhail’s Clinical Anesthesiology) may be sufficient. 

3. Apply for Exam Registration Early:

The standard registration fee is $975 ($830 for retakes), and the late registration fee is $1,475 ($1,330 for retakes).

ABA Basic Exam Pass Rate

The ABA doesn’t publish an annual BASIC Exam pass rate, but its 2025 research found that more than 99% of candidates pass the BASIC Exam by their third attempt. Your ITE performance can also help you gauge your readiness, since a higher ITE percentile generally means a higher chance of passing the BASIC.

The most important thing to take away from this, is that you probably have good odds of passing, but you shouldn’t neglect the exam altogether. After all, it’s not a 100% pass rate. Passing on your first attempt keeps you on track and saves you the cost and stress of a retake.

What Happens if You Fail the ABA BASIC

If a resident fails the BASIC Exam, they can retake it at a later administration. The exam is offered twice a year, in June and November. Under the ABA’s updated BASIC training policy, effective January 1, 2025, failing the BASIC Exam a second or subsequent time no longer leads to an automated “unsatisfactory” on Clinical Competence Committee (CCC) reports. Each residency program sets its own academic and graduation requirements for how BASIC Exam results are used.

It’s good to know you have a plan B, and a plan C. But of course it’s better to pass the first time around.

This blog post was written with the help of Amanda Xi, MD, MSE. She is active in the American Medical Women’s Association (AMWA) and the Accreditation Council for Graduate Medical Education (ACGME). Amanda is passionate about helping individuals succeed and provides advice through her blog (blog.amandaxi.com) and social media channels (@amandasximd on Instagram and X)

References

1. Tabibian B, Upadhyay U, De A, Zarezade A, Schölkopf B, Gomez-Rodriguez M. Enhancing human learning via spaced repetition optimization. Proc Natl Acad Sci U S A. 2019;116(10):3988-3993.
2. Feng K, Zhao X, Liu J, et al. Spaced Learning Enhances Episodic Memory by Increasing Neural Pattern Similarity Across Repetitions. J Neurosci. 2019;39(27):5351-5360.
3. Zhou Y, Sun H, Lien CA, et al. Effect of the BASIC Examination on Knowledge Acquisition during Anesthesiology Residency. Anesthesiology. 2018;128(4):813-820.
4. Augustin M. How to learn effectively in medical school: test yourself, learn actively, and repeat in intervals. Yale J Biol Med. 2014;87(2):207-212.
5. Fowler A, Whitehurst K, Al Omran Y, et al. How to study effectively. Int J Surg Oncol (N Y). 2017;2(6):e31.