Everything You Need to Know About the ABSITE

Getting ready for your first year of general surgery residency? Then, you may be asking yourself, “What is the ABSITE?” The ABSITE, or the American Board of Surgery In-Training Examination, is an annual exam given to general surgery residents. It is administered as an evaluation to identify areas of weakness and guide education. 

The ABSITE format

The ABSITE format is aligned with the SCORE Curriculum Outline for General Surgery. It has 28 organ-based categories and 13 medical knowledge categories.

Topic areas include:

• Patient care
• Medical knowledge
• Radiology
• Outcomes
• Ethics 

Clinical management is 80% of the exam’s primary focus, and 20% is applied science topics. For a complete ABSITE breakdown, view the ABSITE Content Outline.

2025 Changes to ABSITE Scoring

In previous years, there were three different ABSITE scores.

1. Standard: A calculated number from the entire group of examinees that transforms scores to have a total group mean of 500 (average) and standard deviation of 100.
2. Percent Correct: The percentage of questions answered correctly.
3. Percentile: The percentile performance within your postgraduate year.

In January 2025, the American Board of Surgery (ABS) percentile scoring will be discontinued. This change was made due to high-stakes decisions being made on percentile scoring. Decisions included fellowship selection, resident promotion, and resident termination. 

Results are given exclusively to the residency program, and since a percentile ABSITE score is not normally distributed, this decision allows the residency program to measure a resident’s knowledge without partiality.

How long is the ABSITE? How many questions does it have?

The ABSITE is 5 hours long and has 250 multiple-choice questions. There are no scheduled breaks for the exam, so even if you take a break, the time will continue to elapse.

How long should I study for the ABSITE?

Whether you know it or not, you’re studying for the ABSITE throughout your general surgery residency! The ABSITE is typically administered annually at the end of January or the beginning of February, but you should engage with the material early.

We recommend starting early, but a standard range of studying is three to six months. Looking for ABSITE 2025 dates? The exam window is January 24–28. Visit the ABS website for more information.  

Does ABSITE performance indicate board performance?

Yes, it does. In the past, residents who scored below the 30 through 35th percentile had an increased risk of failing the ABS Qualifying and Certifying exams. Even with percentile scoring going away in 2025, failing the ABSITE can indicate poor performance on both board exams.

Top 5 ABSITE Study Tips

1. Start Early

Don’t make studying your New Year’s resolution. Before the holidays, create your study plan leading up to the exam. By early Fall is the ideal time to start, so you can balance time with family, friends, and everything in between.

2. Pick a Question Bank

Most general surgery residents opt for a long-term Qbank subscription to study for the ABSITE and utilize it throughout their program. You’ll want to select one mapped to the ABSITE format, like TrueLearn’s. 

TrueLearn’s ABSITE SmartBank has 1,000+ practice questions and 600+ surgical illustrations, radiology images, clinical photographs, and decision-making algorithms. Additionally, there are 440+ tables summarizing high-yield topics, conditions, and procedures. It’s a well-rounded and useful tool for practicing your test-taking skills, tracking your progress, and improving your understanding. 

According to a recent study published by the Journal of Surgical Education, ABSITE scores are positively correlated to the number of TrueLearn ABSITE practice questions taken.

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3. Work Your Way Up

With TrueLearn’s performance dashboard, you can identify your weaknesses. These are the topics you should focus on first in your ABSITE study routine. Set a goal on how you’d like to perform in each category and divide each study week by topic. If you’re worried about recalling other topics, pencil in some review time every other week or monthly. It’s up to you!

4. Use Active Study Methods

From spaced repetition to digital flashcards, an active study method will benefit your ABSITE study approach. Practice questions and quizzes are great examples of retrieval practice that will help you recall information and improve your test-taking skills on exam day.

Try these ABSITE Sample Questions from TrueLearn to get started.

5. Trust What You Know

You may be tempted to start cramming before the ABSITE, but don’t overthink it. At the end of the day, the ABSITE is meant to help you prepare for the boards and demonstrate your general surgery knowledge.

What happens if you fail the ABSITE?

If you’re in your first year of general surgery residency, don’t sweat it. You’ll have other opportunities to take the ABSITE. If you’re in your later years, however, a poor ABSITE score can foreshadow poor exam performance on the written and oral boards. If you fail, use it as a learning opportunity for next time and re-evaluate your study approach.

Do you have to take the ABSITE?

According to the ABS, it is not a requirement for any reason or part of the board certification process. However, most general surgery programs require residents to take the ABSITE.