Amanda Xi, MD, MSE
Current Critical Care Fellow at Massachusetts General Hospital where she also completed her anesthesiology residency. 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 Twitter)
Dr. Amanda XI Shares Insight Into Everything You Need To Know About Studying For The ABA Basic.
Some basics about the BASIC – From the ABA:
The BASIC Examination, the first in the series of exams, will be offered to residents at the end of their CA-1 year. It focuses on the scientific basis of clinical anesthetic practice and will concentrate on content areas such as pharmacology, physiology, anatomy, anesthesia equipment and monitoring.
There is always a summer (June) and fall (November) administration of the exam. Exact dates can be found on the ABA website. For each administration, there are two days – you have no say in which day you are going to take it (believe me, I tried to request a specific date from the ABA for my ADVANCED exam since I was running a 1000+ attendee conference that week… and was denied).
The exam isn’t cheap – $775-$1275; sign up once they announce that you’re able to register so you don’t have to shell out an extra $500 for waiting. My program reimbursed us for this exam and the ADVANCED, so make sure you save your receipt.
The exam has 200 questions and you have 4 hours to complete it. As you’ll see from the sample questions, they’re pretty short and to the point. The exam will offer you a break at the 100 question mark.
How do you have any credibility to advise me? Well, I passed my exam (first attempt, June of my CA1 year). That’s a start, don’t you think?
WAMC [what are my chances] of passing? Show me the data!Lucky you, the ABA has this useful data to guide your likelihood of success: 2017 ABA Exams Report. Pass rates based on your ITE score:
I’d like to highlight that the norms table from the 2018 ITE shows that for CA1s, 31-32 translates into 46-55%ile. Using this information with the data presented in the table above, if your ITE score was average, you fall into the 94% BASIC pass rate (*raises hand* that was me!). And if you are more awesome than average, you have an even HIGHER likelihood of passing.
If you’re curious about overall pass rate for the BASIC exam:
Here’s another table with some vital information — for the 1,696 candidates that took the exam in June 2017 (oh hey, I’m one of those candidates!), they had an 88.4% pass rate! This slightly down from the June 2016 pass rate of 90.7% [a similar document is available for 2016 through the ABA] but are still pretty good odds.
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.
Pick your adventure…
Anesthesiology residents come in numerous varieties and are enrolled in a diverse range of programs. This means that what works for one resident may not work for another resident. The amount of time that a resident has at one program to study may not align with another resident at a different program. The availability of resources may also differ. I’m writing this entry to try to address a couple of different scenarios, but I’m delineating the different “adventures” [in a somewhat snarky manner] based on time to examination.
Here are your options:
- Gunner Style (1+ year prior to the exam)
- Casual Studier (3-6 months prior to exam)
- Procrastinator (1-3 months prior to the exam)
Gunner Style [1+ year prior to the exam]
If you’re an intern looking into studying for the BASIC exam, I applaud your advanced planning and motivation. I also wonder if you could send some of your ambition and drive this way to me?
There are a ton of resources out there if you’re more than a year out from your exam. The most difficult thing about trying to tackle studying for the BASIC exam before you’ve started clinical anesthesiology training (unless you’re at a categorical program that integrates anesthesiology rotations into your intern year or elected to do an anesthesia elective rotation) is that… well, you don’t have a ton of context or background in the material you’re studying. A lot of the material will be difficult to learn without a patient, experience, or person around to explain why a topic actually matters. Either way, you can still start trying to lay the foundation for your anesthesiology practice.
If you’re at an internship that requires the anesthesiology in-training exam (ITE), this exam will be a good launching point for determining where you stand. When you get your score report, there will be a page titled, “Personal Performance Report.” This page will give you “Your Percent Correct Score for Basic Items” and another one for Advanced items. For the purposes of this exam, you only care about the Basic items. At the bottom, you will have categories laid out and the # Answered Correctly. On the third page, you will get a categorized report of the questions you got wrong, with specific numbers of Basic vs Advanced items. “Clinical Subspecialties” is an Advanced-only category… so you can glance over that (until you’re a CA3).
How will this report help you? Well, you have just used this information to identify where you need to focus your attention from the ABA Content Outline. Make sure you review the areas that you got wrong and understand the concepts surrounding those keywords! There are only so many questions that can be generated about “basic” anesthesia topics, so inevitably there will be repeats.
Now, in terms of an active study plan, if I had the patience, organization, and time to study this far in advance for the BASIC exam, here’s how I’d do it:
6 months to 1 year prior to your exam, make a review book/document & flashcards out of the ABA Content Outline – Basic Topics in Anesthesiology and supplement this with questions.
Pages 4-21 include an outline of the specific keywords you will be asked on your exam. Starting a Google Document or creating Anki flashcards (this is a free program that automatically employs the spaced repetition concept for your review; it costs money to get the phone app, but this is well worth the cost) with each of the keywords and pertinent things to memorize would essentially serve as an active way to study and will be useful for ITEs during CA2 and CA3 years.
I would make a schedule (by week) so you have an idea of how long it’ll take you to get through each of the topic areas. This way you can keep yourself accountable and give yourself flexibility each week. You can then also account for your busier rotations; if you’ll be q3-4 call or an ICU rotation with a brutal stretch of nights, studying for this exam should be low on your priority list.
I recommend this approach if you have lots of time because you will be creating a study bank/book on your own schedule/time rather than paying for one later. This also gives you an opportunity to delve into the evidence and original studies related to concepts you’re learning and collect helpful references that you can pull up easily/quickly.
Just keep in mind that you may find that once you start CA1 year, you’ll feel overwhelmed with trying to learn the clinical aspect that this type of studying takes a backseat. That’s okay.
Make sure to supplement your studies with questions!
The other big advantage of starting to study more than 6 months in advance of your exam is that you’ll have time to complete a question bank more than once. If you’re at a residency program that administers the ITE to interns, I recommend using the TrueLearn ITE question bank starting at least 6 months prior to the exam (purchase it in mid-August), then in February, purchase the TrueLearn BASIC question bank in order to focus your studies.
In order to learn effectively from question banks, you MUST make sure to review the questions you were either unsure of or got wrong. I personally did this the old-fashioned way; I remember content by writing it down, so I kept a notebook around when I was studying in order to take notes on topics to review later. Additionally, I created Anki flashcards for topics that required rote memorization.
The TrueLearn BASIC question bank has ~800 questions; I would aim to review the entire question bank at least twice. My personal preference is to complete the question bank once, then create quizzes of the questions I got wrong until I’ve seen all of those questions again. At that point, I start making quizzes of questions I have seen once, until I’ve completed the question bank a second time.
Casual Studier [3-6 months prior to the exam]
I fell into this category – I studied for the ITE then took a long break before realizing that I didn’t have a ton of time to study for the BASIC. Looking back, I wish I had looked at my ITE breakdown of incorrect questions in my report a bit closer so I could make sure to address those obvious weaknesses. So don’t make the same mistakes I did.
The single best resource for the BASIC exam is the TrueLearn BASIC question bank. I have heard from numerous residents that they passed by just completing the BASIC question bank and reviewing the questions they got wrong (including going back to a primary source and reviewing the concepts missed). There are ~800 questions in the bank, so it is manageable to do 10-20 questions a day and finish it. That’s totally doable.
The approach I took to reviewing questions I got wrong was to write down the concept as well as make Anki flashcards with similar types of questions. This ensured there was an active learning component, and also meant that I’d see the question over again to reinforce the concept. I also tried to finish the question bank at least 2-3 weeks prior to my exam date to give me time to review the incorrect questions and do them all again.
If you have enough time to complete the TrueLearn BASIC question bank twice, I highly recommend aiming for this. Spaced repetition is vital to truly learning concepts, so the more times you see it, the more likely it’ll stick.
Procrastinator [1-3 months prior to the exam]
If you’ve gotten away with approaching all of your exams this way and did at least average on the ITE, you’ll probably pass the BASIC as long as you are using a study resource addresses the ABA BASIC Keywords/Concepts. I want to mention that if you scored less than 20-30 percentile on the ITE and you’re scheduled for the June administration, I’d seriously consider talking with your program to determine whether you’ll be adequately prepared to take the exam. There is a later administration date in November — it may make more sense to take more time to prepare.
My advice from the Casual Studier category above applies here — finish TrueLearn’s BASIC question bank, and make sure to review what you got wrong. The biggest mistake people make is picking up a new resource and only getting through part of it; you need to be exposed to all the concepts before you take the exam and the TrueLearn BASIC question bank is the highest yield resource you can use.
The BASIC exam turned out to be more straightforward than I had originally anticipated, though there were definitely curveball questions. Most people pass. Many questions that you see in TrueLearn you will see on the exam [in some flavor]. Many concepts are repeated on the exam itself. There are curveballs [there always are!], but you have to go into the exam recognizing that this and just take your best guess.
You got this!
There are more words of wisdom available on my personal blog: blog.amandaxi.com. As always, feel free to email me with any questions, concerns or just to get some positive words of affirmation.