ABA BASIC Exam: Everything You Need to Know to Prepare

I had not really heard of the ABA BASIC Exam until I matched into an anesthesia residency and after some research, I recognized that this test carries the same weight as a Step/COMLEX. The ABA basic examination determines whether or not you will be able to continue your training in an anesthesia residency, graduate, and continue taking the remaining portions of the anesthesia certifying exams. I had heard stories of people who failed the BASIC Exam during my residency, so I made sure to study early and often. 

Residents who have completed 18 months of satisfactory anesthesiology training in clinical practice (12 months of intern year + 6 months of CA-1 anesthesia) are eligible to register and pay for the BASIC Exam starting in March of CA-1 year. The exam is offered twice a year, once in the summer and again 5-6 months later. The exam is scored as pass/fail. If you score in the top 10 percent of test takers during that testing window, a few weeks after receiving your passing result, you and your residency PD will receive a letter stating this result. This accomplishment can help improve your likelihood of matching to competitive fellowships. Have I stressed yet the importance of passing this exam? Because it’s very important to do well on the BASIC Exam.

ABA BASIC Exam Content Outline

The ABA provides a blueprint to assist with study preparation. The ABA BASIC exam content outline lists a breakdown of the relative percentage of the 200 exam questions that are from each broad content category: basic sciences (24% of the test), clinical sciences (36% of the test), organ-based basic & clinical sciences (37% of the test), and special problems or issues in anesthesiology (3% of the test). The content categories are then further divided into subcategories (respiratory system, cardiovascular system, hematologic system, etc.) to detail their relative percentages and questions that appear on the 200-question exam. Most of the major board review courses will utilize this blueprint to represent the appropriate amount of questions per topic in their question banks.

What is the format of the American Board of Anesthesiology BASIC Exam?

The ABA BASIC Exam consists of 200 questions that need to be completed in 4 hours. The American Board of Anesthesiology exam contains A-type questions, which are multiple-choice questions with a single best answer that require the application of knowledge rather than simple recall of factual information. These questions often include a brief clinical vignette followed by a lead-in question and four response options. The BASIC Exam does include questions that reference static images.

What do the ABA BASIC Exam questions cover?

After doing some research about anesthesia board certification, it was apparent that the BASIC Exam does not cover the entire breadth of anesthesiology, instead, it focuses on the basic science of clinical anesthesia practice: pharmacology, physiology, anatomy, anesthesia equipment and monitoring, etc. The ADVANCED Exam (taken after graduation from anesthesia residency) will cover subspecialty-based practice topics such as pediatrics, OB/GYN, interventional pain, cardiothoracic, etc.; thus you do not need to study these topics for the BASIC Exam.

You can find a content outline on the ABA website that provides the framework for the assessment of anesthesia knowledge, however, this outline covers the ITE, BASIC, and ADVANCED exams and based on how it is written, serves as only a guideline for anesthesia content that’s required for board certification.

Clinical Anesthesiology Training: Preparing for the ABA BASIC Exam

When I first heard about the BASIC exam and had this newfound fear of not passing the exam, I decided to do everything in my power to pass this test the first time. That meant starting as early as possible to study. I took my COMLEX Level 3 exam early on during my intern year and I would recommend any anesthesia resident do the same so that the rest of their study time during residency can be dedicated to anesthesia. There is some overlap between the content of the ITE and the BASIC Exam (ITE consists of basic and advanced testing concepts, while the BASIC Exam is just general anesthesia concepts), so when I started studying for my ITE I realized this information would not only help on the BASIC Exam but also with the overall anesthesia knowledge base I would need as a CA-1 resident.

I started studying for both my ITE and the ABA BASIC Exam in December of my intern year. I think the biggest obstacle in preparation for the BASIC Exam was being consistent in my study schedule and making sure to continue studying and not become distracted. For me, this meant studying for 1-2 hours every day and longer on the weekends (up to a few hours if time permitted). During my intern year as a prelim resident, I had some easier rotations since I was an off-service resident during most rotations, so I balanced out my studying compared to when I was on busier rotations.

There is a very steep learning curve when you start anesthesia and are in the operating room for the first time by yourself, and it can be very stressful. My studying decreased during the first few weeks of CA-1 year but as I felt more comfortable in the OR, my BASIC Exam prep picked up. I studied also for the ITE concurrently with the BASIC, as previously mentioned there is content overlap. I wanted to do well on the ITE as I knew fairly early on that I wanted to pursue a competitive fellowship. 

I asked some of my Attendings and older co-residents what their strategies were (for both those who failed and passed) to get advice on how best to study. I recommend this for anyone preparing for an ABA exam, as they may give you study guides or presentations they made. The American Society of Anesthesiologists provides a study guide that details a similar study strategy that I used.

Best Anesthesiology Board Review

During medical school, I learned that I don’t retain much information simply from reading. I found it helpful to have audio lectures to listen to while driving to work or working out at the gym. There are great audio lectures such as ACCRAC which are very focused on topics that are important to the BASIC exam. Additionally, question banks are important to have because they are a way to test your knowledge and get yourself used to seeing questions that are very similar to what you may see on test day, as well as helping with timing. When going through a question bank, be sure to read the questions and be able to pick apart what they’re actually asking and eliminate the wrong answers to identify the correct answer. If time/money allows, you can use additional question banks: one to learn from with detailed answer explanations and another to test your knowledge or one that combines both.

Question banks don’t cover every topic you’ll see on test day, but the concepts should be familiar to you because the test is just an application of what you already know. The best review courses contain a little bit of each of these different learning modalities: audio, visual, and question banks.  Also, the ABA offers 60 sample questions and responses (no explanations), and the International offers additional resources for residents preparing for the Basic or ADVANCED exams.

The Pass Machine offers a 12-month subscription to their board review course which consists of 1100+ practice questions, 33 lectures from board-focused faculty, an illustrated study guide, access to an online study group with other course participants, and easy access to these sources via an iOS & Android app. The Pass Machine also has other resources that can be useful for both anesthesia board studying as well as clinically during anesthesia residency.

Even better, The Pass Machine offers a triple trust guarantee on their Anesthesiology Basic Board Review course, meaning that if you sit for the exam and fail, you will receive 110% of your paid tuition for the review course plus a free subscription renewal. 

Need help studying for the BASIC exam?

In addition to The Pass Machine’s anesthesiology board prep resources, you can access a free EXACT exam prep guide to create a customized study schedule for the ABA BASIC Exam. This time-management tool will take the guesswork out of what to study and help you stick to your study goals.

Anesthesiology Board Exam: Frequently Asked Questions

What is the ABA basic exam?

It is the first half of the written tests, with the other being the ADVANCED Exam. It is a multiple-choice licensing exam that determines if you can continue your anesthesia training and ultimately (if you pass the later portions of the certifying exams) become a board-certified anesthesiologist. In layman’s terms, this exam is a way to make sure that an anesthesia resident is retaining and learning information that will make them a safe anesthesiologist.

How many times can you fail the ABA BASIC Exam?

The exam is offered twice a year with the expectation that if you fail the summer exam, you will retake it 5-6 months later when it’s offered again during the fall/winter. Each residency program is a little different with how they handle two failures of the BASIC Exam but it’s safe to say at that point you can expect your residency training to be extended, to be placed on a remediation program, some type of disciplinary action with your residency program’s clinical competency committee, and/or possible dismissal from your residency program.

What is the ABA BASIC Exam pass rate?

Starting in 2020, the ABA changed its website and no longer clearly reports pass rates for the BASIC Exam (in fact the 2022 assessment results published in July 2023 don’t mention Basic results at all). Floating around the internet there are some resources that list the most recent published data from June 2017 with a pass rate of 88.4%. There is a 92% pass ABA pass rate for those who take The Pass Machine’s board review course.

How long do I need to study for the ABA BASIC Exam?

I would recommend studying for at least 6 months. I know people who studied less than that, some passed and some failed. I personally studied for a little over a year. Need help studying for the ABA BASIC exam? Use this free EXACT exam prep guide to create a customized study schedule.

How long is ABA BASIC Exam?

The BASIC Exam consists of 200 multiple-choice questions, and you have 4 hours to complete the exam.

When do I take the ABA BASIC Exam?

Most residents will take the American Board of Anesthesiology BASIC Exam at the end of their CA-1 year. And there are two chances to take it. If you feel fully prepared early, you can take the summer exam that happens in June 2024, or take a little more study time to ensure you pass and register for the winter exam in November 2024.

Taking the early exam can get you into different programs earlier, but if you’re running the risk of not passing, make sure to take the time you need to get it right the first time. And be sure to check early and late registration dates. You don’t want to pay more than you need to, and you don’t want to miss the window completely.