What You Need to Know to Pass the ABS Qualifying Exam

Prepping for a General Surgery Board Exam? Get a comprehensive General Surgery Qualifying or General Surgery Certifying review course from The Pass Machine to get your board prep on track.

So, you’re faced with the challenge of taking the ABS qualifying exam, and you’re wondering what’s the best way to prepare to ensure that you pass the first time around. The process of taking the ABS certifying exams can feel daunting and overwhelming, with so much to review in so little time. This article aims to 1) review the exam content and structure and 2) provide effective general surgery board prep strategies to pass the exam.

The first step toward obtaining board certification in General Surgery is passing the General Surgery Qualifying Exam (QE). This rigorous assessment is designed to test your knowledge of general surgery, surgical subspecialties, and applied science – your ability to diagnose and manage surgical patients and your aptitude for sound clinical decision-making. See the detailed ABS Qualifying Exam content outline.

Who Is Eligible to Take the ABS Qualifying Exam?

According to the American Board of Surgery, individuals who fulfill the following eligibility criteria can participate in the ABS Qualifying Exam (QE):

• Completion of residency training within a general surgery program accredited by the Accreditation Council for Graduate Medical Education (ACGME) or the Royal College of Physicians and Surgeons of Canada (RCPSC)
• Satisfaction of all ABS training prerequisites for advanced education in general surgery.
• Submission of an operative experience report adhering to ABS standards with respect to case volume, complexity, and diversity
• Active involvement in the practice of general surgery or ongoing pursuit of further graduate education in a related field
• Certification in ACLS, ATLS, FLS, and FES
• Provision of documentation demonstrating successful completion of previous program years, if applicable
• Presentation of evidence of holding an unencumbered medical license within the United States or Canada (required for certification)
• Adherence to the guidelines outlined in the ABS Ethics and Professionalism Policy

ABS Qualifying Exam Content and Structure

The ABS Qualifying Exam consists of two main categories: 1) Patient Care and 2) Surgical/Medical Knowledge. The Patient Care category constitutes 80% of the exam and evaluates competencies essential for providing safe and efficient care to surgical patients. The questions in this category assess your clinical knowledge, decision-making skills, patient management, and ability to handle various scenarios that might arise during surgical practice.

The Surgical/Medical Knowledge category accounts for 20% of questions. It tests your understanding of core basic science concepts and their application in general surgery. The questions in this section cover various topics that form the foundation of surgical practice, including applied science, preoperative care, perioperative care, and miscellaneous topics.

What content does the ABS QE cover?

The ABS QE covers two main categories: patient care and medical/surgical knowledge.

Patient Care (80%): This category includes topics related to the general body systems and subspecialties:

• Abdomen (12%): general abdominal surgery, hernia, biliary, liver, pancreas, and spleen
• Alimentary Tract (15%): esophagus, stomach, small bowel, large bowel, and anorectal surgery
• Endoscopy (2%): endoscopic procedures and techniques
• Breast (7%): breast surgery and related conditions
• Endocrine (5%): surgical diseases of the endocrine glands
• Skin and Soft Tissue (2%): surgical management of skin and soft tissue disorders
• Surgical Critical Care (10%): management of critically ill surgical patients
• Trauma (8%): trauma evaluation, resuscitation, and surgical management
• Vascular surgery (7%): arterial, venous diseases and vascular access topics
• Transplantation (2%): organ transplantation principles and management
• Thoracic Surgery (2%): surgical topics related to the thoracic region
• Pediatric Surgery (2%): surgical conditions in pediatric patients
• Head and Neck (2%): surgical topics related to the head and neck
• Surgical Specialties (4%): plastic surgery, genitourinary surgery, gynecology, and nervous system surgery

Medical/Surgical Knowledge (20%): This category includes topics related to the following:

• Applied Science (13%): fluids, electrolytes, acid-base balance, immunology, infection, antimicrobial therapy, nutrition, metabolism, oncology, tumor biology, pharmacology, transfusion, coagulation disorders, and wound healing
• Preoperative Evaluation and Perioperative Care (2%): patient evaluation and care planning before and after surgery
• Miscellaneous Topics (5%): anesthesia, biostatistics and evaluation of evidence, geriatric surgery and end-of-life care, principles of minimally invasive surgery, ethics, outcomes, and radiology

How many questions are on the General Surgery Qualifying Exam?

The General Surgery Qualifying Exam (QE) by the American Board of Surgery consists of approximately 300 multiple-choice questions. The questions are curated to cover a broad range of topics within general surgery. Candidates preparing for the ABS QE should consult the official ABS resources.

The computer-based exam occurs in various authorized Pearson VUE testing facilities across the United States. The exam is divided into four sessions, with each session typically lasting 115 minutes. The four sessions collectively span the entire examination period. Once a session is completed, candidates cannot revisit or modify their answers to the questions.

After the first and third sessions, there is an optional 10-minute break. An extended 40-minute break is also available between the second and third sessions.

The ABS QE places significant emphasis on both patient care and surgical/medical knowledge. The patient care section constitutes most of the exam, reflecting the practical skills and decision-making abilities essential for competent surgical practice. 

Tips for Acing the ABS Qualifying Exam

The ABS qualifying exam is a challenging exam that tests your knowledge of general surgery. Preparing for it requires a combination of knowledge, strategy, and focused preparation. It requires diligence and a dedicated approach to review. If you want to ace the exam, it is essential to start studying early, create a study schedule that works for you, and take practice tests. Here are some tips to help you approach the exam with confidence:

Early exam preparation is key

Success in the general surgery qualifying exam requires strategic preparation. Begin your journey well in advance, allowing ample time to review and master the extensive content areas. Create a personalized study plan covering all the exam domains, allocating extra time for places you feel less confident.

Consider enrolling in general surgery board review courses, utilizing study guides, and reviewing case-based clinical problems to solidify your understanding.

The Pass Machine offers a general surgery board review with a library of lectures covering all of the material on the ABS certifying exam and can even help you create a customized study schedule with the Exam Prep Accelerator. The lectures are high-yield and designed to help you understand the material and learn how to apply it to clinical practice.

The course includes expert-led video lectures presented by experienced surgeons and educators. These lectures break down complex topics, explain key concepts, and offer practical insights to enhance your understanding.

Leverage online resources

In today’s digital age, a treasure trove of online resources are at your disposal to help you prep for the general surgery qualifying exam – websites, forums, and social media platforms dedicated to surgical education provide opportunities for knowledge sharing, discussions, and question-solving.

Online you can participate in online surgical communities, follow expert surgeons, and engage in virtual case discussions to broaden your perspective and enhance your critical problem-solving skills so you are ready by the exam date.

The Pass Machine’s general surgery board review provides comprehensive learning materials covering all ABS qualifying exam topics. The General Surgery Board Review is structured to align with the ABS qualifying exam content outline, ensuring you master all the necessary content topics.

Master clinical decision-making

The ABS qualifying exam tests your factual knowledge and ability to make informed clinical decisions. To do well on this exam, you should practice interpreting radiographs, lab results, and clinical scenarios to simulate real-life situations. Develop a systematic approach to case analysis and decision-making that aligns with current evidence-based practices.

One commonly tested question in clinical decision-making involves treatment algorithms in surgical patients. Understanding first-line treatments, second-line treatments and the remaining sequential steps for any patient problems is a high-yield way to prepare for the exam.

Stay updated with current literature

Surgery is an ever-evolving field; staying updated with the latest research and advancements is paramount to success – not only on the ABS qualifying exams but as a practicing surgeon as well. Be sure to follow conferences and surgical journals related to your areas of interest and subscribe to surgical news outlets to keep abreast of emerging techniques, technologies, and treatment modalities.

Simulated exam practice

Simulated exams are an invaluable and necessary tool for assessing your readiness and identifying areas of weakness that require additional attention. You should obtain sample exam questions and practice answering them under timed conditions, analyze your performance, and use the feedback to adjust your exam preparation strategy.

The Pass Machine also offers a large bank of practice questions that closely resembles those found on the actual exam. Consistent practice with these questions will help you become familiar with the question style, assess your knowledge, and refine your test-taking skills.

Balance theory with practical experience and general surgical principles

While theoretical knowledge is essential, practical experience is equally important. Be sure to engage actively in clinical rotations, hands-on procedures, and patient care to reinforce your understanding of surgical principles. Real-world exposure will boost your confidence and enhance your ability to apply theoretical concepts to common clinical scenarios as well as rare clinical conditions.

Effective time management

Time management during the exam is critical. Allocate an appropriate amount of time to each section and question. If you encounter a challenging question, don’t get bogged down – mark it and move on. Return to it later if time permits. Prioritize questions based on your knowledge and comfort level.

Enrolling in a structured general surgery board review course provides a clear roadmap for your studies, and can help you maintain motivation, discipline, and practical time management skills throughout your preparation journey.

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General Surgery Board Certification: Frequently Asked Questions

How long do I need to study for the ABS Qualifying Exam?

The amount of time you will need to study for the ABS QE will vary depending on your circumstances. However, most test takers begin to study for the exam at least three months before the exam date, usually during their general surgery residency.

• If you have a strong foundation in general surgery, you can study for a shorter time. However, if you are less experienced or have gaps in your knowledge, you may need to study longer.
• If you have effective time management skills, you can study for the QE in a shorter time. However, if you struggle with time management or have difficulty focusing, you must allocate a longer time for review and practice.
• If you have access to high-yield general surgery board prep study materials and resources, you can study for the QE in less time and more efficiently. There are even tools that will create a customized study schedule based on your strengths and weaknesses.

What is a passing score on the American Board of Surgery qualifying exam?

As of January 2025, the passing score for the American Board of Surgery Qualifying Examination (QE) is 400. The new passing score is based on a percentile ranking, reported on a 100 to 900 scale.

In 2016, the American Board of Surgery (ABS) adopted a clearer and more consistent system for reporting results of all written summative exams, including qualifying, certifying, and MOC exams. Results are now presented as scaled scores ranging from 100 to 900, with a fixed passing score of 400, rather than raw scores. This change accounts for slight variations in exam difficulty using psychometric equating, ensuring the passing standard remains consistent over time. Scaled scores provide a clearer reflection of performance and allow examinees to compare results across exams. For example, a score of 500 represents one standard deviation above the passing score. This system does not affect the way passing standards are determined, and there is no predetermined failure rate; all examinees have an equal chance of passing regardless of exam year or difficulty.

What is the pass rate for the general surgery qualifying exam?

The pass rate for the ABS qualifying examination (QE) in 2022 was 95%. The pass rate has been relatively stable in recent years, ranging from 92% to 95%. You can find the most up-to-date ABS pass rates here.

 

*Article revised in January 2025 to accurately describe the scoring process.