The ABSITE is an annual, formative multiple-choice exam of roughly 250 questions in two 2.5-hour blocks, taken by general surgery residents at their own program. It is ordered and paid for by residency programs, is not required for board certification, and follows the SCORE Curriculum Outline: about 72% Patient Care, 24% Medical Knowledge, and 4% Radiology, Outcomes and Ethics topics. This guide explains eligibility, logistics, the content weights, how scoring now works, and how to turn the outline into a study plan.
What the ABSITE is and who can take it
An annual formative exam for general surgery residents, ordered by programs, not individuals, and not part of board certification.
The American Board of Surgery In-Training Examination (ABSITE) is an annual multiple-choice exam for general surgery residents. It measures your progress in applied science and in the management of clinical problems in your specialty. Your program director uses it as a formative evaluation, meaning it tracks progress rather than certifying anyone.
You cannot register for the ABSITE as an individual. Each ACGME- or RCPSC-accredited program orders the exam for its residents, and the ABS accepts payment only from programs. If you have left a general surgery residency, a program director must agree to host you with their residents, and that option exists only within 24 months of leaving.
Eligible trainees include residents in clinical positions, residents in research or lab years, and trainees hosted from another accredited program. Faculty are not permitted to take the exam.
One point is worth settling early: the ABSITE is not a step toward board certification. Certification in general surgery requires the General Surgery Qualifying Exam and the General Surgery Certifying Exam. The ABS states that the ABSITE is not required as part of that process.
Sources: In-Training Exams | ABSITE | PSITE | VSITE | ABS — absurgery.org in-training exams page; General Surgery Examinations - American Board of Surgery — absurgery.org general surgery exams page
Format, timing and fees
About 250 multiple-choice questions in two 2.5-hour blocks, proctored in person at your program, with a $110 per-trainee fee for the 2027 administration.
The ABSITE consists of approximately 250 multiple-choice questions delivered in two 2.5-hour blocks. It is given as a single exam to all residents regardless of clinical level, and it runs online on each program's own computer facilities.
The 2027 exam window runs January 29 to February 2, with a separate international window of February 5 to 9. The fee is $110 per trainee, or $130 for international programs, paid by the program. If a program changes its order after the order deadline, ABS charges a $350 fee per change.
The exam must be proctored in person at your program. ABS does not permit remote or virtual administration, and the exam cannot be taken at a Pearson VUE testing center.
Questions in both sessions are randomized. Once you complete the first session, you are locked out of reviewing or changing those answers. One break sits between the two sessions: it is optional, and you set its length up to a maximum of 45 minutes.
Sources: In-Training Exams | ABSITE | PSITE | VSITE | ABS — absurgery.org in-training exams page
What the content outline covers
The ABSITE follows the SCORE Curriculum Outline: 28 Patient Care categories, 13 Medical Knowledge categories, and three additional topic areas, with about 80% of items targeting Clinical Management.
ABS aligns the ABSITE with the SCORE Curriculum Outline for General Surgery, the list of patient care and medical knowledge topics to be covered across a five-year general surgery residency. The ABSITE content outline maps directly onto those SCORE categories.
Roughly 72% of questions come from 28 organ-based Patient Care categories, 24% from 13 Medical Knowledge categories, and about 4% from three additional areas: Radiology, Outcomes, and Ethics. Across the whole exam, approximately 80% of items target Clinical Management and 20% target Applied Science, which covers subjects such as anatomy and physiology.
The table highlights selected Patient Care categories within the 72% total; consult the complete ABSITE content outline for every category.
| Content area | Target weight |
|---|---|
| Patient Care categories (28, organ-based) — total | 72% |
| Abdomen (general, hernia, biliary, liver, pancreas, spleen) | 17% |
| Alimentary Tract (esophagus, stomach, small and large intestine, anorectal) | 14.5% |
| Endoscopy | 2% |
| Trauma | 6% |
| Surgical Critical Care | 5% |
| Breast | 4% |
| Endocrine | 4% |
| Skin and Soft Tissue | 3.5% |
| Vascular (arterial, venous, access) | 4% |
| Medical Knowledge categories (13) — total | 24% |
| Radiology, Outcomes and Ethics | 4% |
Sources: In-Training Exams | ABSITE | PSITE | VSITE | ABS — absurgery.org in-training exams page; General Surgery Content Outline for the ABS In-Training Examination (ABSITE) — ABSITE content outline PDF, updated 01/2021
Reading the outline as a study budget
Each percentage point is worth roughly two to three questions, so the largest categories deserve the largest share of your time.
The outline tells you where the questions cluster, so it can shape how you divide your revision time. At roughly 250 questions, each weight point represents about two to three exam questions. The Abdomen block at 17% and the Alimentary Tract at 14.5% together dwarf any single small category, including Endocrine at 4%.
Among Medical Knowledge categories, the heaviest weights go to Preoperative Evaluation and Perioperative Care (4%), Fluids, Electrolytes and Acid-Base Balance (3.5%), and Infection and Antimicrobial Therapy (3%). ABS notes that all these weights are approximate targets, so the final exam can vary slightly.
The 80% Clinical Management target also matters: it points to around 200 of 250 questions asking you to manage a clinical problem rather than recall basic science in isolation. As general advice, favor practice material organized by the outline's categories rather than by arbitrary topic lists.
Practice exercise
Using the outline's targets, estimate how many of the approximately 250 ABSITE questions fall under Alimentary Tract (14.5%) and how many under Trauma (6%). Roughly how many times more Alimentary Tract questions should you expect?
Show answer
About 36 Alimentary Tract questions and 15 Trauma questions — roughly 2.4 times as many.
Multiply each weight by the question count: 0.145 × 250 = 36.25, so about 36 questions, and 0.06 × 250 = 15. The ratio 36 ÷ 15 is about 2.4. Treat these as planning figures only, because ABS states the weights are targets and actual percentages may vary slightly in the final examination.
ABSITE, VSITE or PSITE: which version applies
General surgery residents take the ABSITE; vascular and pediatric surgery trainees take the VSITE and PSITE respectively, each with its own outline.
ABS offers three in-training exams, and each specialty takes its own. General surgery residents take the ABSITE. Vascular surgery trainees take the VSITE, which has about 200 questions and covers both core surgery and vascular surgery, with all examinees required to take all content. Pediatric surgery trainees take the PSITE, a five-hour exam of about 200 questions.
All three exams share the same delivery format and functionality, but each has its own content outline. Confirm you are studying from the right document before you plan your preparation.
Sources: In-Training Exams | ABSITE | PSITE | VSITE | ABS — absurgery.org in-training exams page; PSITE Content Outline — Pediatric surgery exam blueprint, updated 09/2023; VSITE Content Outline — Vascular surgery exam blueprint, updated 09/2025
How scoring works now
Percentiles were discontinued in January 2025; reports now show percent-correct and standard scores and go to your program director.
In January 2025, ABS stopped reporting percentiles on the ABSITE. Score reports now show percent-correct scores and standard scores. ABS made the change because percentile figures were an imprecise measure of knowledge: small differences in raw scores near the middle of the distribution could produce large percentile swings that did not reflect real differences in ability.
Results reach program directors within eight weeks of the exam, and directors may share them with you. ABS does not retain individual score reports and will not reissue one, so keep your own copy. If you have questions about your results, contact your program director; ABS will not discuss results with examinees.
The ABS describes the ABSITE as one factor of many in assessing a trainee's performance. Standard scores also feed a program-level tool showing the likelihood of passing the Qualifying Examination at each score level — a planning aid for program directors, not an individual verdict.
Sources: In-Training Exams | ABSITE | PSITE | VSITE | ABS — absurgery.org in-training exams page; ABS to Discontinue the Reporting of Percentiles on the ABSITE in Jan. 2025 — ABS announcement PDF, updated 11/21/2023
Common mistakes to avoid
The recurring errors involve registration, test delivery, outdated percentile expectations and mishandling exam content.
- Assuming you can sign up yourself. Only programs order and pay for the exam.
- Planning to test remotely or at a commercial testing center. The exam must be proctored in person at your program.
- Chasing percentile rankings. Percentiles are no longer reported; percent-correct and standard scores are.
- Treating the ABSITE as a certification hurdle. It is formative and is not required for board certification.
- Recording or sharing exam content. The ABSITE is copyright-protected and its contents may not be reproduced or disclosed.
- Budgeting review time after the first session. Earlier questions lock when that session ends.
Sources: In-Training Exams | ABSITE | PSITE | VSITE | ABS — absurgery.org in-training exams page
Next steps and official documents
Confirm your order and clinical level, work from the official outline, try the sample test, then practice by category.
- Confirm with your program that you are on the exam order and that your clinical level is coded correctly; ABS will not revise score reports for clinical-level errors.
- Download the ABSITE content outline and use its category weights to divide your study time.
- Try the interactive sample test — ten questions plus a survey — in Microsoft Edge, Google Chrome, or Apple Safari; it does not run in Firefox. It teaches the screens and navigation you will use on exam day.
- Practice by category with our free ABSITE practice questions and browse our other study guides.
- For authoritative detail, consult the ABS In-Training Examinations page and the ABSITE content outline on absurgery.org.
Sources: In-Training Exams | ABSITE | PSITE | VSITE | ABS — absurgery.org in-training exams page
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