Behind the Knife’s Take on ABSITE Preparation

05 Dec 2021

By Shanaz Hossain and Shreya Gupta

With the arrival of December, ABSITE (American Board of Surgery In-Training Exam) looms on the mind of every general surgery resident. For interns taking the exam for the first time, the ABSITE is a 5-hour standardized exam that consists of ~250 multiple-choice questions and is taken at the end of January. The test is graded on a percentile curve specific to each year of graduation. 

Behind the Knife’s surgical education fellows, Dr. Shreya Gupta (S.G.) and Dr. Shanaz Hossain (S.H.), discuss test preparation strategies to #dominate the ABSITE. Shreya is currently a PGY-4 at Case Western Reserve/University Hospitals while Shanaz is a PGY-3 research resident at the Cleveland Clinic.

There is a plethora of available resources, such that it can be overwhelming for surgical residents with limited time outside of the hospital. How do you figure out what to use? 

S.H.: There are so many options to choose from! I remember as an intern, I was inundated with so many recommendations that it was hard to know where to start! I found it helpful to categorize resources according to its role in my study plan – I have “reference”, “review” and “ABSITE” books. From there, I trialed each option in the categories until I figured out which one I learned best from. Listed below are a few options I found for each category:

Reference Textbooks:

  • Sabiston’s Textbook of Surgery
  • Schwartz’s Principles of Surgery
  • Greenfield’s Surgery

Review Books:

  • Clinical Scenarios in Surgery
  • The Mont Reid Surgical Handbook

Dedicated ABSITE Review:

  • Fiser’s The ABSITE Review
  • Behind the Knife’s ABSITE Review Podcasts and ABSITE Podcast Companion Book

Textbooks are still pretty expensive, so check with your program (or some of the senior residents) to see whether a textbook is provided or if it is accessible electronically!

S.G.: That’s the key – find one book and stick with it. If you can’t learn from one, switch to another. These books all cover the same content at the end of the day. For senior residents, transition to advanced references as you progress through training – appropriate resources include:

  • Cameron’s Current Surgical Therapy
  • Fischer’s Mastery of Surgery

Textbooks are also not the end all be all, especially in the current era of technology. Medical education as a whole is undergoing a transformation, including surgical training – and I’m not just saying that as a member of the Behind the Knife team! Everyone learns differently, so if textbooks don’t click with you, look into comprehensive online curriculums and podcasts. The SCORE curriculum and SESAP are online compendiums that both have the benefit of integrated questions. With regards to podcasts, we obviously love Behind the Knife! There’s also a lot of other surgical societies with their own podcasts for their subspecialities.

S.H.: Speaking of questions, there are multiple question banks available– don’t feel pressure to do them all! Pick one and finish it. We were advised to complete a minimum of 1000 questions before ABSITE, but more is always better. Make sure to review each question. You’re only hurting yourself if you’re simply going through the motions to reach that 1000-question milestone without understanding the reasoning behind each correct AND incorrect answer. 

Question bank options include:

  • SCORE
  • TrueLearn
  • Decker
  • SESAP

*Note: The textbooks and question banks listed are offered as suggestions. These lists are not comprehensive.

Alright, you broke down the resources, but that still is a pretty daunting list to work through, especially given the size of these textbooks! How do you tackle all your readings and questions?

S.G.: Longitudinal studying is crucial, especially given the breadth of information we need to retain. Residents should be reading from those “reference textbooks” throughout the year to build their knowledge base. I aim to read a certain number of pages from a textbook every day. Podcasts are also a great way to stay current on new research and topics of debate while multitasking (i.e. commuting to work, cleaning, running errands, etc).

S.H.: Each patient also serves as a learning opportunity as you rotate through different services! In terms of questions, I aim to complete 10 questions a day and ramp this up when it gets closer to ABSITE. A lot of the question banks also have an accompanying app, so you can do questions on the go! When I’m in dedicated ABSITE studying, I also bring out my ABSITE review books and flashcards to improve my knowledge recall.

What are some additional ABSITE-specific study strategies?

S.G.: ABSITE preparation should be incorporated into your overall study plan for the year. After you get your score back, use the list of missed topics to make your study schedule. For interns who never took ABSITE before, take a practice test and use those missed topics to guide your plan. Focus on your areas of weakness to maximize points. The SCORE curriculum is also helpful as a longitudinal study guide. 

S.H.: CRAMMING DOES NOT WORK! Trust me, I learned the hard way. ABSITE is a marathon, not a sprint. Starting early also gives you the flexibility to adapt your question and reading goals to variable clinical schedules. Include dedicated reviews – use review books or flashcards (including Anki) to refresh information. Also, figure out a way to hold yourself accountable to your study plan, whether that be a study buddy or an individual reward system. 

S.G.: Remember to review nutrition formulas, cancer stages, genetic syndromes, and statistics right before the test! These topics refuse to stick in our brains because we don’t use the information on a daily basis, but are easy points on the exam!

S.H.: As with any standardized exam, get a good night’s sleep and eat a solid breakfast for brain fuel! Pace yourself during the exam. You got this!

Please join us on December 13th at 8-9 PM EST for an AWS Tweetchat about ABSITE preparation with Behind the Knife. The chat will be moderated by Dr. Shreya Gupta (@shreyaguptaMD) and Dr. Shanaz Hossain (@ShanazHossainMD) of Behind the Knife. The questions will be posted directly from the @WomenSurgeons Twitter account. You can also find them by following the hashtag #AWSchat. If you have not participated in a tweet chat with us before, check out this tutorial written by Dr. Heather Yeo (@heatheryeomd) to know more. 

We will be discussing the following topics during our tweet chat:

  • What resources did we find the most helpful with exam preparation?
  • What is your advice for developing a specific study plan? Any tips for studying for the ABSITE?
  • Any study aids or mnemonics that you found particularly helpful?
  • What do you find helpful to do the night before or the day of the ABSITE?
  • How does ABSITE preparation differ from studying for the boards?

Dr. Shreya Gupta is a PGY-4 general surgery resident at University Hospitals/Case Western Reserve. She completed her undergraduate degree at the University of Pittsburgh followed by medical school at Sidney Kimmel Medical College in Philadelphia. Shreya has also completed a research fellowship at the National Cancer Institute.

Dr. Shanaz Hossain is a PGY-3 general surgery resident at the Cleveland Clinic. She completed her undergraduate degree at the Johns Hopkins University and obtained her MD from University of Pittsburgh. She is interested in pursuing HPB Surgery vs Surgical Oncology for fellowship.


Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.

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