The True Cost of ABSITE Prep

20 Nov 2021

By Martha Godfrey 

Everyone thinks in dollars and cents when it comes to the cost of preparing for the American Board of Surgery In-Training Examination (ABSITE): $150 for a textbook, $295 for a question bank. While there are always financial considerations made when developing a study strategy, the true cost of a better ABSITE score is quantified not in dollars, but rather in minutes. 

Studies have shown that residents who spend more time studying for the ABSITE tend to do better. This is certainly not surprising. Unfortunately, this means when a resident is asked to score above a certain percentile on the ABSITE, they are functionally being asked how many more minutes than their peers are they willing to devote to studying for a standardized test. It serves as an annual opportunity to demonstrate how much more a resident (and potentially their families) are willing to give up for the job. This certainly is not the goal of ABSITE, but with emphasis placed on high ABSITE scores, the test has become a ruler not simply for knowledge, but also for dedication…and as a result sacrifice.

As one of the most important elements in doing well on ABSITE is time, that time has to come from somewhere. So where does one find the time to study? For me personally, it means getting up earlier, staying at work later, and spending most of my weekends doing questions. This is likely the case for any resident wishing to do well, however for those of us with families or significant obligations outside of work, the implications of this are farther reaching. Dedicating this time means not just sleeping less, but also missing out on date nights, family dinners, and bedtime stories.

During ABSITE season everything in my dual career household changes. My husband’s workload increases dramatically, as he takes on nearly all of the household work and childcare load that we usually share. Those without children are often unaware of the second job I’m responsible for when I go home each day. I’ve even had a male peer with children tell me they don’t have the same strain in their homes during ABSITE because their partner does the majority of the housework and childcare year-round. For me however, doing well on ABSITE is not simply a reflection of how much work I put into studying, but it is also a reflection of how much my family is willing to sacrifice to support me becoming a surgeon. 

Residents are often advised to improve ABSITE scores through a conversation about study materials and strategies, while avoiding the harsh truth. In order to improve a score, residents, who are already strapped for time, have to identify additional time they must take away from something else and instead allot it to studying. In doing this they must also identify others who can then fill in the gaps at home or elsewhere created by pulling that time. Ultimately, it is the identification and commitment of time to study as well as support from others that is the key to ABSITE success, without it no question bank or organized study strategy is enough.   

References:

Godellas CV, Hauge LS, Huang R. Factors affecting improvement on the American Board of Surgery in-training exam (ABSITE). Journal of Surgical Research. 2000 Jun 1;91(1):1-4.

Godellas CV, Huang R. Factors affecting performance on the American Board of Surgery in-training examination. The American journal of surgery. 2001 Apr 1;181(4):294-6.

 

Martha Godfrey, MD, MS  is a PGY-5 general surgery resident at the University of Florida- Jacksonville and former fellow of the American College of Surgeons – University of Wisconsin Surgical Education Research Fellowship. After college at the University of Chicago she became an English teacher in Western China with the Peace Corps. She then completed medical school at Emory University. Following residency she will be continuing her training in the 2 year AAST Acute Care Surgery Fellowship at the University of New Mexico. Outside of work, she is a wife and mother to two small children who keep her busy.


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