Enhancing Resident Preparedness for the American Board of Surgery Certifying Exam Through Low-Stakes Mock Oral Sessions.

Abstract

Background: The American Board of Surgery (ABS) requires trainees to pass both a written qualifying examination (ABSQE) and oral certifying examination (ABSCE) to achieve board certification. The high-stakes nature of the ABSCE, which assesses knowledge, clinical judgment, and decision-making, necessitates extensive preparation. To address the challenges of the ABSCE format and associated trainee stress, structured mock oral programs have been developed. Here we evaluate the impact of structured mock oral sessions on residents' comfort levels and familiarity with the ABSCE at a single institution.

Methods: A mixed-methods survey was given to 50 general surgery residents in different training years who participated in 1-hour individual mock oral sessions with an attending surgeon between August 2021 and February 2024. The survey assessed demographic information, previous oral board practice experience, confidence describing the test format, and identified common pitfalls before and after the session. Statistical analyses using McNemar's chi-square test and a thematic analysis of open-ended responses were performed.

Results: We observed a significant increase (70% of participants) in residents' reported confidence while describing the ABSCE format and identifying common pitfalls (68% of participants) after the sessions, compared to pre-implementation of the mock oral practice sessions. Many residents (97.9%) found value in frequent mock oral sessions. Residents identified insufficient practice, clinical experience, and time for preparation as barriers to their success.

Conclusion: Repeated, low-stakes mock oral practice sessions and protected educational time are valued by residents and could enhance examination readiness, thereby improving ABSCE pass rates (68%, prior to the 1:1 mock oral sessions, to 83% after the sessions were implemented). Future studies should explore the nationwide impact of integrating regular formal mock oral sessions into surgical residency programs.