Resident In-Training Exams

María Eugenia Mulero
Nov 26, 2022
2 min read

Updated: Jan 18, 2023

So, you've gone through countless standardized exams and you're thinking "Once I enter residency, I'm done! No more tests!" Wrong.

What is the In-Training Exam?

Resident In-Training Exams (ITEs) are tests designed to evaluate residents' progress while forming part of a residency program. "They provide program directors with comparative knowledge assessment data to better understand program year (PGY) class progress and the knowledge gaps between residents in their respective PGY" [1]. It is taken annually, and the date will depend on the residency program. For example, General Surgery programs take it in January, Internal Medicine in September, etc.

How is the test graded?

Tests may differ in their composition by specialty. For example, the ABSITE is a one-block five-hour exam composed of 250 multiple-choice questions. ITE reports will provide you with a full rundown of your performance per topic tested. It will score you based on two things: the percentage of questions you got right, and your percentile compared to other residents across the United States that are at your same PGY level.

What is it used for?

ITE performance has been related to board performance. The better you do in ITEs, the more likely you are to pass your specialties board upon graduation. It is a measure of how well your program is preparing you. It is also taken into account by Fellowship programs when reviewing applications. The better your scores, the more likely you are to get into a Fellowship program.

How do you study for the ITE?

Studying for the ITE is like preparing for a marathon. Studying should be yearlong with a focused "crunch time" in the months coming up to it. Everyone has different ways to approach it and there are tons of resources available such as question banks, review books, podcasts, review courses, etc.

The gist of it

Although it sucks to be constantly judged and compared based on standardized tests, programs need data to assess their residents' progress and Fellowships use numbers to compare candidates. My ABSITE (American Board of Surgery In-Training Exam) is coming up. This is my fifth year taking the exam and it doesn't get any easier. Having a good percentile is harder every year because your percentile score is affected by even the slightest change in your percent correct and it gets narrower every year. I am cramming to get that short-term memory to its maximum capacity, stressed about Fellowship applications, and rotating through surgical services. It's a balancing act.

Tips

Study the "big picture" yearlong and focus on the details closer to the exam date.
Questions, questions questions. Do as many questions as you can and be sure to study the concept carefully. Ask yourself why the other options aren't the correct choice. The question's concept may pop up on the ITE in a different way.
Prepare flashcards and drill details that are pathognomonic.
Have a study plan that works for YOU and don't get stressed out if it is different than someone else's. Remember, not everything works for everyone.
My favorite resources for the ABSITE are: