Residents' Review: Changes to ABA Board Exams

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June 1, 2013 Volume 77, Number 6
Residents' Review: Changes to ABA Board Exams Katie J. Schenning, M.D., M.P.H. Resident Component Governing Council

The American Board of Anesthesiology (ABA) recently announced details of a transition in the process by which anesthesiology residents become Board-certified anesthesiologists. This paradigm shift happens to coincide with the 75th anniversary of the establishment of the ABA. As this will represent a significant change for new residents, we would like to present some of the most frequently asked questions about the new process.

Will the new certification process include additional testing?
Yes. Traditionally, Board certification has required a written exam and an oral exam, both of which were taken after residency was completed. Part 1, the written test, is currently taken at the end of July or beginning of August following the CA-3 year. Rather than a single exam, Part 1 will now consist of the BASIC Examination, taken during residency, and the ADVANCED Examination, taken after the completion of residency training. Consequently, there will now be a total of three exams rather than two.

What will the BASIC and ADVANCED Examinations cover?
According to the ABA, the BASIC Examination will focus on the scientific basis of clinical anesthesia practice and will concentrate on content areas such as pharmacology, physiology, anatomy, anesthesia equipment and monitoring. The ADVANCED Examination will focus on clinical aspects of anesthetic practice and will emphasize subspecialty-based practice and advanced clinical issues. Similar to the current Part 1 Examination, the BASIC and ADVANCED Exami-nations will each consist of 200 multiple-choice questions of A-type, G-sets and R-sets.

When will the BASIC exam be administered?
The BASIC exam will be taken by residents starting in July of the CA-2 year, and will be offered each January and July throughout the CA-2 and CA-3 years.

What will happen if a resident fails either the BASIC or the ADVANCED Examination?
Failing the exam on the first attempt does not change the length of residency training, although it does obligate the resident to take the test again. If a resident fails the BASIC Examination twice, the residency program is required to assign an “unsatisfactory” for Medical Knowledge on the Clinical Competence Committee (CCC) report for the six-month period in which the exam was administered. After a candidate fails the BASIC Examination for a third time, his or her training must be extended by six months for each CCC reporting period in which he or she has not passed the BASIC Examination. It will not be possible for a resident to graduate from residency training without passing the BASIC Examination.

While failing the ADVANCED exam has no bearing on graduation from residency, both the BASIC and the ADVANCED exams must be passed before an individual is eligible to sit for the “oral boards.”

Will there be any changes to the oral boards?
What is currently the ABA Part 2 (Oral) Examination will become the APPLIED Examination. Beginning in 2017, in addition to the traditional Oral Examination questions, the APPLIED Examination will include elements of Objective Structured Clinical Examinations (OSCEs) in which the candidate will be evaluated in a number of simulated clinical situations. The OSCE will assess aspects of clinical practice, including history-taking, physical exam, procedural skills, decision-making, counseling, professionalism and communication. A dedicated assessment center is being created at the ABA headquarters in Raleigh to administer the current Part 2 (Oral) and future APPLIED Examination.

Who will be affected by these changes?
Residents beginning their CA-1 year in July 2013 will undergo the new certification process. Residents further along in training – those completing residency training before June 30, 2016 – will still be required to successfully complete the current Part 1 (Written) and Part 2 (Oral) Examinations for Board certification within seven years of completing residency training.

Will the additional test mean paying additional fees?
Though each of the three exams will incur a separate fee, the total cost for the staged examination system will be unchanged from the current total cost of the Part 1 and Part 2 Examinations.

Why are these changes being implemented?
The realignment in the certification process will complement the Accreditation Council for Graduate Medical Education’s transition to the Next Accreditation System, an outcomes-based accreditation process focused on competency-based training. Additionally, the transition to staged exams is intended to encourage residents to engage in continuous study throughout the course of residency training.

Where can I find more information?
Further information regarding the examinations, including content outline and examples of each of the three types of multiple choice questions, can be found on the ABA website

Katie J. Schenning, M.D., M.P.H. is an anesthesiology resident, Oregon Health and Science University, Resident member of ACGME Anesthesiology Residency Review Committee (RRC) and Vice-chair, ACGME Council of Review Committee Residents (CRCR).