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Options for a Low ABSITE Score

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Frustrated surgeon leaning up against a wall after learning that he got a low ABSITE score.


You just got your score report back for the ABSITE and your score is below the goal you set for yourself. Perhaps you dedicated months to preparing or perhaps this was the year your winter rotation schedule was so brutal you had no time to prepare. Regardless of the reason, don’t panic! Although you can’t “drop” a score, you have options no matter the scenario. The key to success is to understanding the reason for the score and planning for the future. Below, we will review your options after a sub-optimal ABSITE score.


What is a “low” ABSITE score?

This is often the most important question to be addressed after receiving your score report. While many general surgery residents may be used to scoring in the top percentiles on other standardized tests in the past, the ABSITE is a whole different animal. First and foremost, know your “competition”: every other surgery resident at your level of training. If you are a second or third year resident, you may also be competing against residents who have stepped away from clinical training for research, advanced degrees, or other reasons – these residents will be scored against residents in the year of training that they most recently completed. Yes, that means if you are PGY-3, you are competing with residents who are PGY-5 or 6 (having completed their 3rd year of clinical training and in the midst of two or three year research fellowships). While this fact may not alter your score, it does afford some perspective. 

Furthermore, a resident should not expect to score in similar percentiles as they have on tests of the past. Given the degree of competition, residency and fellowship program directors will admit that a score above the 50th percentile is in a good range, even for competitive fields such as pediatric surgery and surgical oncology. While this may seem questionable at first glance, remember that this indicates a superior score as compared to more than half of the residents in the nation in that respective year. In general, a score below the 50th percentile may leave something to be desired, while test-takers with scores below the 30th percentile are typically flagged by resident program directors for added help. 


Scenario 1: I took the ABSITE for the first time and scored very lowly

Frequent pitfalls for interns take the ABSITE for the first time are failing to prepare adequately and/or failing to identify helpful study material. A poor score on your first ABSITE is not reason for panic but is rather a call to action. If your score was below your goal, take an honest and objective look back at your study plan. Did you start two to three months ahead of the exam with enough time to read one of the review texts and complete a question bank? Or did you start studying with less than one month to go (considered “cramming”, given the extent of information tested)? If you fall into the latter camp, you have your explanation and you can start planning accordingly for next year. But if you fall in the former group, perhaps you need to reassess the study materials you have selected. You should also look ahead to your clinical schedule for next year and do your best to avoid an extremely busy/stressful rotation the month prior to the ABSITE. Remember, EMP has ABSITE tutoring services available to improve your scores!


Scenario 2: I scored very lowly on the ABSITE for the first time after previous good results

This is probably the most common scenario for general surgery residents. In the past, perhaps you scored much better and this year was your first subpar performance. Even if you dropped from above average to a single-digit percentile, don’t abandon all hope. Some of the greatest leaders in academic surgery have shared similar ABSITE “horror” stories. While your singular anomalous score is not cause for panic, it is still an opportunity to objectively reassess the reason for your drop. If you were post-call, in the midst of your hardest clinical rotation, you need to make every effort to avoid a similar fate next year. If you took your foot off the gas and didn’t put in the typical amount of studying, then this is a healthy reality check for you. The most important factor after a subpar ABSITE score is the score the next year. If you demonstrate a return to your typical form the next year, it is infinitely easier to justify the drop and wash it clean from your record, particularly for fellowship applications. 

Note: if you did fairly well on your intern year ABSITE but bombed your PGY-2 test, be cautious about ignoring this result or writing it off as an “off year” because intern year ABSITE scores are traditionally inflated by non-surgery residents completing prelim surgery years for whom the exam carries no value.


Scenario 3: I have taken the ABSITE previously and have scored very lowly more than once

This is the most at-risk group of test-takers. Failure to perform on the ABSITE is predictive of an increased likelihood of failure of the written boards, hence the importance of results to both residency and fellowship programs. Some residency programs will elect to have residents remediate clinical training years based in part on ABSITE performance. Similarly, some fellowship programs, particularly in competitive fields, will flag a potential fellow’s application if there are multiple low scores. Residents with multiple low scores need to seriously consider their study methods prior to taking future ABSITEs. The most effective strategy to improve scores is a study plan that uses multiple resources, including a review book, a question bank of good quality, flashcards, and possibly a dedicated ABSITE tutor.  Failing to act in response to a series of poor scores is preparing to fail. Without a serious change in study practices, it is extremely unlikely that a test-taker will dramatically improve from one year to the next. Did I mention, EMP has ABSITE tutoring services available to improve your scores?


Scenario 4: I am preparing to take the ABSITE for the first time

If you are reading this a few months prior to your first ABSITE, you are in a great spot to plan for success. Use the resources mentioned above and create a study schedule that you can maintain (see our blog post on creating an ABSITE study schedule). Make a record of the resources you used so that you can objectively assess their relative utility after you receive your score reports.

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About the Author

Michael Zobel, MD

Michael Zobel graduated Phi Beta Kappa and Magna Cum Laude from the University of Southern California as a member of the Baccalaureate/MD Program, with a…

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