How to Prepare for the ABA ADVANCED Exam

Prepping for an Anesthesiology Board Exam? Get a comprehensive ABA BASIC or ABA ADVANCED board review course from The Pass Machine to get your board prep on track.

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The ABA ADVANCED Exam is the second written test that an anesthesiologist must take in the process of becoming a board-certified anesthesiologist through the American Board of Anesthesiology (ABA), with the BASIC Exam being the first test. The ADVANCED Exam is taken after graduation from an anesthesia residency. It is offered twice a year: in the late summer and 6 months later in the winter.

You register for the ABA ADVANCED in the spring prior to graduation. You must pass this test before you can register for the oral portion of your anesthesia board exam. Also, keep in mind you must be a board-certified anesthesiologist, with satisfactory clinical anesthesiology training before you can register for your specialty anesthesia board exams.

It is a different test than the ABA BASIC and covers more of the subspecialty and clinical duties of an anesthesiologist, rather than basic science. It’s still important to retain some of that foundational information, both for this exam and for your career as an anesthesiologist. It is recommended that you study for this test for at least 3 months, though for all board examinations, I recommend starting to study early. It’s especially important to start studying early if you are moving after residency either for your first attending job or fellowship, as these life events can significantly disrupt your study schedule.

You shouldn’t take the ADVANCED exam lightly. I thought the test was more challenging than some question banks led me to believe. When your exam result comes out, you should try to immediately register for an oral exam to get a test date within a reasonable amount of time. I know people who couldn’t get an oral test date for over a year out because they didn’t immediately register.

ABA Exam Blueprint

The ABA provides an exam blueprint that details the exam content categories: basic sciences, clinical sciences, organ-based basic & clinical sciences, clinical subspecialties, and special problems or issues in anesthesiology. The ABA exam blueprint is also a content outline that lists the relative percentage of questions from each content category that will appear on the exam. It also details the more specific content category percentages such as each organ-based system and the clinical subspecialties.

What is the format of the American Board of Anesthesiology ADVANCED Examination?

The ADVANCED Exam consists of 200 questions which you have 4 hours to complete. It includes A-type items which are single-best-answer multiple-choice questions that require the application of knowledge acquired, rather than simple recall of factual information. These questions often include a brief clinical vignette followed by a lead-in question and four response options. The ABA ADVANCED includes questions that reference static images. A small number of exam questions may include short video clips. The exam is scored as pass/fail.

What do the ABA ADVANCED Exam questions cover?

Studying for the ABA In-Training Exam (ITE) will include a great deal of overlap in knowledge needed to pass the ABA ADVANCED. While the BASIC Exam focused on the scientific basis of clinical anesthesia practice, the ADVANCED exam focuses on clinical subspecialties such as pediatrics, obstetrics, critical care, etc. This applied exam covers basic sciences and organ-based sciences, although these topics represent fewer relative percentages of questions present compared to the ABA BASIC. All of these topics are covered in the practice questions on The Pass Machine’s Anesthesiology ADVANCED Board Review course.

You can find a content outline on the ABA website that provides the framework for the assessment of anesthesia knowledge, however, this outline covers the ITE, BASIC, and ADVANCED exams and based on how it is written, serves as only a guideline for anesthesia content that’s required for board certification.

Clinical Anesthesiology Training: Preparing for the ABA ADVANCED Exam After the BASIC Exam

I made it a point to start studying early for the ABA ADVANCED examination because I was starting a busy fellowship that required a cross-country move very shortly after graduation from residency. I came across the American Society of Anesthesiologist‘s list of ADVANCED Exam review resources and found that many resources were similar to those which I used for the BASIC exam.

The general study resources I used to prepare for the exam were keywords, listening to podcasts, completing multiple question banks, and reviewing flashcards. I tried to focus on topics that I missed from my previous year’s ITE. As I did with studying for the ABA BASIC, I asked my Attendings and recently graduated residents what study materials they found helpful and worthwhile. I also focused on topics that I missed in my previous year’s ITE. I still tried to study for an hour or two a day and use any downtime at work to use mobile-friendly board review apps.

I’ve always been a fan of the Anesthesia and Critical Care Reviews and Commentary (ACCRAC) podcasts which allowed me to study while driving and working out at the gym. Open Anesthesiology also publishes a free list of keywords that allow you to study, test yourself, and review specific concepts that are frequently tested on and missed on the board exam. My residency incorporated keyword lectures into our weekly didactic education.

Best Anesthesiology Board Review

The best review courses contain a little bit of each of the different fundamental board study learning modalities: audio, visual, and question banks. If time/money allows, you can use additional question banks: one to learn from with detailed answer explanations and another to test your knowledge. Question banks and practice exams alone don’t cover every topic you’ll see on test day, that’s why a comprehensive board review course is such an effective way to prepare. 

The Pass Machine offers a 12-month subscription to their Anesthesiology ADVANCED Board Review which consists of 1500+ practice questions, 42 hours of recorded and audio-only lectures from board-focused faculty, an illustrated study guide, access to an online study group with other course participants, and time-easy accessibility to these sources via an iOS & Android app. The Pass Machine’s free blog also has other resources that can be useful for both anesthesia board studying as well as clinically during anesthesia residency.

The Pass Machine offers a triple trust guarantee on their Anesthesiology board review courses, meaning that if you sit for the exam and fail, notify The Pass Machine within 45 days of the date of your result notification and you will receive 110% of your paid tuition for the board review course, plus a free subscription renewal. 

Need help studying for the ABA ADVANCED Exam?

In addition to anesthesiology board prep resources, you can access a free EXACT exam prep guide to create a customized study schedule for your anesthesiology exam at The Pass Machine. This free tool outlines what you should study, and how long you should spend studying it, specifically for the ABA ADVANCED examination.

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Still need more help prepping for your Anesthesiology Board Exam? Get 100 FREE ABA BASIC or ABA ADVANCED practice questions from The Pass Machine!

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ABA ADVANCED Exam: Frequently Asked Questions

What is the ABA ADVANCED Exam?

It is the second half of the written examination required to achieve board certification status in anesthesiology. It is taken after residency is successfully completed, while the first half of the written boards (BASIC examination) is taken at the end of CA-1 year.

How many times can you fail the ABA ADVANCED Exam?

There is no limit to the number of times you can fail the ADVANCED exam. However, according to the ABA, you must satisfy all requirements for board certification within 7 years from the last day of the year in which you graduated residency to satisfy all certification requirements. If you don’t, you’ll have to reestablish eligibility for the ABA exam system, meaning you’ll need to retake the BASIC exam.

What is the ABA ADVANCED Exam pass rate?

The pass rate has slowly been declining since 2018. In 2022 the pass rate for all test takers was 84%.

How long do I need to study for the ABA ADVANCED Exam?

I would recommend at least 3 months of studying, but longer is better to allow any unexpected changes to your study schedule.

How long is ABA ADVANCED Exam?

The ADVANCED Exam consists of 200 questions, and examinees have 4 hours to complete the exam.