Today’s inane image of the day:
[Updated 9/2022 with updated TrueLearn discount ($25 off!)]
Introduction
For those of you at the beginning of your residency trying to plan for future exams, please start with my guide to studying for the ITE and my entry on studying for the ABA BASIC exam, first. Then make your way back here when you’re a CA3.
If you’re a CA3 or a graduate about to take the ABA ADVANCED exam, you’re in the right place.
Some basics about the ADVANCED exam
After graduating from residency, you’ll take the ADVANCED Exam. It focuses on clinical aspects of anesthetic practice and emphasizes subspecialty-based practice and advanced clinical issues. We’ll assign you an exam date after you register and can only change your assignment for religious observance, military commitments and medical accommodations.
https://theaba.org/staged%20exams.html
There is always a summer (July) and a winter (January) examination period. Exact dates can be found on the ABA website. For each administration, there are two days – you have no say in which day you are going to take it. Usually the days are Friday and Saturday.
The exam isn’t cheap [but it’s cheaper than the APPLIED, heh]. Standard registration starts at $875 and late registration is $1375. My residency program reimbursed the cost of the exam as long as I registered during the standard registration period – make sure with your program what the stipulations are for getting this cost reimbursed.
Just like the BASIC exam, the ADVANCED has 200 questions and you’re given 4 hours to complete the exam. Questions are usually short and to the point. Check out these sample questions to get an idea of the style.
How do you have any credibility to advise me?
Well, like the BASIC exam, I passed my ADVANCED exam on my first attempt, July 2019, immediately upon completion of my residency. I did not pass with the highest percentile [
WAMC [what are my chances] of passing? Show me the data!
Lucky you, the ABA released information on pass rates for the ADVANCED exam between 2011 and 2017. Here’s what it looks like:
Remember, the ADVANCED is a relatively new exam and the first examination was in 2016. The two administrations of the ADVANCED have had 90%+ pass rates, which is reassuring!
Another question that arises is whether there is any other type of score that can help you determine your chances of passing. For those of you currently in residency, it can be helpful to use your ITE score to determine where you stand for passing the ADVANCED. This being said, February to July (or January if you take the later administration) can be a long time, so even if you do really well on the ITE, that doesn’t mean that you shouldn’t study for the ADVANCED!
Here was the breakdown of scaled ITE scores compared to the ADVANCED pass rate:
As you can see, if you’re in the middle of the road or higher, you’re probably in pretty good shape for the ADVANCED!
So, if you did okay on the ITE and you’re willing to put in some work, you should pass the ADVANCED. This being said, you shouldn’t blow this exam off!
Some unsolicited advice
Many of you may be looking forward to finally graduating residency, starting a new job or fellowship in July. Taking another board exam can feel like just another annoying task to check off. I urge you not to blow this exam off. While the pass rate is higher than the APPLIED [e.g. oral boards/OSCE], it is still a standardized exam that is expensive and time consuming. You do not want to put yourself in a situation where you may have to re-take it.
I personally decided to go “straight through” [I graduated residency on June 30, 2019 and started fellowship on July 1, 2019]. I took my ADVANCED boards on July 27, 2019 after working a full month in the ICU. Because I was the only fellow in my class that started on July 1st, I had a tough clinical schedule. On top of this, I have been planning the American Medical Women’s Association [AMWA] meetings for the last 6 years and this year, the meeting was conveniently scheduled for the same weekend as my exam. To say that I was a bit over-committed… is an understatement.
Looking back, if I knew I would be working 3 weeks of nights leading up to the meeting, I would have started fellowship August 1st. By some miracle, I was able to study enough for the exam to still pass. I was falling asleep during the exam, despite my best efforts at sleep hygiene [i.e. melatonin, getting ready for bed early] the night before.
Long story short, make sure you give yourself adequate time to study AND transition into a new role [whether that’s graduating, fellowship, a new job, a new city, etc].
Studying for the ADVANCED
I sat down about 3 months prior to the exam to decide which resources I would use. I’m motivated by some sort of countdown or numeric progress on my studying, so I created a very simple Google spreadsheet with the 3 resources I decided to focus on finishing. For the book, I wrote the total number of chapters at the top and for each chapter I read, the bottom of the table updated with what was left. For my question-based resources, I put the number of questions at the top with the total left at the bottom. I roughly calculated how many chapters/week and questions/week I needed to do in order to finish all of the resources with a 2 week buffer.
I don’t know about you, with every passing year it has become harder for me to sit down and focus on studying. Many of you have partners, children, or other commitments that take time and effort. As residents, although it’s still “training,” it feels more like a job rather than school, which can pose another challenge for studying. Because of this, I really tried to get out of my apartment to force myself to study for a specific amount of time. It didn’t always work, but I think I got more done this way.
TEXTBOOK. By this point, most of you have discovered your favorite textbook or review book to study from. If you want some ideas, check out my ITE post for the resources I’ve used to study.
REVIEW BOOK. If I had extra time, I would have taken the ABA ADVANCED Content Outline and created my own study guide. But because I only had 3 months, I opted to use Anesthesiology Core Review: Part Two ADVANCED Exam as my study guide. The review book is based off of the Content Outline and is much better than Part One of the series [I found that Part One had enough mistakes and typos to make it distracting from studying the material].
I made sure to read the entire book and look up the areas where I was weak. The review book is comprehensive in what it covers for the exam.
QUESTION BANKS. I think that the USMLE exams have conditioned us to rely on question banks. Anyway, I stand by the TrueLearn ADVANCED Smart Bank [$10 off if you use my link or code “AMANDAXI”] – you just buy the number of months you have left until your exam and you can access the question bank from your computer OR your phone. The app really made a huge difference – many of the other question bank resources do not have a dedicated app or an easy to use interface, so I appreciate this about TrueLearn.
I want to mention that the ABA recognizes that more and more anesthesiology residents are using TrueLearn. Questions are not as similar as they had been in the past, however, the TOPICS are the same. The explanations should teach you enough to figure out how to answer a question on the topic.
I finished the question bank then went back and did all of the questions I got wrong over again. If I had more time, I would’ve completed the entire question bank over again. TrueLearn does NOT let you reset your subscription, but has built in tools to allow you to complete all of the questions a 2nd, 3rd, 4th, etc time.
Finally, another resource that you can use if you run out of TrueLearn questions are the ACE books from the ASA. It’s a pricey resource [with ASA membership, it’s $75/book], so you might want to consider sharing it with someone else or asking your residency program to purchase them annually as a resource. My program purchased the ACE books annually for all of the residents. Although the resource doesn’t come from the ABA directly, it has some of the BEST explanations I’ve seen.
Parting advice
Something I didn’t mention earlier was that my ITE performance my CA3 year was pretty abysmal. Because of this poor performance, I knew that I really had to sit down and commit to learning the material. I did exactly what I recommended above and passed my ADVANCED exam. It wasn’t my best performance [you actually get a percentile score report from the ADVANCED], but it’s done and I’m now focusing my attention on the APPLIED exam.
Even though this is WAY in the future for those of you reading this entry, the day that you get your score [Pass/Fail] from the ADVANCED, the APPLIED exam registration opens. Be ready to register for the APPLIED IMMEDIATELY upon receiving your email notifying you that results are available. I didn’t heed this advice and am now taking my APPLIED more than a YEAR later. As a result, my critical care boards have been delayed a year, too.
Anyway, remember that YOU’VE GOT THIS.
As always, feel free to drop me an email or message on Instagram/Twitter.