How Many Attempts Are Needed to Achieve General Surgery Board Certification?

Objective: Surgical trainees are subject to pressure from variety of stakeholders to secure board certification from the American Board of Surgery (ABS). To meet these expectations, trainees must pass a written qualifying exam (QE) and an oral certifying exam (CE) within 7 years of completing general surgery residency. Board certification outcomes for candidates who fail either the QE or CE examination are not well characterized, but this information could help candidates, policymakers, and other stakeholders make informed decisions about how to respond to examination failure. Methods: We retrospectively examined ABS records for all surgeons who completed general surgery residency from 2000 to 2013 and attempted general surgery board certification. Results: Among 14,483 surgeons who attempted general surgery certification, 13,566 (94%) passed both the QE and CE within the 7-year certification window. Of those who did ultimately obtain certification, 97% passed the QE within 2 attempts and 97% passed the CE within 2 attempts. For those who failed either the QE or the CE twice, 67% ultimately obtained certification. Conclusions: Most surgeons who obtained ABS general surgery board certification did so within 2 attempts at each board examination. Candidates who fail either examination twice are less likely to achieve board certification.