The Impact of a Structured ABSITE® Remediation Program on Resident Performance

We aimed to identify the impact of a formalized American Board of Surgery In-Training Examination (ABSITE®) remediation program at our institution, with a primary outcome of avoidance of ongoing remediation.

Residents with ABSITE® scores below predetermined performance metric targets were assigned to a mandatory remediation program consisting of assigned quizzes through a purchased question bank repository, faculty meetings with individualized learning plan (ILP) development, and a mock ABSITE®. Question bank usage and performance were compared to ABSITE® performance standardized to the national median for the training year.

This work was conducted within the Medical College of Wisconsin academic general surgery residency program (Milwaukee, WI) across the 2023-2025 academic years.

Ten residents were assigned to the remediation program, based on scores below the 30th percentile on the 2023 ABSITE®, and 5 additional residents utilized the question bank but were not in remediation for the 2023-2024 academic year. Five residents were assigned to the remediation program, based on predetermined percent correct targets for postgraduate training year for the 2024 ABSITE®, and 32 additional residents utilized the question bank but were not in remediation for the 2024-2025 academic year.

Across the 2023-2024 and 2024-2025 academic years, 5 (50%) and 2 (40%) residents within the remediation programs improved their ABSITE® performance above the remediation threshold for the following year. During the first study year, a higher volume of practice question performance correlated with more profound score improvement, particularly when completed gradually throughout the academic year. Significant correlations were also observed between mock ABSITE® scores and ABSITE® performance during both study years.

Implementation of a formal ABSITE® remediation program at our institution was associated with improved resident performance, highlighting the value of structured support and informing ongoing efforts to address persistent underperformance.