General Surgery Board Review Practice Test

General Surgery Board Review Exam at a Glance

What changed for General Surgery Board Review in 2026

• Oct 25, 2026: Eligibility (Certifying Exam (GSCE)) changed to Pass GSQE (plus unconditioned U.S./Canadian license) (previously Pass GSQE + full unrestricted U.S./Canadian license).^[2]
• Oct 25, 2026: Passing score (Certifying Exam (GSCE)) changed to No preset pass/fail rate (previously No preset pass rate; aggregate of 6 examiners).^[2]
• Oct 25, 2026: Eligibility (Qualifying Exam (GSQE)) changed to Completed general surgery residency (previously Completed ACGME/RCPSC general surgery residency).^[1]
• Oct 25, 2026: Time limit (Qualifying Exam (GSQE)) changed to Four 115-minute sessions (previously Four 115-minute sessions (~8 hours)).^[1]
• Oct 25, 2026: Retake policy (Certifying Exam (GSCE)) changed to Up to 3 attempts in 3 years; once per academic year (previously Up to 3 attempts in 3 years).^[2]
• Oct 25, 2026: Delivery (Qualifying Exam (GSQE)) changed to Pearson VUE testing centers (previously Pearson testing centers).^[3]
• Oct 25, 2026: Delivery (Certifying Exam (GSCE)) changed to Virtual oral exam (Zoom) (previously Virtual oral exam).^[2]

What the General Surgery Board Review is and how it works

According to American Board of Surgery, “The exam consists of about 300 multiple-choice questions, lasting approximately eight hours”^[1]

The American Board of Surgery (ABS) certifies general surgeons through two exams, and they are very different in style.

The Qualifying Exam (GSQE) is computer-based and delivered at Pearson VUE testing centers. It has about 300 multiple-choice questions, administered in four 115-minute sessions with a scheduled break after each session. Applicants must have completed a general surgery residency. Results are posted approximately 4-6 weeks after the exam. Applicants get up to 4 attempts in 4 years, and the exam is offered once per year.

The Certifying Exam (GSCE) is a virtual oral exam held over Zoom. It consists of consecutive 30-minute sessions, each conducted by a team of examiners. You must first pass the GSQE, and you need an unconditioned U.S. or Canadian license. Results are posted within 10 business days after the final day of the exam. Applicants are offered up to 3 attempts within 3 years, and the exam is offered once per academic year. The ABS states that its certification decision is not based on any preset pass/fail rate.

Candidates have no more than 7 academic years following residency to complete the certification process. Licensing details, fees and application deadlines are not covered here, so check the ABS website for the current rules before you apply.

General Surgery Board Review content outline and where to practise each area

The content areas below are copied from the official General Surgery Board Review content outline published by American Board of Surgery, with the share of the exam each area carries. The right-hand column shows which of our practice sets covers it.

Worked examples: how to reason through General Surgery Board Review questions

These are practice questions written for this site, not questions from the real exam. Each explanation shows why the right answer is right and why the others are wrong.

Example 1

Question: Which ASA physical status classification is assigned to a patient with severe systemic disease that is a constant threat to life?

1. ASA II
2. ASA III
3. ASA IV
4. ASA V

Answer: C. ASA IV

Explanation:

ASA IV is correct because it describes a patient whose severe systemic disease is a constant threat to life, for example a recent heart attack, stroke or ongoing cardiac ischemia. ASA II is wrong because it describes only mild systemic disease without real functional limitation. ASA III is wrong because the disease is severe and limits activity, but it is not an ongoing threat to life. ASA V is wrong because it is reserved for a moribund patient who is not expected to survive without the operation.

Rule to remember: the ASA class rises with how much the disease threatens life now. Look for the words that mark the step, such as mild, severe, constant threat and moribund.

Example 2

Question: Which of the following best describes the Hartmann's procedure?

1. Sigmoid resection with primary anastomosis and diverting loop ileostomy
2. Anterior resection of the rectum with colorectal anastomosis
3. Sigmoid resection with end colostomy and closure of the rectal stump
4. Total colectomy with ileorectal anastomosis

Answer: C. Sigmoid resection with end colostomy and closure of the rectal stump

Explanation:

Hartmann's procedure is a sigmoid resection with an end colostomy and closure of the rectal stump, so that option is correct. It is used in emergencies when joining the bowel ends is unsafe. Sigmoid resection with primary anastomosis and a diverting loop ileostomy is wrong because it restores continuity at the time of surgery. Anterior resection with colorectal anastomosis is also wrong because it joins the colon to the rectum. Total colectomy with ileorectal anastomosis is wrong because it removes the whole colon and rejoins ileum to rectum.

Rule to remember: Hartmann means no anastomosis, an end stoma and a closed stump. Choose it when contamination or instability makes a join risky.

Example 3

Question: A patient with papillary thyroid carcinoma has clinically apparent lateral neck lymphadenopathy (N1b disease). Which surgical procedure is required for the lateral neck?

1. Level I node dissection only
2. Central neck dissection (Level VI) only
3. Therapeutic lateral neck dissection (Levels II-V)
4. Total lateral neck dissection including Level VII

Answer: C. Therapeutic lateral neck dissection (Levels II-V)

Explanation:

Therapeutic lateral neck dissection of Levels II-V is correct because clinically apparent lateral nodes in N1b papillary thyroid carcinoma call for clearing the lateral compartments that drain the gland. Level I node dissection only is wrong because Level I lies in the submental and submandibular region and is not the usual drainage path. Central neck dissection of Level VI only is wrong because it treats the central compartment and leaves the diseased lateral nodes. Total lateral neck dissection including Level VII is wrong because Level VII is in the upper mediastinum and is not part of a standard lateral dissection.

Rule to remember: match the operation to the compartment that is involved, central for Level VI disease and lateral for Levels II-V disease.

How to use these practice tests

Start with the official ABS pages for the exam you are about to sit, so you know the delivery format, the rules on attempts and the content areas. Then use the blueprint table on this page to see which practice set matches each area.

Take a mixed MCQ set cold to find your weak areas. Do not worry about the score at this stage. For every miss, read the explanation, then write one line in your own words stating the rule behind the right answer. Return to the area-specific sets for the topics where you missed the most, and repeat them after a few days so you are testing recall rather than recognition.

Give extra time to areas that carry a large share of the blueprint, such as the alimentary tract, abdomen and surgical critical care. Do not neglect small areas, since they still appear.

If you are preparing for the Certifying Exam, which is oral, use the case-based sets as prompts. Say your answer aloud as if an examiner were listening: state the diagnosis, the immediate step, the operation and the main complications. Our questions are written by us and are not real exam questions, so treat them as practice for reasoning, not as a prediction of what will be asked.

Sources & last verified

1. American Board of Surgery — number of questions, time limit, retake policy, eligibility (official source). “The exam consists of about 300 multiple-choice questions, lasting approximately eight hours” Verified Oct 25, 2026 · source checked Oct 23, 2026.
2. American Board of Surgery — time limit, passing score, retake policy, validity (official source). “It is a virtual oral exam consisting of three consecutive 30-minute sessions, each conducted by a team of two examiners.” Verified Oct 25, 2026 · source checked Oct 23, 2026.
3. pearsonvue.com — delivery (official source). “The ABS offers computer-based testing through Pearson VUE” Verified Oct 25, 2026 · source checked Oct 24, 2026.
4. American Board of Surgery — other (official source). “abdomen 12%” Verified Oct 28, 2026.

How we verify: editorial & fact-checking policy. Report an error: contact us.