Jacqueline J. Blank, MD; Joshua C. Dilday, DO
WMJ. 2026;125(1):113-114.
Graduating general surgeons are required to pass a two-part board certification exam: the first is the written exam – the American Board of Surgery (ABS) Qualifying Examination (QE). Upon successful completion of the QE, they must take the oral board exam – the ABS Certifying Examination (CE). While written exams and test-taking techniques have long been engrained in medical education, oral exams strategies are far less familiar.1 Oral exams are not unique to general surgery; anesthesiology, otolaryngology, and ophthalmology are among the many other specialties that rely on them for board certification. Sequential participation in mock oral exams is associated with improved first-time pass rates among general surgery residents.2 Due to the COVID-19 pandemic, many specialties transitioned to a virtual format for the oral examinations, including general surgery. Following suit, the Medical College of Wisconsin (MCW) general surgery residency annual mock oral exam transitioned from an in-person to a virtual format in 2020.
The four general surgery residency programs in Wisconsin (Gundersen Health System, Marshfield Clinic Health System, MCW, and the University of Wisconsin) all utilize annual or biannual mock oral exam events, held internally or with a single neighboring institution. This has proven worthwhile for residents, but there are several drawbacks. At MCW, familiarity between examiner and examinee has potential for bias regarding both test answers and nonverbal communication. Examinees desire more impartiality, and examiners have noted that residents inappropriately tailored their answers to the examiner’s subspecialty.
In April 2025, the four institutions collaborated to offer the first Wisconsin statewide virtual mock oral exams. The 58 participating residents were divided into morning and afternoon sessions and were examined by 41 surgeons from around the state. Both community surgeons and academic surgeons volunteered as examiners. (See Figure in full-text pdf.) Each exam “room” was hosted by two examiners from different institutions, decreasing the risk of familiarity with the examinee. Residents rotated through three different exam rooms, with three separate scenarios per room.
Participant feedback was overwhelmingly positive. Residents from all institutions demonstrated poise, professionalism, and preparedness for the scenarios. Examinees received individual scores, written feedback, and a graphical representation of their performance relative to their peers. Faculty from all surgical subspecialties participated, and their feedback was invaluable. Several faculty expressed enthusiasm for participating in the 2026 virtual event. Suggestions for improvement included providing contact information for both examiners and examinees to facilitate discussion of performance and test-taking strategies, as well as implementing longitudinal measurement of examinee performance and correlation with oral CE scores. Additionally, the institutions hope to begin a similar event for fellows who may be taking the certifying exam shortly after beginning fellowship.
Oral board practice throughout residency is associated with improved first-time pass rates among general surgery residents. Involving multiple institutions has the added benefit of replicating a testing situation in which examinees are unfamiliar with their examiners. Multi-institutional mock oral examinations have been successful regarding examinee preparation, confidence, and certifying exam pass rates.2-4 However, much of the literature regarding mock orals was published prior to COVID-19. In these papers, residents were required to travel to a central institution. This utilized space and resources, diverting the workforce away from the residents’ home programs. Additionally, cost and safety concerns can impact travel.
To our knowledge, Wisconsin is the first to offer a virtual statewide mock oral exam. In addition to preparing trainees, the exam placed minimal burden on institutions; it was conducted virtually, required only 1.5 hours of absence per examinee, and did not significantly disrupt clinical duties. Furthermore, with the widespread adoption and accessibility of virtual platforms that emerged during the COVID-19 pandemic, exams will likely remain in a virtual format for the foreseeable future. Our virtual mock oral exam provided trainees with a format similar to the actual CE. Not only does this program benefit residents, but it may also positively impact the state: more than 52% of Wisconsin residents across all specialties remain in state for postresidency practice.5
We are excited to continue offering this educational event and remain committed to its ongoing contribution to Wisconsin trainees. We also believe it has the potential to be adapted for practice oral examinations across multiple specialties.
REFERENCES
- Maker VK, Zahedi MM, Villines D, Maker AV. Can we predict which residents are going to pass/fail the oral boards? J Surg Educ. 2012;69(6):705-713. doi:10.1016/j.jsurg.2012.08.009
- Fingeret AL, Arnell T, McNelis J, Statter M, Dresner L, Widmann W. Sequential participation in a multi-institutional mock oral examination is associated with improved American Board of Surgery Certifying Examination first-time pass rate. J Surg Educ. 2016;73(6):e95-e103. doi:10.1016/j.jsurg.2016.06.016
- Lu Y, Miranda R, Quach C, et al. Standardized multi-institutional mock oral examination: a feasible and valuable educational experience for general surgery residents. J Surg Educ. 2020;77(6):1568-1576. doi:10.1016/j.jsurg.2020.05.015
- Falcone JL, Gagne DJ, Lee KKW, Hamad GG. Validity and interrater reliability of a regional mock oral board examination. J Surg Educ. 2013;70(3):402-407. doi: 10.1016/j.jsurg.2012.12.004
- Association of American Medical Colleges. Table C6: physician retention in state of residency training, by state. Report on residents. Published 2022. Accessed June 1, 2025. https://www.aamc.org/data-reports/students-residents/data/report-residents/2022/table-c6-physician-retention-state-residency-training-state