Multiple-choice examinations typically predict performance on future multiple-choice examination. Therefore, an annual examination of cognitive knowledge cannot and should not be used as the yardstick to set standards for educational programs as complex as graduate surgical education or to summate the performance of trainees who work daily in association with mentors, performing the skills of patient management where outcomes are obvious.
Subject matter of the ABSITE reflects the preference of a group of surgical leaders, all with considerable experience in training residents. The performance of residents in the various areas of the examination may be helpful to program directors in designing their program's learning issues. Individual residents may guide their future study based on their own performance. To ask for more from the ABSITE ignores the magnitude and the complexity of graduate surgical education.
This article raises again the issue of universal standards for graduate education. The ability to set