The American Board of Surgery Certifying Exam (ABSCE) is 1 part of the 2-stage board certification (BC) process in the United States.1,2 BC surgeons have better surgical outcomes (i.e., lower surgery-associated morbidity and mortality rates) when compared to non-BC surgeons.3,4 Residents must be prepared to start an independent practice upon completion of their training; their ability for safe, independent practice is measured, in part, by the ABSCE,1,5 which is an assessment of surgeons’ clinical knowledge and skills in managing various relevant clinical scenarios.

As a high-stakes examination, rigorous and thorough preparation is very important.6, 7, 8 As a result, many residency programs have instituted mock oral exams to facilitate senior residents’ preparation for the ABSCE.6 However, to date, not many initiatives have been undertaken to provide a comprehensive program/curriculum that would progressively and longitudinally support residents in successfully developing the skills necessary to complete the ABSCE.9 Given that lack of familiarity with the format of the ABSCE can be a factor influencing resident performance, efforts to incorporate resources to aid in the preparation across all levels of training are necessary.10 A previous study from our group provided information on the time and cost-efficacy of resident Individual Clinical Evaluations (rICE), a tool developed to assess interns’ clinical judgment in level-appropriate clinical scenarios.9 rICE provides low-cost, face-to-face interviews that more closely simulate the experience of the ABSCE. Real-time feedback on clinical knowledge, judgment and presentation skills are also key features.9

Presently, most resident assessment tools evaluate technical skills, and the ones available to evaluate clinical judgment most commonly focus on senior residents (i.e., mock oral exams).11, 12, 13, 14, 15 It is well known that these mock oral examinations are associated with improved ABSCE first-time pass rates.14 However, little to no preparation is formally provided to junior residents for the ABSCE. Ultimately, a lack of early exposure to this exam format may influence the residents’ performance.10 Additionally, to our knowledge, no publicly available curriculum objectively evaluates presentation skills. Therefore, no comprehensive and longitudinal program currently exists to assess residents' clinical judgment and presentation skills in level-appropriate clinical scenarios. While developing rICE, we sought to create a tool that would help: 1) assess PGY1's comfort with level-appropriate clinical scenarios that they would be responsible for managing in the wards, and 2) prepare residents from all clinical levels for their mock orals and the ABSCE. In this study, we aimed to evaluate residents’ perceived overall utility of the rICE and present all the components of this novel curriculum, including its expansion to include scenarios for PGY1, 2, and 3, as well as to compare mock oral exam and ABSCE pass rates.