100+ Free ABA ADVANCED Exam Practice Questions

The ABA ADVANCED Exam is the second of three stages of American Board of Anesthesiology initial certification. It is a computer-based multiple-choice exam administered by Pearson VUE, lasting 4 hours and containing approximately 200 single-best-answer items. Unlike the BASIC Exam (which emphasizes basic sciences), ADVANCED focuses on clinical and subspecialty anesthesia: cardiac, thoracic, neuro, OB, pediatric, regional, ambulatory, critical care, pain, trauma, and transplantation. It is taken at the end of CA-3 (PGY-4) residency, and passing it qualifies the candidate to sit the in-person APPLIED Exam.

The ADVANCED Exam is offered in summer (typically July) and winter (typically January) testing windows at Pearson VUE testing centers across the United States and select international locations. Candidates must register through the ABA portal and schedule their seat through Pearson VUE. The ABA does not offer remote/online proctored testing for ADVANCED — all sessions are in-person at a Pearson VUE center.

Standard registration is approximately $975. Late or amended registration may add fees. Retake fee is approximately $830. These fees are set by the ABA and may change year to year. The total cost across all three ABA stages (BASIC, ADVANCED, APPLIED) is roughly $4,350-$4,850 if no retakes are needed.

The ABA's publicly reported first-time pass rate for the 2024 ADVANCED Exam was approximately 87%. Pass rates have historically ranged from about 85-90% for first-time takers and lower for repeat takers. Standards are set criterion-referenced, not curved, so the absolute scaled score required is determined through the ABA's standard-setting methodology.

BASIC (taken at end of CA-1) emphasizes foundational science: pharmacology (induction agents, MAC values, NMBs), physiology (cerebral and coronary perfusion, hypoxic pulmonary vasoconstriction, shunt), anatomy, equipment (anesthesia machine, monitors), and statistics. ADVANCED (taken at end of CA-3) emphasizes clinical practice and subspecialty decision-making: complex cardiac/OB/pediatric/neuro/thoracic cases, critical care, pain, trauma, transplantation, regional techniques, and crisis management. Basic sciences are still represented in ADVANCED but at lower weight.

Top-rated resources include: ABA content outline (theaba.org) as the source of truth; question banks — TrueLearn ADVANCED, BoardVitals, M5 (formerly Anesthesia Toolbox) — aim for 4,000-5,000 questions; ASA's SEE (Self-Education and Evaluation) and ACE (Anesthesiology Continuing Education) self-assessments; textbooks — Miller's Anesthesia, Barash Clinical Anesthesia, Stoelting's Anesthesia and Co-existing Disease, Yao & Artusio's Problem-Oriented Patient Management; and dedicated review courses (Pass Machine, OpenAnesthesia, ACCRAC podcast). Use rotation experiences (CA-2 subspecialty months) to reinforce reading.

Failed candidates can retake the ADVANCED Exam at the next administration. All three ABA exams (BASIC, ADVANCED, APPLIED) must generally be passed within 7 years of initial eligibility. Failing ADVANCED does not affect residency completion (the program director independently certifies clinical competence), but it does delay eligibility for the APPLIED Exam and therefore delays initial board certification.

After passing ADVANCED, the candidate is eligible to register for the APPLIED Exam — the third and final stage of initial ABA certification. APPLIED is administered in person at the ABA Assessment Center in Raleigh, NC and consists of two 35-minute Standardized Oral Examination (SOE) sessions plus seven 8-minute Objective Structured Clinical Examination (OSCE) stations covering communication, professionalism, ultrasound/echo interpretation, and crisis management. Once all three stages are passed, the diplomate is initially certified and enters the MOCA 2.0 continuous 10-year maintenance cycle.