100+ Free ABA APPLIED Exam Practice Questions

The ABA APPLIED Exam is the final component of American Board of Anesthesiology (ABA) initial certification, taken after passing the ADVANCED Exam. It has two parts taken on a single day at the ABA Assessment Center in Raleigh, NC: (1) the Standardized Oral Examination (SOE) — two 35-minute sessions with two examiners each, where candidates work through a long case (preop, intraop, postop questions) and several short cases (focused crisis or perioperative dilemmas); (2) the Objective Structured Clinical Examination (OSCE) — seven 8-minute stations with 4-minute transitions, covering communication and professionalism, technical skills (ultrasound, TEE), and interpretation (ECG, echo, monitors). Total exam day runs about 5.25 hours.

The OSCE has seven 8-minute stations across three broad domains: (1) communication and professionalism — informed consent for anesthesia, breaking bad news using the SPIKES protocol, disclosure of intraoperative awareness or medication errors, conversations with families and difficult colleagues; (2) technical skills — identification of regional ultrasound anatomy (interscalene, supraclavicular, TAP, ESP, femoral, adductor canal), TEE standard 11-view exam, gastric ultrasound, vascular access ultrasound; (3) interpretation — 12-lead ECG (STEMI, hyperkalemia, blocks, WPW, long QT), capnography waveforms (esophageal intubation, embolism, rebreathing), TEE pathology (severe AS, MR, RV failure, tamponade), and monitor abnormalities.

The SOE and OSCE each carry their own criterion-referenced pass/fail standard set by an ABA standard-setting committee — both must be passed for certification. There is no numerical 'percentage to pass' that the candidate is given; instead, examiners score each case or station against anchored performance descriptors. First-time APPLIED Exam pass rates have historically trended in the 80-88% range and vary from year to year. Candidates who fail one component may be required to retake only that component or both, depending on the failure pattern.

The APPLIED Exam fee is approximately $2,500, which covers both the SOE and OSCE components administered on the same day. Candidates should budget another $500-$2,000 for travel to Raleigh, NC, hotel for 1-2 nights, and optional in-person mock oral courses (Ultimate Board Prep, Jensen, M5, Ho Anesthesia Consultants). The APPLIED fee is in addition to BASIC (~$875) and ADVANCED (~$975), bringing total ABA exam fees to approximately $4,350+ if no retakes are required.

Preparation should begin in CA-3 and continue after ADVANCED. Build a systematic case framework you can apply to any stem: preoperative assessment (ASA Physical Status, RCRI, DAPT, comorbidity optimization), anesthetic plan and consent, induction, intraoperative monitoring, intraoperative crises (with algorithms), emergence, PACU handoff, and postoperative pain. Schedule 30-50 mock oral sessions with attendings or oral-board-trained mentors. Practice speaking succinctly, defending your plan, and recovering from gentle pushback without flip-flopping. Memorize crisis doses cold — dantrolene 2.5 mg/kg, Intralipid 1.5 mL/kg + 0.25 mL/kg/min, epinephrine 10-100 mcg IV for anaphylaxis.

OSCE preparation requires deliberate timed rehearsal because each station is only 8 minutes. (1) For communication stations, memorize the SPIKES protocol (Setting, Perception, Invitation, Knowledge, Emotions, Strategy/Summary), informed consent scripts, and Jehovah's Witness blood management talking points. (2) For technical stations, drill regional ultrasound anatomy with a high-frequency linear probe (interscalene, supraclavicular, TAP, ESP, adductor canal) and the TEE 11-view sweep. (3) For interpretation stations, practice ECG pattern recognition (STEMI, hyperkalemia, AV blocks, WPW, long QT), capnography waveforms, and TEE pathology. Use timed 8-minute drills with an attending playing examiner.

The APPLIED Exam is administered in person only at the ABA Assessment Center in Raleigh, North Carolina. There is no remote, virtual, or live-stream option — the OSCE physical stations and the in-person SOE structure require attendance. The ABA briefly used a virtual SOE during the COVID-19 pandemic but has returned to fully in-person testing. Candidates should book travel and a hotel near the ABA Assessment Center, plan to arrive at least one day early, and dress in business-professional attire on test day.