100+ Free ABOS Orthopaedic Surgery Practice Questions

ABOS Part I is the written certification examination administered by the American Board of Orthopaedic Surgery. It is the first of two parts leading to ABOS Board Certification in orthopaedic surgery. The exam evaluates candidates' knowledge of general orthopaedics, basic science, and clinical problem-solving across six content domains. It is administered at Pearson VUE test centers on a single day each July to approximately 900 candidates. Part I must be passed before candidates can sit for the ABOS Part II (Oral) examination.

ABOS Part I consists of approximately 320-330 multiple-choice questions delivered in seven sections. Total time at the testing center is 9 hours — 8 hours of testing time plus 40 minutes of break time and a 20-minute tutorial. The 2026 blueprint allocates General Principles 15.5%, Adult Spine 9.5%, Upper Extremities 24%, Lower Extremities 32%, Pediatrics 12%, and Neoplasms approximately 7%. The exam is computer-based and secure — all administered on the same day each July.

ABOS Part I uses a criterion-referenced passing standard set annually by the Written Examination Committee based on item-by-item analysis performed by a volunteer Standard Setting Task Force. Candidates are measured against a fixed content-expert standard rather than curved against peers. Each question has undergone five levels of review through the Question Writing Task Force, Field Test Task Force, and Written Examination Committee. Candidates receive pass/fail plus performance profiles by content area. Historical first-time pass rates for ACGME-trained candidates are approximately 85-90%.

Candidates must have completed an ACGME-accredited orthopaedic surgery residency (typically 5 years) or qualify through an approved alternate pathway. First-time takers apply during PGY-5 (application window August 1 - October 1 of the year before the exam). Candidates must also meet the KSB (Knowledge, Skills, Behaviors) Program requirements — for July 2026 first-time takers, that means 80 completed Surgical Skills and 6 completed End of Rotation Professional Behavior assessments by June 30, 2026. Requirements escalate in subsequent years (160 Surgical Skills by 2027, 240 by 2028).

The 2026 ABOS Part I fee is $1,240, which covers both application and examination (paid together by credit card at application). A late fee of $750 is automatically applied for applications submitted after the initial deadline but before the late deadline. Fees are non-refundable and non-transferable. The fee is paid at the time of application, and examinations cannot be scheduled until payment is received. Candidates should also budget for OITE, board review courses, and other preparation materials — the ABOS registration fee does not cover those.

ABOS Part I is administered at Pearson VUE Testing Centers throughout the United States on a single day each July (mid-July, e.g., July 15, 2027 for the 2027 cycle). Approximately 900 candidates take the exam each year. Candidates are notified of examination admission at least 60 days prior to the exam date. After application is accepted and the fee is paid, candidates schedule a location and specific seat at their chosen Pearson VUE center. Candidates cannot schedule until the examination fee has been paid.

Lower extremities (32%) is the largest domain — master ACL/PCL/MCL/LCL mechanisms and reconstruction options, meniscus, hip fractures (Garden, Pauwels), femoral neck AVN risk, tibial plateau (Schatzker), ankle (Weber/Lauge-Hansen, syndesmosis), Lisfranc, and compartment syndrome (ΔP <30 mmHg or absolute >30 mmHg). Upper extremities (24%) — rotator cuff, shoulder instability (Bankart, Hill-Sachs), proximal humerus (Neer), distal radius, scaphoid, Kienböck, and CTS. Pediatrics (12%) — Salter-Harris, supracondylar humerus (Gartland), DDH, SCFE, Perthes. Tumors (7%) — Enneking staging, Mirels, high-yield diagnoses (osteoid osteoma, GCT, osteosarcoma, Ewing).

Start early in residency using OITE performance to identify weak domains. Recommended resource mix: Miller's Review of Orthopaedics (core text), JAAOS review articles, Orthobullets for high-yield classifications and algorithms, AAOS board review courses, and several thousand practice questions. Take at least two full-length timed 320-question practice exams in the final months. Focus on classifications (Salter-Harris, Gustilo-Anderson, Neer, Schatzker, Weber, Garden, Mirels, Enneking), compartment pressures, pediatric red flags, and surgical indications. Review the ABOS Part I Blueprint to ensure proportional coverage of all six domains.