100+ Free ABU Qualifying Exam Practice Questions
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According to USPSTF 2018 (still current in 2026), what is the recommended approach to PSA-based prostate cancer screening for men aged 55-69?
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Key Facts: ABU Qualifying Exam Exam
~300
Total MCQ Items
ABU Qualifying Examination (Part 1)
~5 hr
Testing Time
1-day CBT (~8 hours total including breaks)
~43%
Oncology Weight
Combined prostate, bladder/UT, kidney, testis, adrenal, penile
~$1,900
2026 Qualifying Fee
ABU (verify current schedule)
5 yr
Urology Residency
ACGME: PGY-1 intern + 4 years urology
~85-90%
First-Time Pass Rate
ABU annual statistics
The ABU Qualifying Examination (Part 1) is a 1-day computer-based written test administered by the American Board of Urology comprising ~300 single-best-answer MCQs over approximately 5 hours of testing time (~8 hours total with breaks) at Pearson VUE. It is the chief-resident / recent-graduate written exam — not the in-person Part 2 Certifying Exam (which requires 16+ months of independent practice). Content spans prostate (~15%), kidney/testis/adrenal/penile (~14%), bladder and upper tract (~11%), pediatric (~10%), female urology (~8%), BPH/LUTS (~7%), stones (~6%), trauma (~6%), infections (~6%), ED/andrology (~4%+~4%), neurourology (~4%), and transplant (~2%). The fee is ~$1,900; eligibility requires completion of an ACGME-accredited urology residency (5 years). Passing Part 1 is prerequisite to Part 2 (Certifying Oral) taken ~16 months post-residency.
Sample ABU Qualifying Exam Practice Questions
Try these sample questions to test your ABU Qualifying Exam exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.
1According to USPSTF 2018 (still current in 2026), what is the recommended approach to PSA-based prostate cancer screening for men aged 55-69?
2On multiparametric prostate MRI, a PI-RADS v2.1 category 4 lesion indicates which of the following?
3A Gleason score of 4+3=7 corresponds to which ISUP/WHO Grade Group?
4Per ARASENS, which triplet is now standard of care for de novo high-volume metastatic hormone-sensitive prostate cancer (mHSPC)?
5The VISION trial established 177Lu-PSMA-617 for which indication?
6Which finding is the strongest indication for adjuvant pembrolizumab (KEYNOTE-564) after partial or radical nephrectomy for clear cell RCC?
7A 32-year-old man has a 2.5 cm left testicular mass. Tumor markers show AFP 450 ng/mL, β-hCG 200 mIU/mL, LDH 280 U/L. What is the most likely diagnosis?
8First-line systemic therapy for BCG-unresponsive carcinoma in situ of the bladder (in a patient who refuses or is unfit for radical cystectomy) per FDA approval is which agent?
9EV-302 established which regimen as first-line therapy for metastatic urothelial carcinoma (mUC)?
10A 1-year-old boy has a non-palpable left testis. Initial ultrasound and exam fail to localize. What is the next best step?
About the ABU Qualifying Exam Exam
The ABU Qualifying Examination (Part 1) is the multiple-choice written exam taken by chief residents and recent urology graduates — distinct from Part 2 (the in-person Certifying Exam taken after 16+ months of independent practice with a documented case log). Passing Part 1 is the required first step toward initial ABU board certification. Content spans urologic oncology — prostate (PSA/USPSTF, PI-RADS v2.1, ISUP/NCCN, Decipher, PSMA-PET, VISION 177Lu-PSMA, ARASENS, PROpel/olaparib), bladder/upper tract (NMIBC BCG, KEYNOTE-057 pembrolizumab, Anktiva, MIBC neoadjuvant, CheckMate 274 adjuvant nivolumab, EV-302 enfortumab+pembro, POUT UTUC), kidney (KEYNOTE-564 adjuvant pembro, KEYNOTE-426, CheckMate 214/9ER, belzutifan VHL), testis (BEP/RPLND/markers), adrenal, penile — plus pediatric urology (cryptorchidism, hypospadias, VUR/RIVUR, PUV, UPJ), female urology and pelvic floor (SUI slings, POP, OAB — vibegron/mirabegron/botox/SNM, IC/BPS), BPH/LUTS (AUA 2023 — HoLEP, Rezum, UroLift, Aquablation, iTind, TURP), stone disease and endourology (AUA — URS/PCNL/SWL, thulium fiber laser), trauma (AAST renal/ureteral/bladder/urethral), infections (CDC 2021 STI, prostatitis NIH, Fournier's), ED and male andrology (PDE5, IPP, Peyronie's Xiaflex, testosterone therapy), infertility and reconstruction (microTESE, varicocele, urethroplasty, urinary diversion), neurourology (urodynamics, neurogenic bladder, autonomic dysreflexia), and renal transplantation. Requires completion of an ACGME-accredited urology residency (5 years).
Questions
300 scored questions
Time Limit
1-day CBT — approximately 5 hours testing time (~8 hours total including breaks)
Passing Score
Criterion-referenced scaled score set by ABU (modified Angoff standard)
Exam Fee
~$1,900 Qualifying Examination fee (ABU 2026 — verify current schedule) (American Board of Urology (ABU) / Pearson VUE)
ABU Qualifying Exam Exam Content Outline
Urologic Oncology — Prostate
PSA screening (USPSTF 2018 Grade C 55-69, Grade D 70+; AUA 2023 baseline 45-50), PI-RADS v2.1 (4 = likely, 5 = highly likely), transperineal vs transrectal biopsy, MRI-TRUS fusion, ISUP/WHO Grade Group (GG1-GG5), NCCN risk stratification, Decipher genomic classifier, PSMA-PET/CT staging and biochemical recurrence, active surveillance, radical prostatectomy, hypofractionated radiotherapy, mHSPC triplet therapy (ARASENS — darolutamide + ADT + docetaxel), PROpel (olaparib + abiraterone BRCA), VISION (177Lu-PSMA-617 mCRPC), TULSA, focal therapy.
Urologic Oncology — Kidney & Testis
Renal mass workup (CT/MRI, selective biopsy), small renal mass AS vs partial nephrectomy vs ablation, hereditary syndromes (VHL — belzutifan, BHD, HLRCC, TSC), adjuvant pembrolizumab (KEYNOTE-564), metastatic RCC IO combos (pembro+axi KEYNOTE-426, nivo+ipi CheckMate 214, nivo+cabo CheckMate 9ER). Testis: seminoma vs NSGCT markers (AFP, β-hCG, LDH), RPLND templates, BEP chemotherapy, stage I surveillance vs carboplatin for seminoma. Adrenal pheochromocytoma (alpha first) and aldosteronoma; penile SCC and inguinal lymphadenectomy.
Urologic Oncology — Bladder & Upper Tract
NMIBC AUA/SUO risk, TURBT with re-TURBT, BCG induction + SWOG maintenance, BCG-unresponsive (pembrolizumab KEYNOTE-057, Anktiva/nogapendekin + BCG, gemcitabine/docetaxel, nadofaragene firadenovec), MIBC neoadjuvant cisplatin (MVAC, gem-cis), radical cystectomy + PLND, trimodal bladder preservation, adjuvant nivolumab (CheckMate 274), metastatic first-line enfortumab vedotin + pembrolizumab (EV-302), erdafitinib FGFR3, UTUC (POUT adjuvant chemotherapy) and nephroureterectomy vs kidney-sparing with jelmyto.
Pediatric Urology
Cryptorchidism (orchiopexy 6-18 mo, Fowler-Stephens for intra-abdominal), hypospadias (MAGPI, TIP/Snodgrass), VUR grading I-V and RIVUR trial (prophylaxis for dilating reflux/febrile UTI), posterior urethral valves, UPJ obstruction (Anderson-Hynes pyeloplasty), hydronephrosis SFU/UTD, neurogenic bladder (spina bifida, CIC), prune belly, DSD (46,XX CAH 21-hydroxylase; 46,XY CAIS), Wilms (COG), neuroblastoma, enuresis (desmopressin/alarm), testicular torsion (bell-clapper).
Female Urology & Pelvic Floor
Stress urinary incontinence (midurethral sling — retropubic/transobturator/single-incision), urethral bulking, autologous fascial sling, urethral diverticulum, vesicovaginal fistula (transvesical vs Latzko), POP (POP-Q, sacrocolpopexy, native tissue, colpocleisis), mesh complications, overactive bladder (behavioral, antimuscarinics, vibegron/mirabegron, onabotulinumtoxinA 100 U, SNM, PTNS), interstitial cystitis/BPS (AUA stepwise), recurrent UTI prophylaxis.
BPH / LUTS
AUA 2023 BPH/LUTS guideline: IPSS, alpha-1 blockers (tamsulosin/silodosin/alfuzosin), 5-ARIs for prostate ≥30 mL, PDE5 tadalafil, combination therapy. Surgical options by prostate volume and morphology — HoLEP (size-independent), Rezum water vapor, UroLift PUL, Aquablation AquaBeam robotic waterjet, iTind temporary implant, prostatic artery embolization, simple prostatectomy or GreenLight for very large glands, TURP benchmark.
Stone Disease / Endourology
Stone composition (calcium oxalate most common, uric acid radiolucent, struvite triple phosphate, cystine hexagonal), metabolic workup (24-h urine), medical therapy (thiazide, K-citrate, allopurinol), dietary (fluid, DASH, normal calcium), MET with tamsulosin for distal ureteral 5-10 mm, low-dose NCCT, SWL vs URS vs PCNL per AUA (size/location/HU), stents, staghorn (PCNL first-line), supine vs prone PCNL, mini-PCNL, Thulium fiber laser vs Ho:YAG.
Trauma & Emergencies
Renal trauma (AAST I-V; CT with delayed-phase urography; NOM for stable blunt), ureteral injury (Boari flap, psoas hitch, ileal ureter), bladder rupture (intraperitoneal surgical; extraperitoneal catheter), urethral injury (posterior realignment vs delayed urethroplasty; straddle anterior), testicular rupture (exploration), Fournier's gangrene (emergent debridement), penile fracture (tunica repair), priapism (ischemic — aspiration/phenylephrine; nonischemic — embolization).
Infections & Inflammation
Uncomplicated cystitis (nitrofurantoin 5 d, TMP-SMX, fosfomycin single dose), pyelonephritis, complicated UTI, prostatitis (NIH I-IV; CP/CPPS), epididymo-orchitis, STIs per CDC 2021 (gonorrhea — ceftriaxone 500 mg IM; chlamydia — doxycycline; syphilis — benzathine penicillin G; HSV — acyclovir), GU tuberculosis, schistosomiasis and bladder SCC risk, emphysematous pyelonephritis, perinephric abscess, antibiotic stewardship, sepsis bundles.
Erectile Dysfunction
ED workup (IIEF, nocturnal tumescence, penile duplex), PDE5 inhibitors (sildenafil, tadalafil, vardenafil, avanafil — contraindicated with nitrates), intracavernosal alprostadil, MUSE, vacuum erection device, inflatable penile prosthesis (AMS 700, Titan), Peyronie's disease (collagenase clostridium histolyticum Xiaflex, Nesbit, plaque incision/grafting), low testosterone (AUA <300 ng/dL on two AM samples plus symptoms), testosterone monitoring (PSA, hematocrit).
Andrology / Male Infertility & Reconstruction
Male infertility workup (semen analysis ×2, FSH/LH/T/prolactin, karyotype, Y microdeletion, CFTR for CBAVD), varicocelectomy (subinguinal microsurgical), obstructive vs nonobstructive azoospermia, microTESE, vasectomy and reversal (vasovasostomy, vasoepididymostomy), urethral stricture (DVIU vs urethroplasty — anastomotic, buccal mucosa onlay), bladder neck contracture, urinary diversion (ileal conduit, Indiana pouch, neobladder — Studer, Hautmann), Mitrofanoff appendicovesicostomy.
Neurourology & Voiding Dysfunction
Neurogenic LUT dysfunction (SCI — autonomic dysreflexia above T6 requires immediate bladder decompression and antihypertensives; MS; Parkinson's; stroke; spina bifida), urodynamics (CMG, pressure-flow, EMG, video), detrusor overactivity, DSD, detrusor underactivity, AUS, bladder augmentation (ileocystoplasty; malignancy, perforation, metabolic acidosis risks), sacral neuromodulation (InterStim), PTNS, CIC, onabotulinumtoxinA 200 U for neurogenic DO.
Renal Transplantation
Donor evaluation (living vs deceased), HLA matching, immunosuppression (induction — basiliximab, ATG; maintenance — tacrolimus + MMF + prednisone; belatacept), rejection (hyperacute antibody-mediated, acute cellular, acute antibody-mediated, chronic), BK virus nephropathy, CMV, PTLD (EBV-driven), surgical complications (lymphocele, ureteral stricture, vascular thrombosis), recurrent disease (FSGS, IgA, aHUS), native nephrectomy indications (ADPKD, refractory hypertension).
How to Pass the ABU Qualifying Exam Exam
What You Need to Know
- Passing score: Criterion-referenced scaled score set by ABU (modified Angoff standard)
- Exam length: 300 questions
- Time limit: 1-day CBT — approximately 5 hours testing time (~8 hours total including breaks)
- Exam fee: ~$1,900 Qualifying Examination fee (ABU 2026 — verify current schedule)
Keys to Passing
- Complete 500+ practice questions
- Score 80%+ consistently before scheduling
- Focus on highest-weighted sections
- Use our AI tutor for tough concepts
ABU Qualifying Exam Study Tips from Top Performers
Frequently Asked Questions
What is the ABU Qualifying Examination (Part 1) and how does it differ from Part 2?
The ABU Qualifying Examination (Part 1) is the multiple-choice WRITTEN exam administered by the American Board of Urology to chief residents and recent urology graduates — it is the first of two required exams for initial board certification. Part 2 (the Certifying Examination) is a separate IN-PERSON oral exam taken approximately 16 months after residency completion and requires the candidate to submit a documented case log of independent surgical practice. You must pass Part 1 before becoming eligible for Part 2.
Who is eligible to take the ABU Qualifying Examination?
Candidates must complete (or be in the final months of) an ACGME-accredited urology residency (5 years — a PGY-1 intern year followed by 4 years of urology training) with program director attestation of satisfactory performance and ethics. A valid unrestricted medical license is required. After passing Part 1, candidates collect a 16-month post-residency case log of independent practice and then take Part 2, the Certifying (Oral) Examination, to achieve initial board certification.
What is the format of the ABU Qualifying Exam?
The Qualifying Examination is a 1-day computer-based written test administered at Pearson VUE test centers, comprising approximately 300 single-best-answer multiple-choice items delivered over roughly 5 hours of testing time (~8 hours total including breaks and tutorial). Items include clinical vignettes, imaging (CT, MRI, ultrasound, nuclear including PSMA-PET), and surgical and endoscopic photographs. The exam is blueprinted to the ABU content outline with urologic oncology comprising roughly 43% of items.
How much does the 2026 ABU Qualifying Exam cost?
The 2026 ABU Qualifying Examination fee is approximately $1,900 — always verify the current schedule on the ABU website. Candidates also pay a separate Certifying (Oral) Examination fee (~$2,000) at the Part 2 stage. Cancellation and refund policies follow the ABU schedule with decreasing refunds as the exam date approaches. Retakes require re-registration and full fee payment within the allowed qualification window.
When is the 2026 Qualifying Exam administered?
The ABU Qualifying Examination is typically offered once annually in the late summer. Applications generally open in the winter with a submission deadline several months before the test. Candidates schedule specific appointments with Pearson VUE after application approval. Exact 2026 dates and deadlines should be confirmed on the ABU examinations page.
How is the exam scored and what is the pass rate?
The ABU uses criterion-referenced scaled scoring with a passing standard set by subject-matter experts via the modified Angoff method — a candidate's pass/fail outcome depends on performance relative to the fixed cut-score, not on other candidates. Historic first-time pass rates are approximately 85-90%. Score reports include domain-level feedback. Candidates must pass Part 1 (Qualifying) before becoming eligible for Part 2 (Certifying Oral), which is taken approximately 16 months after residency with a case log.
What are the highest-yield Qualifying Exam topics?
Highest-yield topics include PI-RADS v2.1 and PSMA-PET interpretation, prostate cancer NCCN risk and ARASENS/PROpel/VISION updates, NMIBC BCG and BCG-unresponsive options (KEYNOTE-057 pembrolizumab, Anktiva), MIBC neoadjuvant chemotherapy and adjuvant nivolumab (CheckMate 274), mUC first-line EV-302 enfortumab+pembrolizumab, RCC adjuvant KEYNOTE-564 and IO combinations, testicular germ cell markers and BEP, AUA 2023 BPH (HoLEP/Rezum/UroLift/Aquablation/iTind), VUR/RIVUR, hypospadias and cryptorchidism, OAB (vibegron, botox, SNM), stone AUA guidelines (URS/PCNL/SWL), AAST trauma grading, CDC 2021 STI treatment, ED/IPP, Peyronie's Xiaflex, autonomic dysreflexia management, and transplant immunosuppression/rejection.
How should I study for the Qualifying Exam?
Use a structured 12-18 month plan layered on chief residency. Map to the ABU content outline: begin with urologic oncology (prostate, bladder, kidney, testis — the largest block at ~43%), then pediatric, female urology and pelvic floor, BPH, stones, trauma, infections, ED/andrology/infertility, neurourology, and transplant. Integrate Campbell-Walsh-Wein, AUA Update Series, AUA Core Curriculum, In-Service exam questions, and high-volume MCQ practice. Complete 2-3 full-length timed mock exams and drill imaging recognition (PI-RADS, PSMA-PET, CT urography) and endoscopic photograph interpretation.