Career upgrade: Learn practical AI skills for better jobs and higher pay.
Level up
All Practice Exams

100+ Free AOBS Surgery Practice Questions

Pass your AOBS Surgery Certifying Examination (General Surgery) exam on the first try — instant access, no signup required.

✓ No registration✓ No credit card✓ No hidden fees✓ Start practicing immediately
100+ Questions
100% Free
1 / 100
Question 1
Score: 0/0

Which of the following describes appropriate management of a 1.5 cm pheochromocytoma during surgery to prevent hypertensive crisis?

A
B
C
D
to track
2026 Statistics

Key Facts: AOBS Surgery Exam

~200 MCQs

AOBS Written Exam

AOBS 2026

~4h 30m

Written Test Duration

AOBS

Scaled 500

Minimum Passing Score

AOA 200-800 scale

~$1,500

Oral Exam Fee

AOBS 2026

5 years

Residency Required

AOA/ACGME

10 years

Certificate Validity

AOBS OCC

The AOBS Surgery boards are the AOA pathway to general surgery certification for DOs, paralleling the ABS American Board of Surgery process. The written exam contains roughly 200 MCQs delivered via remote proctoring in the spring, scored on the AOA 200-800 scale (passing 500). After passing the written, candidates sit a structured oral exam ($1,500 fee). General surgery board-certified DOs work in academic and community settings with compensation comparable to ABS-certified surgeons.

Sample AOBS Surgery Practice Questions

Try these sample questions to test your AOBS Surgery exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 58-year-old man presents with right upper quadrant pain, fever, and jaundice after a recent ERCP. Total bilirubin is 6.2 mg/dL with elevated WBC. What is the most appropriate initial management?
A.Emergent cholecystectomy
B.Broad-spectrum antibiotics and biliary decompression
C.Liver biopsy
D.CT-guided drainage of the gallbladder
Explanation: Charcot triad (fever, jaundice, RUQ pain) signals acute cholangitis. Initial management is fluid resuscitation, broad-spectrum antibiotics, and urgent biliary decompression via ERCP or PTC. Cholecystectomy is deferred until the patient is stabilized.
2Which of the following is the most common cause of small bowel obstruction in adults in the United States?
A.Hernia
B.Adhesions from prior surgery
C.Malignancy
D.Crohn disease
Explanation: Postoperative adhesions account for roughly 60-75% of small bowel obstructions in industrialized countries. Hernia is second, followed by malignancy and inflammatory disease.
3A 32-year-old woman has a 1.2 cm thyroid nodule. FNA shows follicular neoplasm (Bethesda IV). What is the most appropriate next step?
A.Observation with repeat ultrasound in 6 months
B.Diagnostic thyroid lobectomy
C.Total thyroidectomy
D.Radioactive iodine ablation
Explanation: Bethesda IV cytology cannot distinguish follicular adenoma from carcinoma on FNA because the diagnosis requires capsular or vascular invasion. Diagnostic lobectomy provides definitive histology while preserving the contralateral lobe if benign.
4A trauma patient is hypotensive after a stab wound to the left chest. FAST shows pericardial fluid. What is the most appropriate next step?
A.CT chest with contrast
B.Pericardiocentesis
C.Emergent median sternotomy or left anterolateral thoracotomy
D.Echocardiogram in the operating room
Explanation: Penetrating chest trauma with positive FAST for pericardial fluid and hemodynamic instability requires emergent surgical exploration. Median sternotomy is preferred; left anterolateral thoracotomy is an alternative in extremis. Pericardiocentesis is a temporizing measure only.
5Which artery is most commonly injured in a posterior knee dislocation?
A.Femoral artery
B.Popliteal artery
C.Anterior tibial artery
D.Peroneal artery
Explanation: The popliteal artery is tethered proximally at the adductor hiatus and distally at the soleal arch, making it highly susceptible to injury with knee dislocation. ABI <0.9 mandates CT angiography or formal arteriography.
6A 62-year-old man with a 4.5 cm infrarenal AAA reports new severe back pain. He is hemodynamically stable. What is the most appropriate next step?
A.Outpatient follow-up in 6 months
B.Elective EVAR scheduled in 4-6 weeks
C.Urgent CT angiogram
D.Immediate open repair without imaging
Explanation: New back/abdominal pain in a patient with known AAA raises concern for impending rupture even with a stable size. Urgent CTA characterizes the aneurysm and determines feasibility of endovascular vs open repair.
7A 55-year-old woman has a 2.2 cm invasive ductal carcinoma of the left breast with a clinically negative axilla. Which axillary procedure is most appropriate?
A.Axillary lymph node dissection
B.Sentinel lymph node biopsy
C.Observation without nodal sampling
D.Radiation alone to the axilla
Explanation: Sentinel lymph node biopsy is the standard of care for staging the clinically node-negative axilla in early breast cancer. ALND is reserved for clinically positive nodes or specific high-risk situations after positive SLNB.
8A 70-year-old man has an obstructing sigmoid colon mass with peritonitis. He is taken urgently to the operating room. The most appropriate operation is:
A.Right hemicolectomy with primary anastomosis
B.Sigmoid colectomy with end colostomy (Hartmann procedure)
C.Diverting loop ileostomy alone
D.Total abdominal colectomy with ileostomy
Explanation: An obstructed perforated sigmoid lesion with peritonitis is managed with Hartmann resection: sigmoid colectomy, end colostomy, and rectal stump closure. Primary anastomosis is avoided in feculent peritonitis.
9Which of the following is the strongest indication for splenectomy in a hemodynamically stable adult trauma patient?
A.AAST grade I splenic laceration
B.AAST grade II splenic injury with stable vitals
C.Failure of nonoperative management with continued bleeding
D.Isolated subcapsular hematoma
Explanation: Most stable adult blunt splenic injuries are managed nonoperatively with monitoring and angioembolization. Persistent or recurrent bleeding despite nonoperative management is the strongest indication for splenectomy.
10A 4-week-old male infant presents with nonbilious projectile vomiting and a palpable epigastric olive. Lab tests show hypochloremic hypokalemic metabolic alkalosis. The next step in management is:
A.Immediate pyloromyotomy
B.Fluid resuscitation and correction of electrolytes, then pyloromyotomy
C.Upper GI contrast study
D.Nasogastric decompression alone
Explanation: Hypertrophic pyloric stenosis is a medical urgency, not a surgical emergency. Correct the hypochloremic, hypokalemic metabolic alkalosis with isotonic fluids and potassium prior to pyloromyotomy to avoid post-op apnea from alkalosis.

About the AOBS Surgery Exam

The AOBS Surgery Certifying Examination validates clinical and operative competence in general surgery for osteopathic surgeons. The examination has two parts: a remote-proctored written examination (Part 1) and a structured oral examination (Part 2). Content covers alimentary tract, trauma and critical care, vascular surgery, breast and endocrine surgery, surgical oncology, hernia and soft tissue, pediatric surgery basics, perioperative care, and osteopathic principles in surgery. Candidates must have completed an AOA-approved or ACGME-accredited general surgery residency.

Questions

200 scored questions

Time Limit

~4 hours 30 minutes (written, remote-proctored)

Passing Score

AOA scaled score of 500 (200-800 scale)

Exam Fee

Set annually by AOBS; oral exam fee ~$1,500 (AOBS 2026) (American Osteopathic Board of Surgery (AOBS))

AOBS Surgery Exam Content Outline

~25%

Alimentary Tract Surgery

GERD/Barrett, achalasia (Heller, POEM), PUD with hemorrhage, gastric and esophageal cancer, bariatric (RYGB, sleeve), small bowel obstruction (adhesions vs hernia), IBD surgery, colorectal cancer with right/sigmoid hemicolectomy, diverticulitis Hinchey staging, anal fissure/abscess/fistula.

~15%

Trauma and Critical Care

ATLS primary/secondary survey, FAST in unstable blunt trauma, damage control surgery, lethal triad, Parkland burn formula (4 mL/kg/%TBSA LR), TBI management, pelvic binder + REBOA/angioembolization, compartment syndrome thresholds.

~10%

Vascular Surgery

Symptomatic AAA imaging and repair (open vs EVAR), CLTI revascularization, carotid stenosis (asymptomatic >=70% vs symptomatic >=50%), acute mesenteric ischemia, ABI interpretation (PAD <=0.90; noncompressible >1.40).

~10%

Breast and Endocrine Surgery

Sentinel node biopsy for cN0 disease, BI-RADS imaging, thyroid nodule Bethesda categories, focused parathyroidectomy with intraoperative PTH, alpha-blockade before pheochromocytoma resection, primary hyperaldosteronism workup (ARR, AVS).

~10%

Surgical Oncology

Melanoma margins by Breslow depth (0.5/1/2 cm); SLNB criteria; MSLT-II surveillance approach; GIST wedge resection; pancreatic head adenocarcinoma Whipple; BCLC-stage HCC management; CRS-HIPEC patient selection.

~10%

Hernia and Skin/Soft Tissue

Lichtenstein and TEP/TAPP for inguinal hernia, watchful waiting for small umbilical hernias, necrotizing fasciitis (vanc + pip-tazo + clinda + emergent debridement), 4 mm margins for low-risk BCC, off-midline pilonidal repair.

~10%

Anesthesia and Perioperative Care

Single preoperative antibiotic dose within 60 min; VTE prophylaxis with LMWH; refeeding syndrome (low phos/K/Mg); muddy brown casts for ATN; OPSI prophylaxis with vaccinations 14 days pre- or post-splenectomy.

~5%

Pediatric Surgery Basics

Pyloric stenosis (hypochloremic hypokalemic alkalosis, correct then operate), midgut volvulus with corkscrew sign (Ladd procedure), intussusception with air enema, biliary atresia Kasai before 60 days, Meckel scan for painless GI bleed.

~5%

Osteopathic Principles in Surgery

Rib raising and paraspinal inhibition for T5-L2 sympathetic balance to reduce postoperative ileus; lymphatic pump for atelectasis prevention; visceral and autonomic techniques; structure-function unity in perioperative recovery.

How to Pass the AOBS Surgery Exam

What You Need to Know

  • Passing score: AOA scaled score of 500 (200-800 scale)
  • Exam length: 200 questions
  • Time limit: ~4 hours 30 minutes (written, remote-proctored)
  • Exam fee: Set annually by AOBS; oral exam fee ~$1,500 (AOBS 2026)

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

AOBS Surgery Study Tips from Top Performers

1Drill the highest-weight category first — alimentary tract (~25%). Master CVS in laparoscopic cholecystectomy, Hartmann for perforated diverticulitis, Whipple for pancreatic head cancer, achalasia (Heller + fundoplication or POEM), and the GERD-Barrett-adenocarcinoma pathway.
2Internalize ATLS and damage control surgery cold: primary/secondary survey, FAST for unstable blunt trauma, Parkland formula (4 mL/kg/%TBSA LR), tourniquet for extremity hemorrhage, pelvic binder + REBOA/angioembolization for unstable pelvic fractures, lethal triad management.
3Memorize vascular thresholds: AAA repair criteria (>5.5 cm or symptomatic), ABI <=0.90 for PAD, ABI <0.40 or rest pain for CLTI, carotid stenosis cut points, alpha-blockade 10-14 days before pheochromocytoma resection.
4Practice OMM-in-surgery integration questions: rib raising and paraspinal inhibition for T5-L2 sympathetic balance to reduce postoperative ileus; lymphatic pumps to prevent atelectasis; vagal/sacral parasympathetic balancing techniques.
5Hit common-but-easy points: VTE prophylaxis with LMWH, single preop antibiotic within 60 minutes (vanco 120 min), critical view of safety, refeeding syndrome (low phos/K/Mg), OPSI vaccination timing, and BI-RADS interpretation.

Frequently Asked Questions

Who is eligible for the AOBS General Surgery certifying exam?

Candidates must be DOs who have completed an AOA-approved or ACGME-accredited 5-year general surgery residency, hold an unrestricted US medical license, and meet AOBS application timelines. Program director attestation of clinical competence is required. Following residency, candidates take the Part 1 written exam followed by the Part 2 oral exam.

How is the AOBS Surgery written exam structured?

The Part 1 written exam contains approximately 200 multiple-choice questions delivered over roughly 4 hours 30 minutes via a remote proctoring platform. It is offered once per year in the spring. Scores are reported on the AOA 200-800 scaled scale, with 500 representing the minimum passing standard.

What is the AOBS oral examination?

The AOBS oral exam (Part 2) is a separate structured live examination administered after the written exam is passed. It covers operative judgment, complications, and clinical reasoning through case-based scenarios with multiple examiners. The 2026 oral exam fee is approximately $1,500; virtual oral exams are not scheduled for 2026.

How is the AOBS Surgery exam scored?

The AOA reports scores on a 200 to 800 scaled scale, with a scaled score of 500 representing the minimum passing standard established by the AOA Bureau of Osteopathic Specialists. Pass/fail decisions and detailed performance feedback are provided by AOBS after each administration.

What topics are most heavily weighted on the AOBS Surgery exam?

The alimentary tract (GI surgery) is the largest category at roughly 25% of items, followed by trauma and critical care (~15%), vascular surgery (~10%), breast and endocrine (~10%), surgical oncology (~10%), hernia and soft tissue (~10%), and perioperative care (~10%). Pediatric surgery basics and osteopathic principles in surgery round out the blueprint at roughly 5% each.

Does the AOBS exam test osteopathic principles?

Yes. As an AOA board, AOBS expects candidates to integrate osteopathic principles in surgical practice, especially for perioperative recovery. Topics include rib raising and paraspinal inhibition for postoperative ileus, lymphatic pumps for atelectasis, and visceral and autonomic techniques. Approximately 5% of items address OMM in surgery.

How long should I study for the AOBS Surgery boards?

Most candidates report 400-600 hours of dedicated study over 6-12 months. A typical plan allocates substantial time to alimentary tract surgery, trauma, vascular, and surgical oncology. Question-bank drilling, ATLS review, SCORE curriculum modules, and structured review courses are commonly used in addition to AOBS-recommended resources.

What happens if I do not pass the AOBS Surgery written exam?

Candidates who do not pass the written exam may reapply for a subsequent administration per AOBS retake policy. Detailed performance feedback by content area helps target gaps. AOBS publishes time-limit requirements for completing the certification process after residency; candidates should consult the current AOBS handbook for retake policies.