In my book Anesthesiology Boards Made Easy, I discussed the three main objectives to becoming Board Certified:

1.  Do well on your exams.

2.  Graduate from Residency

3.  Complete your board certification process

Everyone Graduates from Residency, Right?

It seems like the hardest part of finishing a residency program is just getting in.  You get in, spend four years in trying, then you graduate and move on.  Graduating from residency seems to be a given.

Most residents will graduate without problems. But other residents might have to extend their residency because of lacking case numbers (or documenting case numbers) or missing out on the required rotations.

You assume that someone (your Chief Resident, Program Director, or Program Chair) is looking out for you to make sure you meet the requirements.  Things still get missed even with this group of people are looking out for you.  Learn residency structure and graduation requirements.  This will help you be a better advocate for yourself.

How Residencies are Structured

Your program is accredited by the American Council on Graduate Medical Education (ACGME).  You hear about

  • the Anesthesiology Residency Review Committee (RRC)
  • the American Board of Anesthesiology (ABA)

How do the ACGME, the RRC, and the ABA have to do with each other?


Once you graduate from medical school, you will then continue your training in Graduate Medical Education (GME).  GME programs are called internships, residency, and fellowships.  The ACGME is the accreditation organization in the United States for GME.

Each medical and surgical specialty has

  • common requirements – shared by all ACGME Programs
  • speciality specific requirements – only required by their own specialty

The ACGME sets the common requirements and relies on speciality specific Residency Review Committee (RRC) for specialty specific requirements.  The ACGME still has oversight over the each RRC, but the RRC can set the tone for the specialty specific requirements.

These two groups will determine the requirements to graduate from residency.  There is one more group that has a say in how your program is run – the American Board of Anesthesiology.

The American Board of Anesthesiology

The ABA is the certifying organization which sets the standards for Anesthesiology Board Certification. It also has requirements regarding your training.   It is the ABA that administers the In Training Exam (ITE) and the Basic exam you taking during your residency.


For Anesthesiology Board Certification, you will have to not only satisfactorily graduate from an ACGME approved residency, but also pass three different exams during and after your training, as we discussed in Chapter 3 of Anesthesiology Boards Made Easy.
Your program will be in contact with the ACGME, the RRC, and the ABA by submitting reports and documenting that your performance.

Learn the requirements to graduate from residency

With such an import requirement, why would you rely on someone else telling you what you need to do.  You went into anesthesiology because you have a bit of a control freak in you.  Use that to your advantage and learn the requirements on your own.

You can find Anesthesiology Residency Specific Information here:

ACGME Main Page for Anesthesiology

  • Here you will find the requirements to graduate from

ACGME Program Requirements

  • This is the document from the ACGME which spells out how your residency program works.
  • Starting on page 14 of this document, you will see all the case number requirements that you need to graduate.

Looking for other Board Certification Resources?   Check out the related articles below