Anesthesia ITEAre you Prepared for the Anesthesia ITE?

Every residency training program has sets of exams that residents take during their training.

Anesthesiology Residency is no different.

During your Anesthesiology Residency you will be taking the Anesthesiology In Training Exam (ITE) every February.  Unlike medical school where you take Shelf Exams after every major rotation, there are no exams for individual rotations; you have a cumulative ITE each year.

What to Expect of the ITE

The American Board of Anesthesiology writes the ITE.  This provides you a good approximation of what to expect on the Basic and Advanced Exams.  One way to look at the ITE is that this exam is a full length practice exam.  You will take the ITE in the same testing environment (a Prometeric Testing Center) as the “real” exams.

The ITE contains 200 questions and you have 4 hours to complete the exam.  You can learn more about the ITE by reading the ITE Blueprint

What to Study for the ITE

Just like every major exam, the ITE has a content outline which will outline what topics will be on the exam.  Take some time and look through the content outline to see what you should expect for the exam.  The content within the ITE is the same type of information that is on the Basic and Advanced Exams.  Some residency programs have a study schedule put together to help prepare their residents for the exam.

When Will You Take the Exam?

You will take the ITE every February.

If you are doing your Internship through the same department as residency, you might have the opportunity to take the ITE.  Study up for the exam, but don’t stress out too much if you are an Intern taking the exam.  Most programs use this first ITE as a baseline to see how you will do in the future.  You want to make sure that you are on track to pass the Basic and Advanced Exams the fist time you take them.

Does Your Score Really Matter?

To the ABA, your score does not matter for Board Certification.  Your residency program might take a different approach, however.

If you take the exam during your Intern year, the score does not hold much weight.  (But you will still be judged against other anesthesiology Interns around the country.)   As you go along further in your training, the ITE score will mean more and more to you (and your program).  This is because your scores will provide a trajectory for you to see if you will pass your Basic and Advanced Exams in the future.  It will also provide you with a measure to see how you stack up against residents across the country.  This objective measure is also used by fellowship programs to see how well residents are doing in their anesthesiology knowledge base.

Some residencies have minimal requirements for ITE scores.  If you do poorly, you may end up at academic risk.  If you are at academic risk, it might impact your standing in your residency program.  It is best that you take these ITE seriously.

What do You Really Get out of the ITE?

You get a practice exam along with feedback to the questions you missed in the form of Keywords.  Keywords are the topics that you did not have a good understanding about based on questions you missed in the exam.  You can use those Keywords to look up information that you need to concentrate on.  You can also look up the Gaps of Knowledge to see what areas tend to trip up residents year after year.

How does the ITE fit in with the rest of your training?

Every February you will be taking  a practice exam when you take the ITE.  You can build your study schedule around this deadline each year.  This is also an important exam when you take it during your CA-1 year, because in June, you will be taking the ABA Basic Exam.  To put it into the big picture, you can check out the ABA Timeline provided by the ABA on their website.

ITE Preparation Resources

When you are studying for the ITE, you are learning your trade and increasing your anesthesiology knowledge, which is one of the components of Board Certification.  When you are studying for the ITE, you will also be studying for the ABA Basic, Advanced, and Applied Exams. You will be using some of the same resources that you will use for your other exams.

If you are an Intern, I would suggest some of the resources found  in our article on Hacking Your Intern Year to help you prepare for the ITE.  Along with the ITE has a content outline, and ITE Blueprint, you can learn more about the ABA Board Certification process here.


ITE Preparation Books

Most of the resources for the ITE will be same that you will use for your other exams.

ITE Specific Books

Anesthesiology Keywords Review is the only book I know of that is specific to the Anesthesiology ITE.   Keywords takes each Keyword from the ITE Content Outline and gives Key Points and Discussion about each one.  It has a table of contents which gives you different ways (alphabetical or rotation) to look up specific Keywords.    You can take you report from your ITE and use this book to help you target your studying.   You can find a review of this book written in Anesthesia and Analgesia.  Keywords Review is available as a paperback book.


Basic Anesthesia Books

The book called Morgan and Mikhail’s Clinical Anesthesiology is my favorite basic anesthesia book.  It is well written, and easy to pickup and read.  I used M&M during my anesthesia training to learn the basics and to prepare for my In-Training Exam (ITE) and my boards.  It makes it easy to look up information you need quickly and can be read for long periods of time.  As one Amazon reviewer stated “ … the (new) authors clearly and concisely present the material in an easily digestible format.”  This book is available in paperback and on Kindle.


Called “Baby Miller” or “Miller Light,” Basics of Anesthesia has been a staple for anesthesia trainees for generations.  I read the 4th edition cover to cover my senior year of medical school.   Basics of Anesthesia has continued to expanded over the years.  It is laid out a little differently than “Clinical Anesthesia,” but it is a basic anesthesia book that will serve you well.  It truly is a classic.  Basics of Anesthesia is available as a hardback, and on Kindle.


At last Baby Barash is here.  (Barash is the author of Clinical Anesthesia which is one of the two big anesthesiology reference books.)  Barash’s Clinical Anesthesia Fundamentals is an introductory text which is on par with Clinical Anesthesiology and Basics of Aneshtsia listed above.  It has the same smooth read that the large Barash is known for.  It has full color pictures and has “Did you Know?” facts in the margins which reinforce a point in the paragraph.  Each Chapter has questions at the end which helps to embed the info in your memory.  It is available as a paperback or Kindle.


Resource Books

Stoelting’s Anesthesia and Co-Existing Disease, 6e  This is a great mashup between Harrison’s and an Advanced Anesthesia text.  The book will present a medical problem, tell you the symptoms, physiology and how to treat it.   Then it has a paragraph or two on how to approach a patient with the disease for anesthesia.  The beauty of this book is that it will “trick” you into reading about the medical/surgical side of a problem, then will reward you with some anesthesia knowledge.  You can use this  book to read up on general medical knowledge as well as on the anesthesia implications related to that knowledge.  It is available as a hardcover and a e-textbook.


While the Anesthesia ITE raises the stress level among residents each year, it is a good deadline to help you schedule your studies.  With such a busy schedule, it is sometimes hard to find the time to study.  Check out our article Study on the Move, to learn how you can build studying into the most busy of schedules.