What are the best multiple‑choice question resources and study approach for preparing for the American Board of Neurological Surgery (ABNS) board exam?

Neurosurgery Board Exam Preparation Resources and Study Approach

For ABNS board exam preparation, prioritize structured weekly didactic sessions combined with high-quality MCQ question banks, specifically the CNS Self-Assessment in Neurosurgery (SANS) and specialty-specific resources, while avoiding AI-based tools like ChatGPT which demonstrate insufficient accuracy (50.4%) for reliable board preparation. 1

Recommended Question Bank Resources

Primary MCQ Resources

• CNS SANS (Self-Assessment in Neurosurgery) question bank serves as the gold standard resource, containing over 2,120 questions across all neurosurgical subspecialties 1
• Self-Assessment Neurosurgery Examination (SANE) Indications Examination provides 149 predominantly higher-order management questions (85.2%) specifically designed for oral boards preparation 2
• These resources directly mirror the format and content depth required for ABNS written and oral examinations 1, 2

Subspecialty Coverage Priorities

Focus your preparation across these core areas with particular attention to high-yield topics:

• Vascular neurosurgery (historically the most challenging category with lowest AI accuracy at 32.9%, indicating complexity) 1
• Spine surgery (significant portion of board content) 2
• Tumor neurosurgery 1
• Trauma and critical care 1
• Functional neurosurgery 1
• Pharmacology (highest accuracy category, suggesting more straightforward recall) 1

Optimal Study Approach Algorithm

Structured Didactic Framework

Implement weekly resident education hours (REH) as your foundational study structure, which demonstrates a 46.2-point improvement on ABNS scaled scores when combined with repeated practice attempts 3

Question-Based Learning Strategy

1. Complete questions in timed, exam-simulating conditions to build stamina and time management 1, 2
2. Focus on higher-order management scenarios rather than pure recall questions, as these constitute 85.2% of oral board content 2
3. Review incorrect answers thoroughly, examining both the correct answer rationale and why distractors are incorrect 1
4. Track performance by subspecialty to identify weak areas requiring additional focus 1, 2

Peer-Based Learning Enhancement

• Form study groups for MCQ creation and peer review, which generates high-quality questions while reinforcing learning through teaching 4, 5
• Present case-based scenarios to colleagues following a standardized format to simulate oral board conditions 4
• Engage in structured discussions of clinical guidelines and journal articles related to question topics 4

Critical Pitfalls to Avoid

Do Not Rely on AI Tools for Primary Preparation

• ChatGPT (GPT-3.5) achieves only 50.4% accuracy on ABNS-style questions, well below passing threshold 1
• AI demonstrates 57.1% "hallucination" rates on imaging-related questions, providing fabricated explanations 2
• Even advanced models like GPT-4, while scoring 82.6%, still fall short of human expert performance and contain unreliable explanations 2

Avoid These Common Study Mistakes

• Do not focus exclusively on lower-order recall questions—higher-order problem-solving constitutes the majority of exam content 2
• Do not neglect imaging-based questions, which require text descriptions for proper interpretation 2
• Do not study in isolation—the practice effect combined with structured didactics yields significantly better outcomes than either approach alone 3

Evidence-Based Study Timeline

Longitudinal Preparation (Throughout Residency)

• Participate in weekly didactic sessions consistently starting from PGY-1, as the benefit compounds over multiple examination attempts 3
• Complete subspecialty rotations with focused question bank review aligned to current clinical exposure 6
• Engage with neurosurgery interest groups and professional societies (AANS, CNS) for access to educational resources and mentorship 6

Intensive Review Period (Final 3-6 Months)

• Complete full question bank passes with performance tracking 1
• Simulate oral board scenarios with faculty and senior residents 2
• Review high-yield guidelines from major neurosurgical societies 7, 8

Supplementary Educational Resources

Professional Society Resources

• AANS and CNS conference materials provide current evidence-based practice updates 6
• Institutional fellowship programs offer mentorship and structured learning beyond standard rotations 6
• Medical student interest groups (if still accessible) provide peer networking and collaborative learning opportunities 6

Quality Assurance Metrics

When evaluating any study resource, ensure:

• Questions demonstrate appropriate discrimination indices (ability to differentiate high vs. low performers) 4
• Distractors are plausible and based on common clinical misconceptions 4
• Content aligns with current clinical guidelines from major neurosurgical societies 7, 8

The combination of structured weekly didactics, systematic question bank completion (particularly CNS SANS), peer-based learning, and longitudinal preparation throughout residency provides the most evidence-based approach to ABNS board success. 1, 2, 3