Background. Because of the content of the American Board of Surgery (ABS) certifying (oral) examination, there is a perception that those in some subspecialty surgical training programs at the time of the examination may have a lower pass rate. In addition, the format of the oral examination has prompted the use of specialized preparation such as “mock orals” and commercial courses. The purpose of this study was to correlate the pass rates on the ABS certifying examination with the practice status and methods of specialized preparation.Materials and methods. A survey covering demographic information, type of surgical practice at the time of the examination, methods of preparation, and results of the examination was distributed to 1997 and 1998 graduates via a request to surgical residency program directors.Results. One hundred one of 268 program directors supplied 717 names. There were 465 responses. Surveys distributed by the other 167 program directors resulted in an additional 81 responses. Four hundred ten (75%) of the respondents had taken the certifying examination. The total pass rate was 91%. There were no significant differences in the pass rate between those in private practice general surgery; those in academic general surgery; Thoracic, Vascular, or Plastic Surgery Fellows; those in other surgical fellowships; and those in the military or research. No significant differences in the pass rates were noted between those who prepared with formal mock orals, with informal mock orals, with a commercial course, with combinations of the three, and with no specialized preparation.Conclusion. Performance on the ABS certifying examination was not influenced by the candidate's practice status at the time of the examination. A substantial percentage of examinees either are exposed to or perceive the need to pursue specialized preparation for the examination, a behavior that in general produces good results.