Pediatric Surgery Oral Board Practice Cases by Domain: A Complete Five-Room Blueprint
A broad original-case architecture that tracks the current five PSCE rooms while adding age, physiology, operation, complication, family, and systems dimensions.
Key takeaways
- Practice distribution should mirror all five published rooms rather than the candidate’s recent clinical exposure.
- Every domain needs typical disease, unusual presentation, procedure description, complication rescue, and family or systems variants.
- Cross-cutting neonatal physiology, nutrition, safeguarding, ethics, transfer, and limits should appear throughout the case library.
- Use original cases and public blueprints; do not seek or reproduce recalled secure questions.
Build cases across three dimensions
| Dimension | Examples |
|---|---|
| Clinical room | Oncology; trauma/critical care; GI/hepatobiliary/abdomen; head-neck/endocrine/GU; thoracic/airway/chest wall. |
| Performance task | Diagnosis, stabilization, timing, operation, complication, postoperative care, communication, ethics, transfer. |
| Child context | Premature neonate, term infant, toddler, school-age child, adolescent, complex congenital disease, limited-resource setting. |
Room 1: Oncology
Wilms tumor
Imaging, metastatic workup, bilateral disease, biopsy boundaries, nephrectomy technique, spill, vascular extension and postoperative therapy.
Neuroblastoma
Risk features, catecholamines, image-defined surgical risk factors, biopsy versus resection, vascular encasement, organ preservation and multimodal timing.
Liver tumors
AFP interpretation, PRETEXT-style anatomy principles, biopsy, chemotherapy, resectability, transplantation discussion and hemorrhage.
Germ-cell and gonadal tumors
Tumor markers, torsion differential, fertility, surgical approach, staging, spillage and multidisciplinary care.
Soft-tissue and chest tumors
Biopsy track, margins, limb or organ preservation, neoadjuvant therapy, reconstruction and recurrence.
Oncologic emergencies
Tumor lysis, hemorrhage, airway or vascular compression, bowel obstruction, infection, line complications and thrombosis.
Room 2: Trauma and critical care
Blunt solid-organ injury
Stability, transfusion, nonoperative management, activity, escalation, embolization and operative control.
Thoracic trauma
Pneumothorax, hemothorax, pulmonary injury, airway disruption, diaphragmatic injury and chest-tube complications.
Abdominal trauma
Hollow-viscus, pancreatic, duodenal, mesenteric and renal injury with delayed presentation and operative decisions.
Burns
Airway, fluids, temperature, pain, transfer, inhalation injury, escharotomy, nutrition and safeguarding.
Nonaccidental trauma
Immediate care, pattern recognition, reporting, evidence preservation, multidisciplinary protection and professional communication.
Critical illness
Sepsis, ventilation, shock, renal dysfunction, nutrition, line infection, abdominal compartment syndrome and goals of care.
Room 3: GI, hepatobiliary, and abdomen
Neonatal obstruction
Atresia, meconium ileus, Hirschsprung disease, small left colon, malrotation and diagnostic sequence.
Volvulus and ischemia
Time-critical recognition, resuscitation, exploration, viability, resection, second look and short-bowel consequences.
NEC and spontaneous perforation
Medical management, drainage versus laparotomy, bowel preservation, stoma, stricture and nutritional failure.
Appendicitis and inflammatory disease
Imaging, antibiotics, drainage, timing, Crohn disease, abscess, obstruction and recurrence.
Biliary and hepatic disease
Biliary atresia, choledochal cyst, gallstones, portal hypertension, liver lesions and postoperative bile complications.
Nutrition and access
Gastrostomy, jejunal access, central access, short bowel, intestinal failure, line sepsis and transplant referral.
Room 4: Head and neck, endocrine, GU, and anorectal
Neck masses
Midline versus lateral, infection, airway, imaging, congenital tracts, thyroid involvement and complete excision.
Thyroid and endocrine
Nodule evaluation, cancer, hyperparathyroidism, MEN syndromes, nerve protection, calcium and multidisciplinary planning.
Inguinal and gonadal disease
Hernia, hydrocele, cryptorchidism, torsion, gonadal tumor, contralateral evaluation and fertility.
DSD and cloaca
Immediate safety, anatomy, endocrine and genetic evaluation, multidisciplinary counseling, timing and staged reconstruction.
Anorectal malformations
Newborn evaluation, fistula localization, associated anomalies, colostomy decisions, repair, bowel management and long-term function.
Urologic interfaces
Obstruction, reflux, ureteral or bladder injury, urinary diversion, renal preservation and appropriate urology involvement.
Room 5: Thoracic, airway, and chest wall
Esophageal atresia and fistula
Associated anomalies, airway, gap, repair, leak, stricture, recurrent fistula, dysmotility and reflux.
Congenital lung lesions
Prenatal counseling, respiratory distress, timing, imaging, lobectomy or segmental considerations and complications.
Diaphragmatic hernia
Ventilation, pulmonary hypertension, stabilization, ECMO discussion, repair timing, recurrence and long-term lung disease.
Airway foreign body
Presentation, imaging limits, rigid bronchoscopy, anesthesia, extraction, complete obstruction and airway injury.
Empyema and infection
Antibiotics, drainage, fibrinolysis, VATS, lung entrapment and persistent sepsis.
Chest wall and mediastinum
Pectus, tumors, mediastinal mass, vascular compression, reconstruction, pain and recurrence.
Cross-cutting cases should appear in every room
- Prematurity, low weight, congenital heart disease and fragile respiratory reserve.
- Hemorrhage, sepsis, hypothermia, hypoglycemia and age-adjusted shock.
- Operation description and an examiner-introduced intraoperative complication.
- Postoperative respiratory failure, leak, obstruction, ischemia, infection or nutritional failure.
- Consent, assent, uncertainty, disclosure, safeguarding or conflict.
- Recognition of personal and institutional limits, transfer and multidisciplinary resources.
- Pain, opioid stewardship, nutrition, rehabilitation and long-term developmental function.
A minimum high-quality practice set
| Category | Minimum deliberate practice |
|---|---|
| Five rooms | At least 20 cases per room across preparation, then repeated weak families. |
| Complete room simulations | At least 10 total, including several with unfamiliar examiners. |
| Full five-room mocks | At least 3 realistic complete rehearsals. |
| Procedure descriptions | At least 40 distinct procedures, with high-yield operations repeated in compressed form. |
| Unstable-child pivots | At least 30 across airway, hemorrhage, sepsis, neonatal and postoperative patterns. |
| Family and professionalism tasks | At least 15 conversations spanning consent, uncertainty, transfer, complication and safeguarding. |
Original cases should test decisions, not trivia
- 01
Write a clear opening problem
Include age and enough information to demand prioritization without revealing the entire diagnosis.
- 02
Define the key decisions
Stabilization, testing, timing, procedure, complication and disposition.
- 03
Add one or two pivots
New physiology, imaging, pathology, family constraint, resource limit or operative finding.
- 04
Create acceptable answer ranges
Avoid forcing one institutional preference when several safe evidence-based strategies exist.
- 05
Protect examination integrity
Do not use recalled secure questions or represent original cases as official ABS content.
Put the framework under pressure
Practice the answer out loud—not only on paper.
Voice-first cases, adaptive examiner follow-up, imaging, complications, and structured educational feedback for pediatric surgery.
Questions candidates ask
Frequently asked questions
What is the current Pediatric Surgery Certifying Examination format?
The ABS currently describes the PSCE as a virtual oral examination with five consecutive 30-minute sessions. Two examiners conduct each session, four structured cases are presented in each room, and the five rooms cover oncology; trauma and critical care; GI, hepatobiliary and abdomen; head and neck, endocrine and GU; and thoracic, airway and chest wall.
Does the PSCE use candidate-submitted personal cases?
The public PSCE description identifies structured cases prepared in advance rather than candidate-submitted cases. The certification pathway separately requires an operative experience report for the Pediatric Surgery Qualifying Examination application. SurgiTest therefore uses original catalog cases and does not present Personal Case Uploads as a current PSCE requirement.
Does SurgiTest reproduce ABS questions or calculate an official result?
No. SurgiTest uses original educational scenarios informed by public examination structure. It does not reproduce secure questions, calculate an official ABS grade, predict certification, or claim endorsement by the American Board of Surgery.
Why is procedure description so important?
The ABS publicly states that candidates are expected to know how to perform and describe procedures in the Pediatric Surgery SCORE outline and that inability to describe a procedure is unsatisfactory performance on that case. Practice should therefore include concise operative explanation, not only diagnosis and indication.
Where should I verify dates and virtual-exam instructions?
Use the current ABS website, your ABS portal, the final assignment, the admission letter, and the mandatory technology-interview instructions. Operational details can change, and the candidate-specific documents control.
Source transparency
Official references
Board requirements, dates, and candidate instructions can change. Confirm current details directly with ABS and the Board’s candidate portal.
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