Progressive transplant oral-exam preparation

A 12-Week Transplant Surgery Oral Exam Study Plan

A deliberate progression from public-format fluency and cross-organ foundations to two complete 50-minute mock sessions with stable personal-case command.

27 min readSource reviewed July 30, 2026SurgiTest Clinical Editorial Team

Key takeaways

  • Start with the public TACC architecture and a baseline rather than beginning with unstructured reading.
  • Advance through immunology, donors, kidney, liver, extended-organ breadth, and post-transplant complications in a defined sequence.
  • Develop the three submitted cases throughout the plan instead of cramming them in the final week.
  • Complete increasingly realistic two-session simulations and reserve the final week for repair, logistics, and taper.

How the plan works

Use an output-driven plan

The oral examination rewards visible decision-making. Reading alone can improve recall while leaving the candidate unable to prioritize, commit, describe an operation, recover from a complication, or answer a changed variable. Every week in this plan therefore includes spoken cases, technical descriptions, rescue drills, and personal-case work.

The plan assumes twelve weeks, but the sequence matters more than the calendar. A shorter timeline can compress adjacent weeks; a longer timeline can repeat difficult domains. Preserve the progression from baseline to focused repair to complete simulation.

Daily retrieval

Use short closed-book prompts for immunology, donor assessment, organ-specific management, infection, malignancy, and complications.

Spoken case practice

Complete original catalog cases aloud and require a structured opening, a primary plan, a meaningful alternative, and an endpoint.

Operation repetition

Describe one procurement, implantation, reoperation, or rescue procedure each day using the same universal framework.

Personal-case development

Add one layer to each of the three cases every week: timeline, decision ledger, operation, complication, branches, outcome, and learning.

Error ledger

Record observable errors by behavior rather than topic alone: delayed commitment, unrequested data, missing bailout, unsafe immunosuppression, or weak longitudinal closure.

Foundation phase

Weeks 1–3: format, baseline, immunology, and donor foundations

WeekPrimary workRequired outputs
1 — Format and baselineRead current TACC public documents; map the two sessions; complete baseline cases across all eight SurgiTest sections; identify three official cases separately.One baseline scorecard, one error ledger, three de-identified case skeletons, and a verified exam-source checklist.
2 — Immunology and allograft injuryHLA and antibody risk, crossmatch, induction, maintenance, sensitization, rejection phenotypes, biopsy interpretation, and treatment tradeoffs.Four spoken immunology cases, two biopsy-based comparisons, and one rejection-versus-infection rescue drill.
3 — Donor selection and procurementDBD and DCD pathways, donor-derived risk, organ quality, procurement conduct, anatomy, preservation, back table, and accept/decline decisions.Three organ-offer drills, two procurement descriptions, one donor-derived disease scenario, and completed donor/graft profiles for all personal cases.

Organ-specific depth

Weeks 4–6: kidney, liver, and technical execution

WeekPrimary workRequired outputs
4 — Kidney transplantationCandidate evaluation, immunologic risk, deceased and living donor strategy, implantation, ureteral reconstruction, delayed function, vascular and urologic complications, rejection, infection, and recurrence.Five kidney cases, two full implant descriptions, one thrombosis rescue, one leak/obstruction comparison, and a kidney branch map for any relevant personal case.
5 — Liver transplantationListing, allocation, acute and chronic failure, donor selection, hepatectomy, caval/portal/arterial/biliary reconstruction, reperfusion, primary nonfunction, vascular and biliary complications, rejection, infection, and recurrence.Five liver cases, two transplant descriptions, one post-reperfusion collapse drill, one hepatic-artery complication drill, and a liver branch map for relevant personal cases.
6 — Technical precision across organsProcurement, back-table work, access, control, reconstruction, reperfusion, completion assessment, postoperative endpoints, reoperation, and safe transfer or escalation.Seven timed operation descriptions, a bailout table, one combined procurement-to-implant mock, and explicit technical narratives for all three personal cases.

Integration phase

Weeks 7–9: extended breadth, complications, and personal-case defense

WeekPrimary workRequired outputs
7 — Pancreas, intestine, and multivisceral breadthCandidate and donor selection, operative concepts, graft thrombosis, leak, rejection, infection, nutrition, rehabilitation, graft-versus-host disease, and complex reoperation.Three pancreas cases, three intestinal/multivisceral cases, two technical comparisons, and a written statement separating SurgiTest breadth from official kidney/liver organ-specific language.
8 — Infection, malignancy, and systemic complicationsTime-dependent infection, donor-derived disease, opportunistic pathogens, PTLD, skin and solid-organ malignancy, metabolic disease, cardiovascular risk, renal injury, cytopenias, medication toxicity, adherence, and pregnancy.Six complication cases, one infection-versus-rejection matrix, one PTLD scenario, one adherence/ethics conversation, and prophylaxis/surveillance plans for each personal case.
9 — Personal-case deep defenseRun each case from recipient and donor selection through operation, complication, outcome, and learning; change anatomy, antibody risk, organ quality, pathology, infection data, and institutional capability.Three 20-minute defenses, three decision ledgers, three operation scripts, at least five branch questions per case, and a contradiction/privacy audit.

Performance phase

Weeks 10–12: full simulations, targeted repair, and taper

WeekPrimary workRequired outputs
10 — First complete two-session mocksRun two 50-minute sessions with different examiner styles, a realistic break, general topics, organ-specific cases, and submitted-case discussion.Two full mocks, domain-level feedback, pacing data, and a ranked list of the five most important repair targets.
11 — Repair and repeatUse short drills for the ranked behaviors, then repeat complete sessions. Include at least one unstable graft, one donor-derived risk issue, one ethical allocation problem, and one personal-case complication.Two more full mocks with objective improvement in the targeted behaviors and no new privacy or factual inconsistencies.
12 — Final stabilityComplete one final mock early in the week, verify current logistics, rehearse opening frameworks, protect sleep and clinical coverage, and avoid changing established answer structures.One final readiness review, technology confirmation, identification and room checklist, current-policy verification, and a concise personal-case one-page memory map for private study only.

Sample cadence

Use a sustainable weekly rhythm

DayCore taskSpoken output
MondayDomain review and retrievalOne 20-minute catalog case plus one five-minute operation description.
TuesdayPersonal case 1 and immunologyOne personal-case branch plus one rejection/infection comparison.
WednesdayOrgan-specific depthTwo shorter cases focused on selection, technique, and complications.
ThursdayPersonal case 2 or 3 and donor/procurementOne personal-case branch plus one organ-offer or procurement drill.
FridayUnstable patient and ethicsOne rescue case plus one communication/adherence/allocation scenario.
WeekendTimed mixed mock and reviewOne 50-minute session, followed by error-ledger repair and spaced retrieval.

Readiness dashboard

Measure behaviors that can actually improve

  • A structured opening appears within the first answer rather than after a long unprioritized differential.
  • Tests and consultations are tied to decisions instead of requested reflexively.
  • The candidate states a primary plan, a meaningful alternative, and the finding that changes the plan.
  • Operations include control, protection, reconstruction, endpoint, and bailout—not only anatomic steps.
  • Graft dysfunction is not labeled rejection before technical, infectious, toxic, recurrent, and systemic causes are considered.
  • Immunosuppression changes account for infection, malignancy, wound healing, renal function, cytopenia, and recurrence risk.
  • Personal-case answers remain internally consistent across repeated questioning and changed variables.
  • Every case closes with reassessment, disposition, prophylaxis, surveillance, and longitudinal ownership.

Alternative timelines

Compress safely when less than twelve weeks remain

Eight weeks

Combine weeks 1–2, 3–4, 5–6, and 7–8 while preserving weeks 9–12 as four distinct performance weeks.

Six weeks

Use one foundation week, two organ-depth weeks, one complications/personal-case week, and two full-simulation weeks.

Three weeks

Audit the public format and personal cases immediately, then alternate 50-minute mocks with targeted repair. Do not attempt to read every source linearly.

More than twelve weeks

Repeat weak organ and complication cycles, add faculty or peer examiner variability, and preserve one lower-intensity recovery week every four weeks.

Put the framework under pressure

Rehearse the exact decisions in your own cases.

Voice-first cases, adaptive examiner follow-up, imaging, complications, and structured educational feedback for transplant surgery.

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Questions candidates ask

Frequently asked questions

What is the current TACC oral examination format?

TACC’s current examinee information describes two online oral-examination sessions lasting 50 minutes each, with a break between sessions and two examiners in each session. The examination can include general transplant topics, kidney and/or liver questions based on the candidate’s Certificate of Completion and current practice, and discussion of three cases submitted during oral-exam registration.

Does TACC use personal cases?

Yes. Candidates submit three post-fellowship transplant cases when registering for the oral examination, and TACC encourages interesting or technically complicated cases. The three oral-exam cases are separate from the post-fellowship surgical log submitted during certification application. SurgiTest Personal Case Uploads are a private rehearsal workflow for newly written, fully de-identified educational summaries; they do not submit or replace either official TACC record.

How many full mock examinations should I complete?

A useful target is at least four complete two-session simulations after foundational work, with shorter 50-minute sessions before that. Quality matters more than a raw number: every mock should generate a small set of observable repairs that are tested again.

Should I study pancreas and intestinal transplantation if current TACC language names kidney and liver?

Study according to your training, current practice, and the current official instructions. SurgiTest includes pancreas, intestine, and multivisceral domains as comprehensive abdominal-transplant education, while clearly avoiding the claim that TACC publishes separate official rooms or weights for those domains.

Source transparency

Official references

Board requirements, dates, and candidate instructions can change. Confirm current details directly with TACC and the Board’s candidate portal.

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