American Society of Plastic Surgeons
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In-Service Exam for Residents Exam Information

The In-Service Exam provides Training Programs and their residents with a means to review the entire scope of plastic surgery, with equal emphasis placed on:

  • Comprehensive
  • Hand/Extremities
  • Craniomaxillofacial
  • Cosmetic/Breast
  • Core Surgical Principles

This exam is held at the Training Program's location and proctored by program staff in a secure environment. Registration can be completed by the Training Program through their ASPS program dashboard.

Registration opens on August 31, 2026.

Administration Requirements

  • Program to provide contact information for administrator/coordinator, chief proctor and program director.
  • Resident to be enrolled under the assigned training program ID (ACGME) to ensure accurate reporting.
  • Accommodation requests are required in writing with consent of program directors, to cover any of the following: extra test time, extra break time (untimed) and resident testing outside of home location site.
  • Reserve adequate lab space: The environment should be free of distractions, away from highly trafficked areas and have minimal noise. Every effort should be made to start testing before 9:00 AM to ensure all examinees have an equal testing environment.
  • Programs to provide workstations and/or laptops with recommended technical configurations for each examinee plus backup workstations in case of the exam day hardware failure.
  • Provide one (1) Proctor workstation with the recommended configuration in each scheduled exam room.
  • Provides minimum of two (2) proctors on the day of the exam, one to monitor the Chief Proctor workstation and one to monitor participants. Computer lab staff may serve as secondary proctors.
  • Provides dedicated technical support staff with administrator privileges, required to check at least one day in advance of the March 4 exam day.
  • Tests and confirms each workstation prior to exam day. Residents who will be testing on laptops must run system checks at least one day in advance of the March 4 exam day.
  • Proctors review Chief Proctor manual and Chief Proctor video ahead of exam day. Practice utilizing proctoring software recommended.

NOTE: ASPS does not support the use of virtual proctoring for the In-Service Exam. All programs are expected to conduct this exam in person at their training facilities.

Technical Requirements

Standard NBME Web-Based Testing Requirements

The standard NBME web-based testing requirements outlined below apply to exams delivered over both wired and wireless networks. Examinees may take a web-based exam on either Macs or PCs. Any combination of fixed desktops, institutional laptops or examinee personal laptops may be used for exam delivery.

Dedicated technical support staff with "Admin" privileges is required prior to and on the test days.
Hardware Requirements
  • Windows 10, Windows 11
  • Mac OS X v10.15, v11.0, v12.0 v13.0, v14.0, v15.0
  • 1 GHz processor or higher
  • 17" or larger color monitor (Desktops)
  • 13" or larger color monitor (Laptops)
  • A minimum screen resolution of 1024x768
  • 32-bit color setting enabled
  • Turn off Windows, virus scanner and Citrix Workspace updates to avoid interruptions during the exam
  • Virtual machines and applications are not allowed
  • iPads/tablets are not allowed
  • ASUS laptops with touchpad/touchscreen are not allowed
Browser
  • Microsoft Edge1
  • Safari 13 or higher
  • Google Chrome1
  • Mozilla Firefox1
  • Do not use beta versions. Other browsers are not supported.

1Edge, Chrome and Firefox support is limited to the current version plus one previous version due to forced automatic updates.

Browser Settings
  • JavaScript, CSS and Cookies all enabled
  • Pop-up enabled
  • TLS 1.2 or higher
  • Disable toolbars and Adware/Spyware programs to prevent slowness
Internet Bandwidth
  • Broadband (DSL, Cable or T1)
  • 256Kbps or higher per workstation (including internet access)

Institutional technical support staff with admin privileges is required prior to and on test day(s) to assist examinees with any technical issues that may arise.

About the In-Service Exam

The purpose of the ASPS In-Service Exam, also known as the Plastic Surgery In-training Exam (PSITE), is to assess current knowledge in plastic and reconstructive surgery. The exam is administered annually and provides both experienced surgeons and surgical residents with a comprehensive review of the core curriculum of plastic surgery. For the resident, there is a correlation1 between one's score on the PSITE and success on the written board examination at the completion of residency. The test consists of 250 items across five disciplines that are meant to test the wide range of knowledge that a plastic surgeon is expected to possess. The specific areas tested include comprehensive plastic surgery, craniomaxillofacial surgery, aesthetic/cosmetic surgery, hand and lower extremity surgery, and core surgical principles. While four of the five modules cover content directly related to plastic surgery, core surgical principles also includes content from other specialties that is important for plastic surgery trainees to know.

The In-Service Exam is a formative assessment to be used as one of several instruments to measure residents' acquired knowledge as compared to their peers among a national norm group composed of plastic surgery residents from accredited U.S. and Canadian plastic surgery graduate training programs. The In-Service Exam is intended to provide information to resident programs that will be used to improve each program's teaching; it is not intended to be used as the sole data point in evaluating a resident's content knowledge. ASPS and the In-Service Exam committee recommend that performance on the In-Service Exam be evaluated in the context of other assessment measures as well as trends.

1. Girotto JA, Brandt K, Janis JE, Cullisen T, Slezak S. Abstract: Saw it coming: The correlation between poor performance on the plastic surgery in service exam and failure on the American Board written exam. Plast Reconstr Surg Glob Open 2017;5(Suppl):70.