Safely transition your senior residents to independent practice with psychometrically sound feedback on their clinical decision making skills.
"The ACS SRRA fills a critical gap in surgical education by providing one of the first structured assessments of complex clinical judgment in the senior years of residency. It empowers faculty to make more confident entrustment decisions, guides residents with targeted formative feedback at a pivotal stage in their development, and supports patient safety by fostering purposeful autonomy. In a training landscape where high-stakes, real-time decisions are increasingly expected of senior residents, the SRRA offers a vital mechanism to ensure readiness and accountability."
The ACS Senior Resident Readiness Assessment (SRRA) is a psychometrically validated, scenario‑based evaluation of clinical decision‑making—not simple recall—administered each September to incoming PGY‑4 surgery residents. Designed for formative purposes, it measures a resident’s ability to manage complex clinical problems, prevent and treat complications, prioritize patient care, and lead clinical teams.
SRRA employs the internationally recognized “key‑features” methodology, presenting 40 brief, level-appropriate case scenarios across 27 high‑yield surgical topics. This methodology assesses the application of knowledge in realistic clinical scenarios—the very skills that distinguish safe, effective senior residents.
Developed by the ACS Division of Education with expert faculty, each question targets critical decision points rather than rote knowledge. Residents complete brief written responses and structured menu‑based items that mirror real‑world prioritization and complication‑management scenarios—ensuring the SRRA focuses on the critical decisions that directly impact patient safety and senior resident readiness for independent practice. Use ACS SRRA results to refine curricula, personalize learning plans, and ensure your graduates transition confidently and safely to independent practice.
ACS SRRA is built on the proven methodology of the ACS ERRA for incoming interns.
The ACS SRRA is a proctored assessment, requiring a staff member to monitor the room where residents take the assessment. The administration is allowed at any time within the Administration Window, indicated above. Each resident will need their own computer with strong Internet connectivity. Ideally, residents will take the assessment in the same window; however, it is possible to split administration. Contact the ACS SRRA staff for more information.
Residents are allowed up to three hours to complete the assessment; however, the average is closer to a two-hour duration. Results will be provided by late September.
ACS staff will be happy to provide training and assistance with the technical and administrative details of the assessment.
Following the assessment, program directors and residents are provided with psychometrically sound, nationally benchmarked, individualized score reports for each resident. The reports identify specific areas of strength, clinical topics that need to be addressed, categories of potentially harmful decisions and actions, and corresponding suggested resources for additional study. Designed for formative purposes, the ACS SRRA score reports outline steps for residents to identify areas for improvement, develop a personalized learning plan, and meet with their program director to put their plans into action over the subsequent months.
After each administration, program directors receive confidential, resident‑level and program‑level score reports benchmarked against national peers. Resident reports are personalized and are meant to be distributed by program staff.
Individual Reports
Program Reports
All results are delivered confidentially to support data‑driven feedback, personalized learning, and continuous quality improvement.
The ACS Division of Education methodically defined a validated domain of cases and recruited expert faculty to develop the assessment. Two pilot studies were conducted in a step-wise sequence with improvements made after each pilot. The first pilot was a small study that focused on the test takers’ understanding of the clinical cases, conducted in summer 2024. The psychometric pilot study was conducted during the winter of 2025 across 14 surgical residency programs nationwide. The results demonstrated validity and psychometric rigor. The development of ACS SRRA and the selection of its content areas have been published in the Journal of Surgical Education (doi: 10.1016/j.jsurg.2022.04.011).
Development is ongoing to protect the integrity and quality of the assessment.
Leadership Team
ACS SRRA Authors
The cost of the SRRA is $160 per resident.
Open through August 1, 2025.
August 18–29, 2025
Complete the form below to request an ACS SRRA demonstration for program staff.
Approximately 80 questions across 40 cases