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Adult Complex Thyroid and Parathyroid Surgery Focused Practice Designation (ACTPS) Exam Preparation

The Adult Complex Thyroid and Parathyroid Surgery Focused Practice Designation, developed jointly by the American Board of Surgery and the American Board of Otolaryngology — Head and Neck Surgery, is examined as a single written paper of roughly 150 questions across two 120-minute sessions. Thyroid disease and surgical concepts together account for around two-thirds of the blueprint. Practise with thyroid and parathyroid vignettes referenced to the American Thyroid Association and AAES guidelines.

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Exam format

Format
Single written examination of approximately 150 multiple-choice questions
Duration
~4.5 h, delivered as two 120-minute sessions with an optional break
Frequency
Once per year, in the spring
Pass rate
Not published as a standing figure by the board
Exam fee
See the American Board of Surgery (absurgery.org)

Eligibility requirements

  • Current certification by the American Board of Surgery, in compliance with the continuous certification programme
  • Non-fellowship pathway: at least 120 thyroid or parathyroid cases over three consecutive years, including at least 24 complex cases
  • Fellowship pathway: 80 cases including 16 complex within the first two years of practice after an AAES, ACGME or AHNS accredited fellowship
  • Demonstrated participation in multidisciplinary care of thyroid and parathyroid disease
  • A maximum of three attempts within five years

Syllabus breakdown

Thyroid Diseases — general concepts, benign disease, malignant disease34%
Surgical Concepts — thyroidectomy, parathyroidectomy, primary and reoperative, neck dissection31%
Parathyroid Diseases — general concepts, primary and secondary hyperparathyroidism27%
Anatomy and Physiology of the Thyroid and Parathyroid Glands8%

Preparation tips

  • Focus your first weeks on the highest-weight syllabus areas — they account for over half the marks and offer the fastest return on study time.
  • Use active recall with timed question sessions rather than passive re-reading. The ACTPS FPD written component rewards speed and precision under pressure.
  • Cross-reference every question explanation with the cited guideline section. Over a 3–6 month preparation cycle, this builds the mental index examiners expect in the oral component.

Frequently asked questions

What is the format of the ACTPS Focused Practice Designation examination?

It is a single written examination of approximately 150 multiple-choice questions lasting about four and a half hours, delivered as two 120-minute sessions with an optional break between them. It is offered once a year in the spring, with a maximum of three attempts within five years.

What does the ACTPS examination blueprint cover?

The published blueprint weights thyroid diseases at 34 per cent, surgical concepts including primary and reoperative thyroidectomy, parathyroidectomy and neck dissection at 31 per cent, parathyroid diseases at 27 per cent, and anatomy and physiology at 8 per cent.

What are the case requirements for the ACTPS designation?

The non-fellowship pathway requires at least 120 thyroid or parathyroid cases over three consecutive years, including at least 24 complex cases. Surgeons who completed an AAES, ACGME or AHNS accredited fellowship may qualify with 80 cases including 16 complex within their first two years of practice. Both pathways require demonstrated participation in multidisciplinary care.

How many ACTPS practice questions are available?

SurgBoardsQ&A provides 494 thyroid and parathyroid practice questions covering nodule evaluation, differentiated and medullary carcinoma, hyperparathyroidism and reoperative neck surgery, each with a guideline-referenced explanation.

Is there a free ACTPS question bank?

Yes — a free account includes 50 practice questions with no credit card required.

Start practising for ACTPS FPD

50 questions free, no credit card required. Filter by board, topic, or difficulty. Explanations cite current ESMO and NCCN guidelines.

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