The SAE is a self assessment as noted above, so there is no pass/fail. The test is also supposed to be proctored and timed, so comparing it to something like UWorld that you can do at home in your PJs is not a realistic comparison. Yes there are going to be unfair circumstances for some (usually PGY-2's) that can affect performance, but that is just the way it is in medicine sometimes. I tried to lobby for no resident to be on call the night before the exam with our attendings as a resident based on the fact that some fellowships actually look at the exam. I got shut down, but they at least allowed the on call resident to be excused from that mornings duties so they could at least take a nap before the test. This happens in other specialties as well and not just PM&R. I think I took the ABSITE as an intern with a fever of 101 after working like 12 days in a row, but that was the only day to take the test, so I did. I know other surgery residents that took it post call, and their call is way worse than any PM&R call for the most part. Surgery fellowships definately look at ABSITE, and some programs will even fire residents based on their performance. Again as I mentioned before, many programs don't ask for it, so it obviously is not super important at fellowships. Some will care though, and the people reading this thread need to realize that. If you don't want to take the test seriously and do poorly, that is the risk you took. If you don't want to do fellowship, nobody will care other than maybe your PD if you do poorly.