5 Common Misconceptions of Candidates Who Fail the Surgery Certifying Exam

From a candidate's perspective

"After I failed the first time, I thought, 'why did these other people I know pass? What is wrong with me? What didn't I do to prepare? What special knowledge or skills, or resources did they use that I don't know about or should have known about? It all feeds into that self-doubt without realizing that we are all in the same boat coming out of residency. Because I'm guessing that pretty much everybody is told the same thing, and we are all told to use the same resources.'"

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This quote is from a recent candidate who is currently preparing with me for his next exam. His reflections represent what I have heard from over 1,000 surgeons who failed the exam before coming to work with me.

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No candidate is ever ready to fail the exam

For most candidates who fail, the Oral Board Examination is the only examination they've ever failed over their many years as professional students – including high school, college, medical school, and residency training. And to fail the last and most crucial professional exam they will ever take can be a shock.

If you have failed the Surgery Certifying Exam, let me say from the outset that there is nothing wrong with you, either as a person or as a surgeon.

I say this because some candidates who fail the exam can develop a high degree of self-doubt and self-criticism, as my candidate mentioned. It is as if the exam "reveals" the candidate has significant "weaknesses" as a surgeon or does not meet the standards of a certifiable surgeon. Like this candidate, most other candidates who fail frequently compare themselves with candidates who have passed and wonder what their shortcomings are compared to other surgeons.  

5 common misconcpetions

The reality, however, is that failing the exam has little to do with shortcomings in the candidate. Instead, poor exam performance has much more to do with the following:

1. Candidates' misconceptions of the exam objectives and how they are achieved.
2. Candidates' misconceptions of what the examiners "want" from the candidate.
3. A profound misunderstanding of the conduct of the Certifying Exam since it is cloaked in mystery, rumor, anecdotal stories, and hidden "rules."
4. The pervasive reputation of the exam as a "dangerous" event where the examiners plan to trick candidates and deliberately fail them. (This misunderstanding is further reinforced by the fact that the exam historically has a 20-25% fail rate.)
5. The skill sets that are required to do well on the oral exam are not innate and are not explicitly taught in residency.
   

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Why do candidates have these common misconceptions? Read Do I have misconceptions about the exam?

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