Do I have misconceptions about the exam?

Common feeling candidates have after failing the exam

Many individuals who fail the Surgery Certifying Exam feel isolated and confused. Over the years of coaching candidates, I have come across patterns and common perceptions in candidates:

• Confusion about why they failed
• Comparison to other surgeons who have passed
• An uncovering of hidden "weaknesses" as a surgeon
• Wondering whether the exam "discovered" that the candidate is not a capable surgeon
• Self-doubt
• Self-criticism
• Guessing why the failure occurred
• Anger at the examiners or the ABS for being unfair

Unfortunately, many candidates have never been told that they had incomplete or incorrect information about the exam. You can read about a personal candidate story and the 5 common misconceptions about the exam. It is important to state: if you have failed the Surgery Certifying Exam, there is nothing wrong with you, either as a person or as a surgeon.

Banking on past success to pass the Surgery Certifying Exam

This can be a hard pill to swallow because many look to past experiences with confusion, believing they should have passed based on the following:

• "I did really well on my ABSITE exams."
• "I did really well on my written exam."
• "My faculty told me I did well in my mock orals in residency."
• "I was an excellent resident."
• My residency faculty said I would have no problem with the oral exam."
• "I never killed a patient in any of my exam scenarios."
• "I walked out of the room feeling really positive."  
• "None of the examiners ever corrected me."
• "None of the examiners ever questioned my choices."  
• "I thought I followed all the correct algorithms to answer the questions on the exam."  
• "I read all the content I was supposed to read."

A common thread runs through each of these beliefs. There are standard false assumptions that give candidates false hope and set them up for sub-optimal performance while taking the exam.

7 common false assumptions from candidates

False assumptions all lead to an incorrect Exam Mindset. Without the proper mindset, candidates trust sub-par or false information:

False assumption #1: Passing written exams correlates with passing the Certifying Exam.

False assumption #2: The skills needed to pass the written exam are the same skills needed to pass the Certifying Exam.

False assumption #3: Being an excellent clinical surgeon means a candidate has all the skills required to do well on the Certifying Exam.

False assumption #4: The evidence that a candidate is doing badly in a scenario is that the patient has an adverse outcome.

False assumption #5: The candidate's impression of her/his performance in the exam always reflects the examiner's impression of her/his performance.

False assumption #6: The examiner will give feedback to the candidate as to whether the candidate is doing well or not.  

False assumption #7: There are behavioral or content algorithms that can be memorized and regurgitated during the exam, allowing a candidate to answer all exam scenarios and achieve exam objectives uniformly.  

The examination's profound misunderstandings and negative reputation create uncertainty, stress, performance anxiety, lack of confidence, poor communication, second-guessing, impaired process thinking, inability to achieve exam objectives, and a host of other problems and behaviors. These contribute to ineffective and counterproductive preparation and dramatically diminish exam performance.    

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Starting by getting to the root cause

In my experience, candidates fail for multiple reasons – but the root cause is almost entirely explained by an incorrect Exam Mindset℠, the candidates' emotions and beliefs associated with the examination, and the examiners. Consequently, most candidates who fail are simply products of their environment.

Understandably, candidates themselves are invariably unaware of exactly why they failed – so they guess. Candidates assume incorrect or incomplete reasons for the outcome. Some common examples include content issues, insufficient confidence, not giving "answers the examiners wanted to hear," and difficulties with communication.

Issues in preparation and performance can only be corrected if those issues can be accurately identified and effectively corrected under experienced guidance. The Odyssey Review 5 Point Process focuses on first helping candidates identify misconceptions and common false assumptions. By understanding the root cause of performance issues, candidates can reorient their thinking and excel in the Surgery Certifying Exam.

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