How to Increase Your CREOG Exam or ABOG Qualifying Exam Score

How to Increase Your ABOG Qualifying Exam Score

“…when at last something is known, understood, explained, then to those who have that knowledge in full comprehension all other things become unknown.”

–John Wesley Powell, Civil War veteran who explored the Grand Canyon
This article covers two easy ways to help increase your likelihood of passing the Council on Resident Education in Obstetrics and Gynecology (CREOG) Exam and the American Board of Obstetrics and Gynecology (ABOG) Qualifying Exam. These two techniques are the most useful, easy to implement, and only require a little of your time. This means anyone can take advantage of them. 

The first tactic is to use a system over a couple of months to identify what you dont know. Sounds easy, right? The key is to go through a curriculum and identify what you don’t know—not what you’re weak at—but what you don’t know. The second strategy is to take advantage of human error. Humans write tests, and humans make errors. This article will show you 5 easy techniques to narrow down an answer choice to either the correct answer or to a 50/50 probability, even if you don’t know anything about the topic. By combining these two strategies, you’ll be able to increase your CREOG Exam or ABOG Qualifying Exam score and increase the likelihood of passing the exam. Let’s get started.

Unknown unknowns 

As you begin to study for an OB/GYN exam, there are areas you know well and are comfortable with. Maybe you have a special interest in obstetrics and feel confident about any question on postpartum hemorrhage. Because you are confident in obstetrics you spend less time reviewing it. Let’s call this one of your known knowns—you know that you know the information. There is very little utility in spending too much time on your known knowns when preparing for your exam.

During medical training, I realized my understanding of pelvic floor disorders was poor. Apical prolapse was just a term to me. I did not understand the underlying anatomic defects, and I had a poor grasp on utilizing the Pelvic Organ Prolapse Quantification (POPQ) system to classify the degree of prolapse. Pelvic floor disorders were a known unknown. Because I recognized this specific deficiency, I was able to target my learning on the anatomy of the pelvic floor and the specifics of diagnosis and management of pelvic floor disorders. 

Once I started to focus my learning, I came across many concepts and ideas that I knew nothing about…never even heard about some of them. These were the unknown unknowns, a concept created by psychologists Joseph Luft and Harrington Ingham. It is part of their “Johari window,” a tool that helps users identify blind spots about themselves and others. 

Known unknowns are things you’re aware that you don’t know—you can recognize that you don’t understand them. Unknown unknowns, however, are unexpected because you don’t know they exist. The way to supercharge your CREOG Exam or Qualifying Exam score is to identify your unknown unknowns. It takes a little effort, but it is rather easy. All you need are two things:

Notebook and time

The system works like this:

Step 1: You answer a question from a question bank. If you get the answer wrong, read the explanation. Then write down in your notebook the part of the explanation that describes why the correct answer is correct. This process helps to identify your unknown unknowns. Subsequently, if there is any other information that you did not know or somewhat knew, record it in your notebook under the same topic.

You must do this for every question you get incorrect. I also encourage it for questions you may answer correctly but discovered new information in the explanation that you previously did not know. 

Step 2: Start each study session by reviewing your notebook that contains the key knowledge that you previously did not know or weakly knew. As you do more questions, you will get questions wrong on topics you already recorded in your notebook. For example, if you answer a question incorrectly on patient selection for medical management of ectopic pregnancy, you’ll record in your notebook something like “ectopic pregnancy: contraindications for methotrexate include ruptured ectopic pregnancy, intrauterine pregnancy, breastfeeding, renal insufficiency, liver disease, active pulmonary disease, and hematologic abnormalities.” Two weeks later, if you can’t name adverse effects associated with methotrexate therapy, you should go back through your notebook to find your first entry on medical management of ectopic pregnancy and add stomatitis, conjunctivitis, alopecia, pneumonitis, dermatitis, and bone marrow suppression as potential adverse effects of methotrexate use.

After a month or two of recording your incorrect answer explanations, you will have a filled notebook of your unknown unknowns and maybe many of your known unknowns. If you do this on a consistent basis and get through 1,000 to 2,000 question bank questions for a 300-question standardized exam, you’ll have identified most of your blind spots that questions can ask about. You end up converting your unknown unknowns to known knowns. 

Here is a page from my old notebook!


This is a composition notebook. All 100 pages (front and back) are filled with explanations from question bank questions I answered incorrectly.

I use the same system and process to prepare for all standardized exams. I even used it to learn how to read EKGs better than a cardiologist.

Study schedule

With the CREOG Exam or Qualifying Exam around the corner, now is the perfect time to begin this system. It leaves time for adjustment and plenty of time to accumulate your unknown unknowns.

Earlier in this post, I mentioned that to supercharge your standardized exam score you’ll need two things: a notebook and time. The notebook you can buy anytime. However, time disappears.

Identifying your unknown unknowns is how you can prepare in the lead-up to your OB/GYN exams. But what can you do to improve your score simply by showing up to your exam?

How can you use the errors made by question writers to boost your score?

The Anatomy of a Question

First, let’s understand the anatomy of a question.

Anatomy of a question

A question is made up of the stem and the lead in. The stem is where you find all the details of the question such as the clinical presentation, past medical history, and laboratory results. But, the critical part of the question is the lead in. The question writer uses the lead in to find out what you know or don’t know about the topic in the stem. But it is also the place where question writers make errors. By applying basic grammatical analysis, you’ll be able to identify the correct answer or at least narrow down the answer choices without knowing anything about the topic. Here is an example of using grammatical cues.

Grammatical cues

Here is another technique that focuses on logical cues.

Logical cues

Let’s now focus on answer choices to identify a few more areas we can gain an edge.

Anatomy of answer choices

Once you understand the goal of the question writer to create answer choices that are supposed to discriminate knowledge, it is easier to exploit technical flaws and improve the odds of getting a question correct.

Absolute terms
Long correct answer
Word repeats

Whether you are taking your CREOG Exam or Qualifying Exam, there is so much at stake. Taking the time to identify your unknown unknowns will not only help you prepare for and excel on your exam, you’ll expand your core knowledge. Then, on test day, use the simple techniques you learned here to identify common flaws in questions, which will increase your chances of getting a question correct.

Give these methods a try and let me know how it goes. Moreover, I’d love to hear about techniques you use that I did not write about.

And if you are looking for an OB/GYN question bank…you know where to find one.

Lindsey Penezic, MD

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