10 Phrases That Hurt Your Score on the ABOS Part II (And What to Say Instead)

The ABOS Part II is won and lost on specifics. You walk in, you walk the examiners through your submitted case summary, and for the next several minutes every word you choose is either building credibility or quietly destroying it.

Most candidates don't fail because they lack knowledge. They fail because of patterns of speech — reflexes from residency, habits from clinic, small linguistic tells that signal to an examiner that this person is sloppy, defensive, or unwilling to own their outcomes. The good news: these are fixable. You just have to hear yourself say them first.

Here are ten phrases to retire before your exam — and what to say instead.

1. “The patient did excellent.”

Say instead: “Overall, I was satisfied with the outcome.”

Examiners react badly to candidates who sound braggy about their results. The moment you say a patient “did excellent” or “is so happy,” you invite pushback — and the examiner will go hunting for the complication you glossed over. Humility is the default tone. A satisfied patient with a good-enough outcome is always a stronger frame than a miracle.

2. “I used a standard approach.”

Say instead: “I used a direct lateral approach because of [specific anatomy/exposure requirement].”

“Standard” is a word that tells the examiner you either don't know the names of your own approaches or you're hoping to skim past a weak point. Name the approach. State the rationale. Tie it to something specific about this patient. That's the kind of language that demonstrates decision-making — which is exactly what's being scored.

3. “The hardware failed.”

Say instead: “The fixation lost purchase in the subchondral bone. In retrospect, I would have augmented with [X].”

Hardware doesn't fail on its own — it fails in a biological and mechanical context that you, the surgeon, chose. Passive language makes examiners suspicious. Own the construct. Own the bone quality decision. Own the post-op protocol. You can pass the exam with complications, but only if you demonstrate ownership and good judgment in hindsight.

4. “I'm not sure, but I think maybe…”

Say instead: “Cefazolin, 2 grams IV within 60 minutes of incision.”

Hedging is appropriate when you're genuinely in gray territory — an obscure test, an off-label technique, a niche subspecialty question. Hedging on the everyday essentials (antibiotic prophylaxis, DVT prevention, universal protocol, tourniquet limits) is a red flag. These are questions every candidate will face. Answer them like you do them every week — because you do.

5. “The patient was non-compliant.”

Say instead: “The patient struggled with the weight-bearing restrictions. I re-counseled them at their two-week visit and adjusted the plan to [X].”

Blaming the patient is one of the fastest ways to fail. It lands you squarely in the Blamer personality type that examiners are trained to catch. Reframe non-compliance as a communication and follow-through problem — yours. What did you do when you noticed? How did you adjust? That's the answer examiners are looking for.

6. “I would never do this case again.”

Say instead: “Given the outcome, I would approach the [indication / fixation / post-op plan] differently.”

Saying you'd never do the case again sounds like you're running from the decision. Examiners want surgeons who can critically analyze their own work without abandoning it entirely. Be specific about what you'd change and why. That's reflection. Blanket avoidance is just regret.

7. “My attending told me to do it this way.”

Say instead: “I chose this construct because [rationale]. My partner and I discussed alternatives.”

You submitted the case. You're the surgeon of record. Deflection to an attending, a partner, or a rep reads as an inability to own surgical decisions. You can mention a conversation with a colleague — that's good practice. But the decision has to land on you. This is tightly linked to how you defend your decision-making throughout the exam.

8. “I didn't expect that complication.”

Say instead: “We counseled the patient pre-operatively on this risk, and when it occurred we [action].”

“I didn't expect” is an excuse phrase. Experienced surgeons anticipate the known complications of the procedures they perform, counsel patients on them, and have a management plan ready. Even if something was unusual, frame it as a known-low-incidence risk you were aware of. Then walk through how you handled it — consultation, follow-up, resolution.

9. “The imaging was read as normal.”

Say instead: “The MRI showed a full-thickness supraspinatus tear with mild retraction and Goutallier grade 2 fatty atrophy.”

Passive language — “was read as,” “was ordered,” “was decided” — tells the examiner that you're outsourcing judgment to the radiologist, the resident, or the system. You looked at the images. You interpreted them. Say what they showed, in your own words, with the specificity a board-certified orthopedic surgeon is expected to bring. If the radiology read differed from yours, that's worth saying too — and owning.

10. “We gave them standard antibiotics.”

Say instead: “Cefazolin 2 grams IV within 60 minutes of incision, redosed at the 4-hour mark, discontinued within 24 hours post-op.”

Notice the pattern? “Standard” is the word you reach for when you haven't prepared the specifics. Examiners are specifically listening for it. Name the drug, the dose, the timing, the redose interval, the stop point. Same principle applies to DVT prophylaxis, universal protocol, and weight-bearing progression. Specificity is credibility.

The Pattern Underneath All Ten

Every phrase on this list does one of three things: it brags, it blames, or it blurs. Bragging invites examiners to hunt for the complication you hid. Blaming tells them you don't own your work. Blurring with vague, passive language signals that you don't know the specifics — or you're hoping they won't ask.

The fix isn't a script. It's a posture: humble about outcomes, specific about decisions, honest about complications. When you speak from that posture, the words take care of themselves. When you drift out of it, the language on this list is what leaks out. This is the same reason honesty is your strongest strategy on the Part II — the exam is designed to reward it.

How to Actually Fix Your Language

You can't correct a verbal habit you can't hear. The single most effective exercise: record yourself presenting one of your twelve cases, out loud, as if you were in the exam room. Play it back the next day with a pen and a notepad. Circle every “standard,” every “was read as,” every “excellent,” every time you blamed a patient or deflected to an attending.

Most candidates are shocked at how often these phrases show up in a five-minute presentation. Once you see them on paper, you can rewrite them. Then present the case again — and again — until the new language becomes the default. Related reading: how to present outcomes the way examiners want to hear them, and what to say when you genuinely don't know the answer.

One Last Thing

Remember that on exam day, you are only defending your own twelve cases — the ones your case selectors assigned you from the list you submitted. You have the advantage: you know these patients, you made these decisions, you saw these outcomes. The only thing standing between you and a clean presentation is the language you choose when describing them. Retire these ten phrases, and you'll sound like the surgeon the examiners already want to pass.