OKAP Exam Pearls for the First Year Resident

By Paul A. Sanchez, MS, MD

In April, ophthalmology residents in ACGME approved residencies take the infamous Ophthalmic Knowledge Assessment Program (OKAP) examination. The purpose of this test is to provide residents and program directors with a quantitative measure of their grasp of clinical and basic science background in ophthalmology. Each residency differs in their view of the OKAP. Some programs consider the exam to be a preparatory test for the Boards while others use the exam results to assess the relative strengths and weaknesses of their residency. Some programs see the exam results as the pinnacle of the academic year, offering positive and negative reinforcement accordingly. Thus, preparing for the OKAP examination can be a daunting task.

The content for the OKAP exam is taken from the Basic and Clinical Science Course (BCSC) published by the American Academy of Ophthalmology. This 13 volume series of books covers general medicine, fundamentals of ophthalmology as well as all subspecialties within ophthalmology. Most of the books in this series are well written and can be easily read. They are, however, quite dense and can take a long time to get through. Despite its size this series is the most complete source of information for the OKAP exam.

There are several OKAP review books on the market. Most are relatively solid, but they are not as complete as the BCSC. The best one I have found is Ophthalmology Review Manual by Chern and Zegans. The best way to use this book is to simultaneously read the basic science series and add any information from the BCSC in the margin of the review book. This way you can personalize your review book as well as make it complete.

There are also several question or assessment type books that are useful in preparing for the OKAP. The book I have found to be most useful is the Massachusetts Eye and Ear Infirmary Review Manual for Ophthalmology by Jager and Lamkin. This book provides over 3,000 questions with answers similar to the OKAP form. Although these questions are difficult, by working through them and learning not only why each answer is correct but why the other answers are wrong can provide an excellent way to study for the OKAP exam.

The final book I will suggest is Clinical Ophthalmology: A Test Yourself Atlas by Kanski. This book is very useful because it provides many questions with pictures of the clinical exam and gross or microscopic pathology. It requires you to think not only about the clinical scenario but also answer tertiary questions about the condition. This is a nice way to solidify your knowledge on a subject.

Now, all of the above books are only helpful if you read them! But sometimes reading them is not enough. Unless you have a “photographic” memory you may want to incorporate an active learning process instead of just reading alone. This can be done by taking notes while you read and putting the information into your own words. Also, one active learning method I have found to be helpful is to record yourself on a handheld recorder reading a review book. This will allow you to put the information into your own words. Then when you play it back to yourself it makes sense and phrased in a way you are familiar with. I have used these tapes to study from or test myself while on long commutes, in airplanes, or while stuck in traffic. It has provided me a way to study without taking away valuable time from my family. Which ever method you choose stick with it and GOOD LUCK!!!