OKAP Scores…What do I do with this information?

By Chris Ketcherside, MD

Ah yes, the OKAPs. You’ve all probably gotten back your scores by now and are either jumping for joy or jumping off of some tall object. For those of you who did poorly (of course this is all relative as I know this guy who got mad about a 97%), let’s talk about what you can do to improve your knowledge base over the year. For those of you who did well (again, relative), remember to use your powers for good and not evil. Most of all don’t rub it in with your fellow residents if you know what’s good for you.

One of the most frustrating things that we all seem to deal with when thinking about this test, is that no one really seems to know what to study. We all go around asking the other residents in our program what they use, or maybe we just find that one person who happened to get a 99% and pepper them with questions. Anyway, I’ve now taken this test 3 times and won’t have to take it again, but I thought I’d try to at least put something together that could help those of you who are wondering what went wrong and what you can change over the next year.

As we said, all you can really do (besides read every book and decide which you like) is ask those around you for their opinion. So, I asked as many people as I could to tell me what they thought was helpful and I’ll share that with you. I’ll also tell you about what they thought was not helpful.

First of all I’ll tell you a story about this guy that I know that rocked the charts with a 36% his first year. Now we all know that if you’ve gotten this far, you probably aren’t used to getting a 36% on anything except that Physics test in college where this would mean a B+. Needless to say this man was disturbed and wondered how this had happened. He tells me that he realized that he had a newborn baby when he started his residency. He also tells me that he had trouble early on organizing his time with a totally new life. Add to this the fact that he had no idea what to study come OKAP time and you get a poor showing followed by ridicule by the staff.

Now why am I telling you this? Good question. The answer is that this same guy scored a 94% the following year. No, he didn’t develop an elaborate Spies Like Us-esque scheme for beating the system. He did not sell his family to pirates and study 24/7 either (although he says he thought about it). What he did do is start early and make a plan. He set goals for himself and organized his time wisely. He says that he talked to as many people as he could and figured out which review books seemed to help the most when approaching the test.

Here is what he recommends:

1. Read for an hour every night no matter what. This guy did it after he put his kid to bed each and every night and made it a habit.
2. Reading willy nilly is great and all, but it’s just that…willy nilly. Make a plan for yourself and stick with it. A personal syllabus if you will.
3. Read the BCSC series throughout the year at least one year. If you can do that your 1st year then great. Try to read the book that correlates with the service that you are on if you can.
4. When it comes time to study for OKAPs then pick the books you will review and stick with it. Most find that buying 50 books and reading 1 chapter of each is less helpful than reading all of just a few key books.
5. In January, read Review Questions in Ophthalmology (Chern/Wright) the whole way through. That will hit the high points of what you’ve been reading over the last several months.
6. Starting in February, begin reading from Ophthalmology Board Review (Tamesis) and The Massachusetts Eye and Ear Infirmary Review Manual for Ophthalmology (Lamkin). He tells me that he would review one subject in the Board Review book and then work the corresponding questions from the Questions book. This is time consuming and will take a while to complete.
7. In April take a week to review optics and go through Last Minute Optics (Hunter).
8. Take a week to go through all of the questions in the back of each BCSC book. They are very helpful and you’ll surely see some similar questions on the test.
9. Use one week to review subjects that you were particularly weak in. This is also a good time to look at that embryology, review the genetics, etc. For some of us this would make for a long week…
10. Finally, the Secret-XJ2000-Trump-Card-Shock-and-Awe-Weapon. The night before, go cover to cover through Eye Pathology: Atlas and Basic Text (Eagle).

That’s one guy’s advice. I polled a few other folks from across the land as well. I made sure to ask some of my fellow future Cornea specialists because not only are they very wise, but it is a known fact that they give excellent advice. Here is what they said:

“I thought the Friedmann book was awesome. Chern and Wright question book was good. I thought the Mass Eye and Ear was too difficult and overwhelming but it’s a good book if you’re not the type that gets overwhelmed.”

“Ophthalmology Pearls are very good for OKAP”

“I like the Friedman Book, Chern Review questions, Ophthalmology Pearls, and Last minute optics.”

“I didn’t like any because I don’t like studying” later followed by “The Mass Eye and Ear questions were poorly worded to prepare you for this particular test. Ophthalmology Pearls, Chern and Wright Question book and the BCSC questions at the back of the book were most helpful.”

“I thought that the Chern and Wright questions were most similar to those that I saw on the test. I loved the Friedman review book. The Essential Optics Review for the Boards (Wilkinson) on MedRounds.org was great. I thought that the Mass. Eye and Ear questions as well as those from the MOC review were less helpful for OKAPs.”

“I used the Friedman Review book and the Chern and Wright questions and I smoked the test.”

“Mass Eye and Ear is not good. I stuck to the Chern and Wright books only”

“Pearls by Tamesis and Friedman are all that I use now. I thought that the Mass Eye and Ear questions were alright, but didn’t like them as much.”

“Review books I would recommend are Review of Ophthalmology by Friedman, the question book by Chern, the Provision questions from the AAO, and Guyton's optics book.”

So there you have it. More opinions than you know what to do with. I got the general feel that people really thought that Review of Ophthalmology (Friedman, Kaiser, Tattler) was very good. What’s even better is that I’m just now finding this out with 15 days to go in my residency. I also found that people were on the fence about The Massachusetts Eye and Ear Infirmary Review Manual for Ophthalmology (Lamkin). I think that it’s very possible that this could be due to the sheer girth of this book and the difficulty of the questions. Once again, that’s nice to know now that I’ve looked at this for 3 straight years. You can take what you will from the rest and remember that we all study in different ways. One 99% test taker may read 12 books and the other read just 3. I think that the key to all of this is read consistently throughout the year and have goals. You will not only do well on your tests, but more importantly, you will excel in your treatment of patients. Remember, that’s why we’re here in the first place…