How to Approach the OKAP Exam as a First Year Resident

By Brad Feldman, MD

The Ophthalmic Knowledge Assessment Program (OKAP) will cause an undue amount of stress to most residents during their three years of ophthalmology training. In order to minimize your stress and maximize your success with the OKAP exam, you need a practical understanding of the true value of the exam and how to approach it strategically, starting with your first year.

The OKAP is an important examination. In most programs, the faculty members will have access to your scores. It will not be the primary instrument for them to evaluate you, but it is one of the only standardized, objective exams that will create a perception for them of your knowledge base. While you’ll hear that most fellowships don’t place an emphasis on OKAP scores during applicant selection, doing well can only help you, while scoring in the lower percentiles can only hurt you. Likewise, you are more likely to get a strong letter of recommendation from your program director or chair if you can stand out with a high OKAP score.

You’ll want to think of the OKAP scores that you receive over your three years as constructive feedback. The primary value of taking this examination three times during residency is to let you know where the holes are in your knowledge base as compared to other residents at your level. This allows you to either feel comfortable and confident that you are on track to learn what you ‘should’ know as an ophthalmologist, or be appropriately concerned that you need to put more time into reviewing ophthalmic knowledge. By the time you’ve taken your third OKAP exam, you’ll have an idea of how hard you’ll have to study for the more important and expensive examinations, as well as the written and oral boards. Walking into your boards with a history of success on the OKAP exam is really going to boost your confidence, and this is extremely important, especially during the stress-inducing experience of the oral boards.

The key to success on the OKAP exam is thoughtful preparation. The amount of time itself you spend studying will not necessarily correlate with your success. The more important factor will be creating a study strategy that works for you. Everyone should personalize their approach to studying, as no single strategy works well for everyone. Whatever strategy you create, starting in your first year of residency, you should incorporate the following components:

1. Set Attainable Goals

The first year is the most stressful year for the OKAP exam, but it’s also the year when your score is least important. However, your studying strategy now will lay the foundation for the next few years (if you do it right).

You will not be able to learn everything well, so don’t set unreasonable goals. Instead, try to learn the most common diseases well (Diabetes, POAG, AMD), and try to familiarize yourself with most diseases (White Dot Syndromes, Corneal Dystrophies, Phakomatoses). This means you’ll need to create a schedule to work through all the subjects once, either through a single review book (if you’re short on time), or through the BSCS (if you’re ambitious). The key subjects should then be revisited repeatedly throughout the year.

You will have the opportunity to learn some subjects in detail, especially when you are on rotations or preparing for presentations. I encourage you to go in-depth on these occasions – be comfortable when you sacrifice breadth for depth, and next year, be prepared to make up for anything that you’ve skipped.

It is a must to take the time to sit down, write a study schedule, and then try your best to stick to it. If you miss a day or a week of studying, double up on studying the next week.

2. Make Reviewing Easy

Be kind to yourself, and devise a study method that will make recalling the information easier when studying for future exams (written and oral board exams). If you are a visual learner, then take notes or make flashcards. If you are an aural learner, then record notes for yourself to listen to later. Be creative if you have to, but remember, you’re going to want to balance efficiency with quality in order to actually get through the material while creating something worthwhile to study with in the future.

3. Schedule in Time for Review and Questions

At the end of any section, test yourself with study questions. More importantly, leave a couple of weeks prior to the OKAP free in your schedule to review everything, rather than continue to focus narrowly on a single subject. This will be the most important part of your strategy, allowing you to review the details of topics that you’ve already studied but may have slipped into the recesses of your mind. This is the time to take out the review books and questions books, and to try to reinforce the knowledge that you have acquired.

Good luck with your studying!