The Ophthalmic Knowledge Assessment Program (OKAP) is an exam dreaded by many ophthalmology residents across the country. The test is made up of 260 multiple-choice questions and is taken by all ophthalmology residents in the United States and Canada. This test, in addition to causing stress ulcers and sleepless nights, is intended to test the knowledge of ophthalmology residents to assess their academic progress. The questions are taken from the thirteen Basic and Clinical Science Course (BCSC) books.
Why is the OKAP exam important?
A great OKAP score can be helpful when applying for fellowship, especially more competitive fellowships such as Surgical Retina. Not only is the exam a great practice run for the real deal (written boards), but a study done at the University of Iowa found the scores from this test in the third year of residency to be the greatest predictor of the written board scores.
The exam is taken online, typically with an in-person proctor. During the COVID-19 pandemic, the test was given by an online proctor who monitored the screen remotely. The test is offered a few different days, and this year will be from March 16-19, 2023. The program will select the dates and times for each of its residents.
Registration opens in mid-November with a deadline of December 31. The total exam time is 4 hours and 30 minutes, with an additional 10 minutes for a break. The break can be taken after 2 hours and 15 minutes or after completing 130 questions. Residents are allowed one sheet of scratch paper and a pencil during testing. You are also allowed to wear earplugs while testing and to bring snacks and beverages for break times.
How is the exam scored?
The scores are given as scaled scores and percentile ranks. Both of these methods compare the test taker to the other residents who have taken the test. The scaled scores are compared to all other residents at every level. The percentile ranks are compared to other residents in the same year. Typically the raw scores are not given. The mean scale score is 500 and is based on OKAP test results from 2017. The standard deviation is 100 points. A score of 600 equates to 1 standard deviation above the mean, and a score of 400 equates to 1 standard deviation below the mean.
Ophthalmic Knowledge Assessment Program study tips
By the time you’ve made it to your first OKAP exam, you have had to pass quite a few standardized tests. It’s important to use methods that have worked for you in the past and cater to your learning style. There is a lot of material to cover, so whatever method you use, it’s important to be consistent. It can be helpful to make and stick to a study schedule to make the work more doable, as it can be quite overwhelming initially.
There are many study options available besides the BCSC books: flashcards, making your own notes, listening to podcasts, review books, and question banks.
Finding time to study can be challenging during residency. You can bring a book with you to read during the rare moments of downtime during clinic or have a question bank or flashcards on your phone to get in a few extra minutes here and there.
The most important thing is to do a little bit each day.
Optics can be especially challenging, as it’s something that we don’t typically use in everyday practice. It can be helpful to practice optics questions with someone else or in a group setting.
To help, download our OKAP Study Schedule!
The following are just a few of the many different resources that residents have used to help with OKAP preparation.
- BCSC Series
- Review of Ophthalmology (William Trattler, MD, Peter K. Kaiser, MD, and Neil Friedman, MD)
- Last-Minute Optics: A Concise Review of Optics, Refraction, and Contact Lenses (David G. Hunter, MD, PhD, and Constance E. West, MD)
- Eyes For Ears (Ben Young, MD and Andrew Pouw, MD)
- OphthoQuestions https://www.ophthoquestions.com/
- BCSC Self-Assessment Program https://store.aao.org/basic-and-clinical-science-course-self-assessment-program.html
- AAO Self-Assessments (Free with AAO membership) https://www.aao.org/self-assessments
- Moran Core Lectures (University of Utah) http://morancore.utah.edu/core-resident-lectures/
- Review of Clinical Optics (AAO) https://www.aao.org/resident-lectures-video/review-of-clinical-optics
- Iowa Glaucoma Curriculum http://curriculum.iowaglaucoma.org/
Study/life balance as an ophthalmology resident
All work and no play leads to a very burned-out resident. While it’s important to be consistent with your study plan, it is also important to maintain a good work/life balance. A good diet, regular exercise, enough sleep, and doing activities you enjoy are important to keep you sane enough to continue to keep working and studying.
Lastly, a positive attitude goes a long way! You have passed many standardized tests to reach this point, and you will do it again!
- OKAP User’s Guide - American Academy of Ophthalmology