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21 Pearls for the OKAPs: Tips from Your YO Info Editorial Board
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Since their development in the 1960s, the OKAPs have grown beyond their original intention of self assessment and program evaluation and gained new significance as a preparatory exam for the boards. To help ensure that you perform your best on the OKAPs, the YO Info editorial board offers these pearls of wisdom.

James G. Chelnis, MD:
  1. Ask your seniors! Every day, as a resident, I work side by side with people with more experience than I have. It’s important to take advantage of things your senior residents and others have to teach about the OKAPs and other residency experiences and potential obstacles. Their advice has led me to the best resources and saved me from having to duplicate their efforts.
  2. Prioritize your commitments. Many residents have personalities that lead them to proactively seek ways to further themselves, learn and expand their horizons. While this is an excellent attribute, it can be counterproductive if one is overextended. Be careful not to take on too much at once. For example, when considering a new research project, determine if there is time already budgeted for it. It’s important to prioritize for the OKAPs.
  3. Play to your studying strengths. Some people study best by reading and then summarizing, while others prefer to drill themselves using questions. By now we should all know what works for us. Because there is so much information to tackle, work in your preferred style to be as efficient as possible.
James G. Chelnis, MDDr. Chelnis is a resident at the University at Buffalo, where he graduated from medical school and was the school government president. In this role, he helped renegotiate the University at Buffalo’s health insurance terms with their provider to exceed AMCAS standards, while also championing other causes, such as creating a nationwide student-alumnus network, and organizing “Career Day” to place students in direct contact with physicians of all specialties prior to clinical rotations. He is a new member of the YO Info editorial board and eager to help infuse a resident’s perspective into the newsletter.

Lauren Eckstein, MD, PhD:
  1. Build time into your day to complete your studies. Set aside time before clinic each morning, immediately after you get home or whenever you are least likely to be interrupted.
  2. Optimize your review materials. Read text, complete questions — whatever results in the most efficient comprehension and memorization of the subject.
  3. Use the same study materials year after year. Familiarity will enhance your retention of the material, and a well-studied manual may prove a useful resource when preparing for the boards.
Lauren Eckstein, MD, PhDDr. Eckstein is an assistant professor of ophthalmic plastic and reconstructive surgery at the Scheie Eye Institute at the University of Pennsylvania. She completed her undergraduate training at the California Institute of Technology and later matriculated in the Medical Scientist Training Program at the University of California, San Francisco, where she completed her graduate dissertation in the biomedical sciences. Thereafter, she received her residency training at the Jules Stein Eye Institute and completed her fellowship training in oculofacial and orbital surgery at the Scheie Eye Institute. As a member of the University of Pennsylvania faculty, Dr. Eckstein is also engaged in translational biomedical research as well as fellow, resident and medical student education.

Natasha Herz, MD:
  1. Set up a reading schedule at the beginning of the year to get through the BCSC. I literally tallied up how many pages were in each book, figured out how much time I had until the OKAP exam, and then set up a reading schedule so that I would read through them all, plus have time to do a four-week review.
  2. Go through copious sample questions. Read the ones at the end of each BCSC book before and after reading the books. This will help you recognize what is important. Sample questions from the Academy are also available online for a reasonable price. Figure these into your reading schedule for your four-week review, as well as getting through a comprehensive review book, such as Kenneth C. Chern's Ophthalmology Review Manual.
  3. Make lists of “most commons” and “key words” (for example, a clinical sign named after a famous person) to serve as a quick way to review and quiz yourself. I was famous for these and often asked by my co-residents to torture them with it!
Natasha Herz, MDDr. Herz is a cataract, corneal and refractive surgeon who works as a solo practitioner at Kensington Eye Center in the DC Metro area. She completed her residency and fellowship at the Cullen Eye Institute at Baylor College of Medicine in Houston, Texas. Local peers selected her to appear in Washingtonian magazine’s Top Doctors of 2012. She also serves on the Academy’s Young Ophthalmologist Committee and is the chair of the young physician committee for her local medical society. She has served as a member of the YO Info editorial board since 2008 and became the chair in August 2011.

Janice C. Law, MD:
  1. Start early. Whether you’re a note taker in the book’s margins or one who likes to paraphrase on separate note cards (my favorite), be consistent throughout residency. Your dedicated system will come in handy when reviewing for the written qualifying exam (WQE).
  2. Learn the material first before using review books. Review books are great for recall of facts, but if you’re solely learning from review books, you’re likely going to miss the concept and potential application in a future question.
  3. Use your previous OKAP result to enhance your study. If you’ve been through the OKAP once, use the results of that OKAP to guide next year’s study plan. Rank your subtests scores from low to high and prioritize your studying. Aim to increase your scaled score in each subtest using the the keywords and specific topics listed under each subspecialty -- these can be “gimmes” for next year. Each topic indicates the type of question asked: recall, interpretation, or decision making and clinical management. Master these concepts or learning objectives by using the BCSC Master Index, which maps out where the topics can be found (often in multiple chapters within the same section and in more than one section.) This allows for a comprehensive approach to the topics missed. Use all three years’ results to prepare for the WQE.
Janice Law, MDDr. Law is an assistant professor at Vanderbilt Eye Institute in Nashville, Tenn., and a new member of the YO Info editorial board. She received her ophthalmology training at Kresge Eye Institute in Detroit, Mich., where she also served as chief resident. After a two-year medical and surgical retina fellowship at Vanderbilt Eye Institute, Dr. Law joined the retina faculty as assistant professor in vitreoretinal diseases and surgery. Dr. Law is also the associate program director for Residency Education in Ophthalmology and plays a very active role in developing curricula and assessing teaching and learning within ophthalmic education.

Lisa M. Nijm, MD, JD:
  1. Study in the way that works best for you. Your study habits may be different than your co-residents. You have studied for tests pretty much all your life. You know what methods you learn from the most — small groups, flash cards, listening to lectures, etc. Set aside a specific time to study for the OKAPs each day when you can really focus and use whichever learning method is the highest yield for you.
  2. Do lots of practice questions. For me, it was the best way to assess whether I was grasping the key points, especially early in my residency. 
  3. Don't panic. Most will agree that OKAPs are important, but they are not the end all. If you study throughout the year, you should do well. Budget time to make sure you still eat healthy, exercise and get restful sleep.
Lisa Nijm, MD, JDDr. Nijm is a corneal, cataract and refractive surgeon at the Eye Institute at Springfield Clinic, where she recently became the first and only surgeon in Springfield, Ill., to perform wavefront-guided, custom Intralase LASIK. Dr. Nijm also teaches at her alma mater, Southern Illinois University School of Medicine. She completed her residency at the University of Illinois Eye and Ear Infirmary and her corneal and refractive fellowship at the University of California at Davis in Sacramento, Calif. Dr. Nijm also serves as the youngest member of the OPTHPAC committee and is an inaugural member of the EyeWiki Corneal Board.  

David E. Vollman, MD, MBA:
  1. Avoid “cramming” for the OKAPs. Take time to make a study schedule that fits your lifestyle so that the test is not always looming over you.
  2. Review subjects that have unique concepts. Topics like optics, which require specific formulas or concepts that may not be used in everyday practice, are good to review in the week leading up to the test so they are fresh in your mind. 
  3. Review the BCSC pathology book at the end of your prep period. A good tip I received is to review the BCSC pathology book towards the end of your test preparation because it allows you to both review the images and integrate the information about the disease processes shown.
David E. Vollman, MD, MBADr. Vollman is a clinical instructor in the department of ophthalmology and visual sciences at the Washington University School of Medicine and a staff ophthalmologist at the John Cochran VA Medical Center in St. Louis, Mo. After completing an MD/MBA dual-degree program at the Ohio State University College of Medicine, he completed his ophthalmology residency at the Washington University/Barnes-Jewish Hospital/St. Louis Children’s Hospital Consortium Program. Subsequently, he served as chief resident at Washington University, helping to direct the inpatient consult service and resident education.

Elizabeth Yeu Lin, MD:
  1. Make notecards. I made tons of notecards in preparation for the OKAPs. I was never a notecard creator prior to preparing for the OKAPs, but I learned to appreciate the value of the precious pearls that I created during residency. The act of writing the information was very helpful for retaining the information. Having the notecards to review from during crunch time was key for me! I dragged them to the gym, my co-residents and I quizzed each other from our notecards, and I used them to prepare for the written boards after residency.
  2. Study, at least sometimes, with your co-residents. The benefits are obvious: keeping each other motivated and on task, having others to clarify questions and sharing information are just a few of them. Studying with my co-residents was much more interesting than studying alone. Since OKAPs preparation started months beforehand, the lack of stress associated with my studying led me to become easily distracted by the television, phone and what was in the refrigerator. 
  3. Don’t blow the OKAPs off! While they do not technically count towards your clinical competencies for graduating from residency, the OKAPs are very important. Studying for them provides a strong foundation and “database” that you will recall from when you are preparing for the written portion of the boards. I prepared for the written exam, as many of you also will, during my fellowship year. I had much less time to prepare than I did as a resident, but having studied adequately during residency had a huge impact on the ease of re-memorizing the information.

    Also, how you perform on the OKAPs appears to be a strong indicator of how you may perform among your peers when you take the written exam. The percentile ranking demonstrates where you stand among your colleagues nationally at the same level. These will be the same people who will test alongside you during the written exam. The written exam is a curved examination. Although there is no guarantee, scoring decently on the OKAPs may also indicate that you may score more favorably among your peers for the real exam.
Elizabeth Yeu Lin, MDDr. Yeu is an assistant professor at the Cullen Eye Institute, Baylor College of Medicine in Houston, Texas. She received her doctorate of medicine through an accelerated undergraduate studies and medical school program from the University of Florida College of Medicine in 2003. She completed an ophthalmology residency at the Rush University Medical Center in Chicago, and a fellowship in cornea, anterior segment and refractive surgery at the Cullen Eye Institute. Dr. Yeu currently serves as an examiner for the American Board of Ophthalmology and serves as an editor for the Academy’s Ophthalmic News and Education (ONE®) Network refractive surgery subcommittee. She is also an appointed member of several national committees, including the Young Physicians and Residents’ Committee of the American Society of Cataract and Refractive Surgery and the Academy’s refractive surgery Annual Meeting subcommittee.

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