• 4 Tips to Prep for OKAP With the BCSC

    If you’ve ever examined the many volumes of the Academy’s Basic and Clinical Science Course™, it can be very daunting. As the founder of an ophthalmology board review web site, I’ve made it my mission to find (stress-free) study tips on how to use the question bank in the BCSC® Self-Assessment Program. Here’s how you can make this resource work for you!

    Create a Study Guide

    It’s often beneficial to have an outline or structure that helps you organize and retain knowledge. Whether that’s using a notebook or a document on your computer, organizing the information you study makes it easier to recall and find as you continue to review. There’s no need to recreate the wheel. Using the table of contents from each BCSC book may be a helpful place to start.

    Turn Off the Answers

    Create a 10-question “test” with the BCSC Self-Assessment Program, turning off the “immediate answer” and timed options and spend about eight to 10 minutes trying to answer all 10 questions in a row without looking up the correct answers. 

    A bonus difficulty would be for you to try and answer the questions without even looking at the answer choices. Set the timer on your phone for 10 minutes (one minute per question). 

    Eventually, you may want to increase that rate to about 30 to 45 seconds per question (longer for optics questions) to allow for extra time at the end of each section. This will allow you to gradually improve your pace without adding too much stress.

    Find the Right Strategy

    A few suggested test-taking strategies for these quizzes:

    • The question format for the Ophthalmic Knowledge Assessment Program (OKAP) and American Board of Ophthalmology Written Qualifying Examination (WQE) are supposed to be standardized to eliminate “cheat” techniques for trying to figure out the answer without actually knowing the material. 

    In your studies, try not to employ techniques such as “guess C” or “choose the longest answer” or tricks that may have been effective on other standardized tests.

    • Answer each question honestly. If you don’t know the answer right away, mark it and move on to the next question. I found that going through the entire test quickly and answering the “easy” questions first gave me a sense of security to go back and work on harder questions without fear of running out of time and missing easier questions.

    • Work towards getting to a point so that after you read the question, you know the answer before looking at the answer choices. This eliminates the effectiveness of “distractor” answer choices if you are searching for the correct answer, rather than trying to evaluate the answer choices to decide which one sounds the best.

    • Hopefully after the first pass you’ll be able to go back and focus on the more challenging questions. Ask yourself, “What makes this question hard?” Try to file the difficulty under a category to review later. Here are some examples:

      • I don’t recognize the clinical vignette to know what the question is asking.
      • I don’t know the answer — I don’t know the material well enough.
      • I am not following the steps to get to the question (multistep analysis questions).
      • The question is asking about an obscure detail I do not know. Avoid blaming the question.

    • After you’ve answered all the questions and if you have extra time, go back and check your answers on all questions again. Use this time to double-check and make sure to eliminate “stupid” mistakes (accidentally clicking B when you meant A, misreading the question, etc.).

    Analyze Your Performance

    Once you feel like you’re done with the test (or time runs out), stop the test. Before you review the answers, take a few minutes and reflect on your confidence level. It might even be helpful to write this down to track throughout the year. Then review the answers. Consider analyzing the questions in the following manner:

    • What is the general subject topic being tested by this question (what BCSC section)?
    • What specific disease, concept, medication, etc. is being tested?
    • Did I get the question right?
    • Why did I get the question right (I knew the material, lucky guess, etc.)?
    • Was my initial hunch correct?
    • If I corrected the answer, did the rationale for changing my answer lead to the correct answer?
    • Do I understand why all of the other answers are incorrect?
    • If I got the answer incorrect, why did I get the answer wrong?
    • What concepts do I not understand?
    • Are there some minutiae that I need to commit to memory, and how do they fit within my understanding of this disease?
    • How would I reword the question so that the incorrect answers are the correct answer?

    I encourage you to write these thoughts down as you go. A tendency when doing practice questions is to move fast and not spend adequate time learning from the questions, both correct and incorrect.


    Given that these questions will be random, take the time to add what you’ve learned into your study guide. If there’s a concept or other details that aren’t in your study guide, add it. Read the BCSC excerpt(s) and make sure that you understand the concepts being tested. 

    Make sure that it stays organized in your outline. Write a note on the side or flag it so that you know that there was a practice question asked about it (this helps you remember it’s important when you revisit the material).


    There is a bevy of knowledge that we need to retain and utilize effectively as ophthalmologists. Practice questions can be a wonderful method of honing our focus and learning what concepts may be important to know. Combine the BCSC Self-Assessment Program with the BCSC texts to enhance your studies beyond looking for “performance evaluations.” 

    Finally, best of luck in your studies!

    Further Resources

    OKAP Resources

    9 Tips for OKAP Success

    Kevin laiAbout the author: Kevin E. Lai, MD, is an Indianapolis-based neuro-ophthalmologist and assistant professor of clinical ophthalmology at Indiana University School of Medicine. He completed his ophthalmology residency at the Scott and White Eye Institute/Texas A&M University, a neuro-ophthalmology fellowship at the Dean McGee Eye Institute/University of Oklahoma College of Medicine and is the founder of OphthalmologyReview.org, a board-review website for residents and young ophthalmologists.