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  • BCSC: Tips to Make It Work for You

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    Starting ophthalmology residency can be daunting. In medical school, it was customary to get the scoop about a new rotation and some recommendations for quick reading material to prepare.

    But when you walk into work on your first day as a first-year resident and ask what you should be reading for ophthalmology rotations, you get this:

    The Basic Clinical and Science Course™ (BCSC®) is intimidating, to say the least (all 13 of the set!). Although it is the most comprehensive resource available to ophthalmology trainees (and even those of us in practice), the BCSC is dense. Reading it cover to cover is time-intensive.

    To help you out, we’ll review how to use the BCSC as a new ophthalmology resident without being bogged down in the details. Here are some tips:

    Prepare for a specific rotation. Use the BCSC as a preparatory resource before starting a subspecialty- specific rotation will help you make the most of your clinical experience. It’s particularly helpful in rotations that involve more observation than hands-on learning. Reading ahead will help you to better engage in what’s happening with each patient.

    Use as a reference for something new you see in clinic or on consults. Although PGY-1 years are structured variably depending on your schedule, the unifying factor is that you will be seeing new and unfamiliar things. Keep a notebook in your pocket or list in your notes app of conditions that you see throughout your day. Look up those particular conditions and read about them in the BCSC later. Do the reading as close to seeing the patient as possible to ensure that the material sticks; seeing is learning, and the BCSC should be used to reinforce what you see.

    Reinforce concepts you may be missing in practice questions. Most ophthalmology residents start using a question bank to prepare for the Ophthalmic Knowledge Assessment Program (OKAP®) exam during their second year of residency. One example is the BCSC Self-Assessment Program, which has over 4,500 online questions tied directly to BCSC content with additional discussion. However, it can be discouraging to feel that you are getting the same types of questions wrong over and over. In spite of the explanations provided by most Q-banks, sometimes there is a lack of fundamental knowledge in the subject area.

    For instance, if you miss questions on the appropriate management of uveitis, you may find that a better understanding of the pathophysiology of ocular inflammatory disease will help you deduce the correct treatment strategy. Conceptual understanding rather than memorizing is a more useful long-term strategy and will allow you to retain knowledge for the rest of your residency career and beyond.

    Take practice questions. The BCSC itself has practice questions in the back of each book — these are great for days when you don’t have the energy to slog through reading, but want to make sure you’re staying up to speed. They are also great for OKAP prep.

    Read it ahead of a lecture. Reading the appropriate section of the BCSC prior to the corresponding lecture can help the material stick. As a bonus, you can look like a star when your attending asks you a question, and you already know all the answers.

    Take advantage of new learning formats for your particular learning style. You may find that you learn material in different ways. For instance, there are links to the online Pathology Atlas in BCSC Section 4 that give you additional pathology images to enhance understanding. And both Section 3 and Section 4 feature Quick-Start Guides that give you the basics that you need before going further into your rotation.

    Try not to lose the forest for the trees. Remember that the goal is always to apply what you are learning to optimal patient care. The BCSC can be your friend, when used the right way!

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    Arthi G. Venkat, MD, MSArthi G. Venkat, MD, MS, is assistant professor and associate residency program director at the University of Virginia, School of Medicine. She joined the Academy in 2013 and specializes in medical retina and uveitis.