The Oral Board Exam: Forming A Study Plan
One of the questions I've asked my friends and now have been asked is "how did you study for the oral board exam?" The answer is more challenging to answer than I would have originally thought, taking into account everyone's unique learning styles, personalities, etc.
However, just as the American Board of Ophthalmology did with their list of "do's and don'ts" of general tips when it comes to preparing for the board exams, I believe that there are some common principles when it comes to formulating a study plan for the oral board exam.
Step 1: Planning A Schedule
Everyone will have different levels of comfort when it comes to the amount of time they want/need in order to feel prepared for the oral board exam. Some people want to go into the test cold and knock it out, others choose to glance through the optics section the night before, some want to read through all of their notes from residency, still others want a whole year to prepare. There's also external factors to consider - typically those first two years out of residency when most people decide to take the board exams are pretty hectic, filled with transitions.
Of course, there's no right or wrong way to schedule - but when you determine your schedule, I think it needs to have the following properties:
- Gives you the level of comfort you need to succeed
- Covers the pertinent topics
- Allows for the unexpected
For me, I was finishing up my fellowship, moving to a new city, and starting a new job during the months leading up to the oral boards. While I would have loved to start studying as early as possible, I decided it was most feasible for me to start studying once we had everything moved into our new place and everything was unpacked, etc. All in all, I planned out 2 months for studying leading up to the test, with a full week (5 working days) off for more distraction-free studying.
Step 2: Planning Your Strategy
Do you know what subjects are your weaknesses? Are you uncomfortable verbalizing your thoughts? Do you find yourself employing a "stream of consciousness" tactic when you're being pimped on your rotations?
Like study plans, everyone's strategy for studying is going to look a little different. Since there isn't time to waste on reviewing things that you already know well, be sure to target your studying towards what you need to work on the most. For me, it was managing anterior segment, orbit and eyelid, and retinal diseases. While I felt pretty comfortable with the basic management, the more complicated management choices had started to elude me over the previous year during my fellowship.
Regardless, of the subject material, one of the major anxiety-provoking parts of the oral board exam is, well, because it's an ORAL exam. While we've all experienced our fair share of pimping/quizzing, the oral board exam is a completely verbal exam that carries far more implications than trying to regurgitate the Spiral of Tillaux for your Pediatric Ophthalmology attending. There are plenty of ways to prepare yourself for this; here are but a few ideas that I either considered or implemented as part of my studying:
- Review flashcards out loud: I created digital flashcards with my pre-written "script" of what I planned to discuss about each disease, and uploaded them to my smartphone. Then, on my commute to work, I would glance at a photo (I have a place on my dashboard I jury-rigged for my phone), then recite my script out loud. It wasn't perfect, and I'm not in any way recommending people stare at their phones while driving, but it was a way for me to start getting in the habit of verbally processing the information I felt I needed to say in an organized manner. Apparently there are some flashcards for the oral boards you can purchase online for your iPhone or Android - I haven't used them myself so I don't know how they work, but it's worth checking out, and if I get a chance to review them I will post links here. Since I can't endorse them right now I will just mention that if you search for "ophthalmology oral board exam review" on the iTunes Store or Google Play you'll probably find them.
- Listen to other people discuss ophthalmology: I have some friends who studied for the oral board exam by listening to Audio Digests or other podcasts that discuss common topics in ophthalmology. For them, hearing someone else verbalize an organized approach to the topic helped them construct their own verbal delivery. I did not do this personally, but I think it's a great option for people who prefer learning aurally.
- Practicing in a group or with a friend: I wasn't working with anyone else preparing for the oral exam, so I couldn't study in person with a group of people. Instead, one of my co-residents and I set aside 2-3 hours once a week to quiz each other with cases and time each other. This gave us some real-time limited feedback, and while neither of us had any realistic idea of whether we were providing the appropriate information, we could at least give each other tips on where we were struggling or how we might be able to shave down a few seconds here or there. During the week leading up to the exam, I took time off from clinic and surgery so that I could do more focused studying, and practiced with two friends every day that week.
- Take a course: The Osler Institute does a ton of marketing for written and oral board review (they do board reviews for other specialties as well). Typically scheduled right before the administration of the oral board exam, it's an in-depth week of intense subject matter review followed by "mock oral board exam" sessions. It does cost some money (registration + travel + food/lodging), but many of my friends have taken the course and have been pretty positive about the experience and its ability to prepare them for the oral board exam. I didn't think I could afford the course, but I think the study strategy that my friends and I employed worked well for us. There are other review courses available, but I think the Osler course is probably the best-known and also does the most preparation for the oral exam. You can register for the entire course or for just the mock exams.
Step 3: Gather Your Resources
Once you've mapped out your study plan, you need to make sure you have all of the resources you think you either need or want for your studies. There are plenty of helpful textbooks and resources out there - too many, in fact. Be sure to choose resources that you're comfortable with and will provide you with the information you think you'll need to succeed. Check out my article on oral board exam resources!
Step 4: Do It!
This step is pretty self-explanatory. In order to have made it successfully through the previous 8 (or more) years of medical training, you have probably mastered a considerable amount of discipline and self-motivation. Once you've got a plan put in place, it's time to put it into action! Here are a few words of encouragement that I'm sure you already know, but put here as a reminder (I had to remind myself of these things throughout my study time):
- You already know the material. By this point, you've passed enough tests and demonstrated enough clinical skills to graduate residency and pass the written board exam. As the ABO points out, the information they're testing you on is not intended to stump you - the test is intended to make sure you are able to articulate verbally how to safely take care of patients. Because of this, your study doesn't require cramming every little obscure detail about every disease.
- The test is intended to mimic your clinic. The questions being asked of you are similar questions to what you have to answer with every patient you see:
- What is their complaint?
- What am I seeing on their exam?
- What else could this be?
- What tests do I need to order to rule out anything dangerous?
- How do I manage this condition?
- Don't change strategies mid-stream; plan the best you can and stick with it. Almost any study strategy will be fine (the ABO strongly discourages doing nothing). If you're a perfectionist, you may have the temptation to tweak your study plans. But if you've planned ahead well (steps 1-3 could potentially be accomplished in an hour or so), trust your plan when you get into the meat of the material. Like the OKAPs and the written qualifying exam, there will always be more to study; but if you're comfortable with what you know and how to work up those conditions you don't know, you'll probably do fine.
- Most people pass the test. I'm certainly not dogging on those people who have struggled with the tests (OKAP, written, or oral) - part of the reason I've put together this site is to help people learn the material and discuss hints and tips for all the tests we have to take. They're tough tests - but they are passable, and based on the pass rates listed on the ABO site, around 80% pass the oral board exam on the first try, and 85% of those repeating the test passed.
Do you have any other suggestions or tips on how to prepare for the oral board exam? Send me a message!