Written Qualifying Exam:  Overview

The written board exam is a computerized, multiple-choice test, formatted similar to standardized exams we’ve been taking almost annually since college.  Of course, gone are the old-school scantrons and #2 pencils we used to use in our younger years, and now all these tests are administered on the computer at Prometric facilities around the country.  Here are 10 basic facts about the test and the test experience:

  1. There are 250 questions divided into 2 sections of 125 questions.
  2. The test is administered over a 5-ish hour period in 1 day.  While the ABO’s website does not provide more details about the actual timing of the test (and I don’t recall the exact details of that day), I think it’s fair to assume a few things:
    • Allow at least 15 minutes for registration.
    • Allow at least 15 minutes for the tutorial.
    • Allow at least 15 minutes for the break in-between sections.
    • Allow at least 15 minutes at the end for an end-of-the-test survey.
    • That leaves approximately 2 hours per section (120 minutes for 125 questions).
  3. BCSC sections 1 & 2 (General Medicine and Fundamentals/Principles of Ophthalmology) are NOT on the test.  Don’t even bother opening the books.
  4. Everything else is fair game.
  5. The American Board of Ophthalmology has posted a pretty detailed breakdown of how the different subjects are weighted.  The breakdown also discusses what topics are important to know about each subject.  It’s also available in PDF for individual-use download.  Since I first wrote this article, the ABO has condensed the outline into much broader categories of disease. Unfortunately, it is not as detailed in specifying what diseases are "testable," but it is still helpful in determining the weight given to each topic and the concepts the ABO wants to test. Since it’s developed and made available directly through the ABO, it’s the closest thing to a “cheat sheet” as one can get directly from the folks who make the test.  I think it’s great that they want to help us focus on the right topics.  Due to copyright restrictions, I can’t reproduce the outline on the site directly, but I’m sure that as we develop the level of content for every topic on this site, these topics will be discussed on some level.
  6. There are 4 answer choices per question.  Theoretically, out of those 4 choices, there is only 1 “best” answer.  Keep in mind that sometimes the “best” answer is also the obvious answer – I’m pretty sure I missed several questions simply because I overanalyzed the answer choices.  If you’re into guessing, you have a 25% chance with each question (a higher percentage chance if you are able to eliminate some choices).
  7. There is no penalty for wrong answers.  Bottom line, make sure you mark an answer for every question!  If you leave an answer blank, you’ll be right 0% of the time; if you blindly guess, you’ll be right 25% of the time (statistically speaking); if you make an educated guess, you might have an even better probability of getting the question right.
  8. The questions in each section are randomly distributed and, though it is possible for one section to be more heavily weighted in one subject and less weighted in the other, the sections should theoretically be similarly weighted.  The year I took the test, almost all of the optics questions were placed in the first section (which made for a somewhat stressful 2 hours).  If I recall, the ABO took steps to ensure that would not happen again.  So, if I understand the spirit of the test correctly, there should not be any significant difference between the two sections – the break only serves as a way to allow you to budget your time better and allow for bathroom breaks, etc.
  9. However, once you complete the first section, you cannot return to the section again.  So if you’re in the middle of the second section and realize you should’ve chosen Voyt-Koyanagi-Harada disease instead of keratoconus in that previous section, you’re stuck.  Pretty standard stuff.
  10. You can still take “unauthorized” breaks throughout each section.  So if you’re like me and make the poor decision to drink lots of coffee right before you start the test and have regrets an hour in, you can still pause the test and void your bladder.  The Prometric people will make you put your test screen on pause, sign out, provide fingerprints, etc. and repeat the same process to sign back in.  The caveat is, all of that time eats into the 2 hours you have allotted for the section.  I’m a pretty fast test taker, so I found myself with extra time that would allow me to take 1 unauthorized break per section.  Not everyone is, though, so budget your time accordingly.

Do you have any other questions about the written qualifying exam? Do you have any suggestions you'd like to share? Contact me and I'll add them to the page!