For the original poster and for those who are taking it in October:
Hopefully I can provide a unique perspective. In residency I had always done well on the OKAPS and I did pretty well on the written boards. I didn't necessarily consider myself smart but I figured I knew my stuff. I took the orals last year during the summer, and for the first time in a long time, failed a career-based examination. The whole event was shocking and traumatic; I found out while on vacation after finishing fellowship, and it was not necessarily the most relaxing vacation afterwards. That said, part me feels that it may not necessarily has been a bad thing. The process I had to undergo in order to pass has made me a better attending in the end.
If you feel uneasy and scared, honestly you should be. The oral board, like other posters have stated, is unlike any other test you have taken. The ABOP website summarizes it nicely so I won't go into detail, but the resources to prepare for this, like OphthoQuestions and the well known review books out there, are scant in comparison. I took a while to process how I failed it, and I realized that the key to passing the oral board are in these three components:
1) Knowledge - if you pass the written boards, you obviously have the knowledge. However, up to a year can pass by after the writtens, so you need to refresh your knowledge, and focus it on clinical information - you don't have to worry about what gene loci certain disease fall on or what viruses are implicated in Fuch's, but you better know the classic signs of things that will kill or blind a patient, like melanomas or a phakomatosis.
2) Pattern recognition - primarily, know what you're looking at and what the testers are trying to get at. It's the same game we played as residents when attendings asked us questions - part of the solution is figuring out what is truly being asked for on the test. The pictures aren't the best, but they should be good enough for you to figure out what to do. Sometimes you may not know what you're looking at until you figure out what the examiner is trying to ask.
3) Preparation - this is the big one. You not only have to know your information, but you have to present it concisely. Doing 10 cases in 25 minutes is very tough without practicing and drilling yourself. The time limit is really what makes this test difficult - I believe that if all applicants had an extra 15 minutes per section, they would probably pass the test easily.
For the first attempt, I read Pemberton and Friedman’s Case Reviews, then attended the Osler course. Obviously it was not enough; the Osler course is meant more for practicing and already having all your knowledge prepped prior to the course. When I walked out, I cursed myself silently because I did not finish strong and realized I had missed some crucial cases that I only realized he answer after walking out of one of the rooms.
The second time around, I regather my thoughts and had an honest analysis of what went wrong. I realized that not only did I not prepare adequately, but I also did not read up and refresh my clinical knowledge. So what did I do?
First, I blocked off time 3-4 months prior to the boards this year, and flipped through Kanski and some of the case vignettes that you can buy with it. This was more so I could look at lots of pictures - an Atlas of any sort would be fine. Then, I read through the Wills Eye Manual. In my opinion, this is what really helped me prepare the most. Yes, it is dry and boring, but everything non-optics related you need to pass is in that book.
For further preparation, I decided to try UC Denver’s mock oral prep day rather than do the Osler course again. If I could do it again, I would have done this instead of Osler. The course is held 3-4 weeks prior to the boards. It is basically a mock run through of the real thing, and you get feedback on your performance. It’s early enough so that if you feel like you bombed it, you have time to rectify your preparation.
For the last three weeks, I spent the majorty of my preparation practicing with a study partner via FaceTime using cases from Pemberton, Friedman Case Reviews, and some extra cases we cobbled up together. This kept us honest and forced us to keep our presentations concise.
The second time through, I felt much better prepared and walked out feeling like I passed. I didn’t take the Osler course but I took off early that Wednesday and made sure I had ample time to get to San Francisco in case I had any delays.
The main advice I can give is to take this test seriously like the writtens and prepare properly. Don’t rely on reading just the main review books (Pemberton, Luciano, Friedman, etc.) because there are some high yield cases not accounted for in those books that you have to know solid due to their systemic implications. Seriously, Wills Eye Manual has all the info you need (was strongly recommended by someone in my shoes before me) and I’m glad I read it.
Whew lad that was a lot. Feel free to ask me any questions.
