I looked at previous posts. any last minute tips?
When he/she asks you to flip that little booklet, just start your prepared "speech" about the condition:
1) Describe the photo.
2) Based on the photo, give your focused differential diagnosis. Make sure to include possible diagnoses that will either kill or blind the patient (e.g. retinoblastoma).
3) State what history you would want to ask from the patient (don't expect any answers from your examiner), what imaging studies (e.g. FA/OCT, etc), labs, etc you would want. Once you mention a study they are looking for...they will make you flip to that page with the corresponding study.
4) Describe the study (e.g. FA). And then "based on this study, the top of my differential is...<blah><blah>"
5) Describe how you would manage the most likely disease (btw, the examiner will never tell you if you are right about the diagnosis)
6) Describe your follow-up, patient counseling, prognosis, etc (e.g. "The overwhelming majority of patients with CME will recover their vision").
* Do NOT stop your verbal barrage unless the examiner tells you to move on.
* Don't look at the examiner for any non-verbal cues -- there won't be any.
* Don't ask the examiner questions -- he/she won't answer them.
The key to this exam is that you have to realize that it's NOT a conversation between you and the examiner. Instead, it is just you reciting an organized monologue about the patient that is presented to you. And hopefully, not missing anything that will kill or blind the patient.
Good luck! I'm sure the $1650 + hotel + airfare is worth it!