The American Board of Ophthalmology (ABO) requires successful completion of written and oral board certification requirements within seven years of graduating residency. According to the ABO website, the fastest one can obtain board certification is nine months after residency graduation, if the first available exam is taken and both the Written Qualifying Exam (WQE) and Oral Examinations are passed on the first attempt. The WQE is a multiple-choice examination that is offered on one day, annually in the fall. After passing the WQE, you will be eligible to take the Oral Board Examination. The Oral Examination is now administered online and consists of a virtual face-to-face interaction with an examiner. The Oral Examination is currently offered twice per year, in the spring and fall.

The Oral Examination is administered virtually via Zoom. Professional attire is recommended for the exam. Most examiners and examinees wear suits. The examiner presents the examinee with a series of clinical scenarios (Patient Management Problems or PMPs). The examinee is expected to verbally lead the examiner through the appropriate data acquisition, diagnosis and management of each PMP. The test is clinical. There is minimal to no esoteric material like what you encountered on the Written Qualifying Exam.

The total examination takes approximately four hours to complete. Following orientation, the ABO meeting host will admit the candidates into one of three private exam rooms. Each exam room session is 50 minutes and consists of 14 cases, totaling 42 cases covering six clinical subject areas. The three separate virtual testing rooms are composed of cases from the following paired subject areas:

1. Anterior Segment of the Eye & Optics, Visual Physiology and Correction of Refractive Errors
2. External Eye and Adnexa & Pediatric Ophthalmology and Strabismus
3. Neuro-Ophthalmology and Orbit & Posterior Segment of the Eye

Each exam room will be a new Zoom room where two examiners will each present 7 clinical scenarios. During the examination, the examiner will introduce the case and display the case information on a shared Zoom screen, which typically includes a case stem and an image.

Examiners are experienced ophthalmologists and ABO volunteers. Examiners are not meant to lead you. Don’t count on the examiner to prompt you to answer the question elements or to redirect you if you veer off the correct path. Although awkward, expect that some may just sit and stare at you as you verbally progress through the PMP. The examiner controls the presentation of any additional material on the tablet following the initial presentation of the clinical scenario. Do not ask the examiner questions regarding the case or how you are doing. They will not tell you how many PMPs you have completed or which topics you have answered correctly. You can ask to skip and come back to a PMP if you are struggling but this is ultimately up to the examiner’s discretion and should be avoided. There is no visible timer and the PMPs are not numbered so you will not readily know how much time you have remaining or how many PMPs you have gotten through.

At the conclusion of each exam, the candidates return to the main waiting room for a 10 minute break between exam rooms. After the candidate has completed the third exam room, the candidate will leave the meeting. The candidates should not disconnect from Zoom until the entire examination is finished. If there are technical issues that arise, a senior ABO official or another examiner may step in. If there is a new examiner training, the mentor examiner will ask all of the questions and both examiners will score.

First, look at your calendar and create a realistic and appropriate study schedule. Some people prefer to start preparing six or more months prior to the examination date. Others may study more intensely for 3 or 4 months. Reflect on what has made you successful in the past and plan accordingly. 

Now, take a breath. You know this material. You’ve proven that by passing the Written Qualifying Exam. Now, you need to prove that you can verbally progress through a clinical scenario in a comprehensive yet succinct manner. The OphthoGenie Method will give you the tools to convey your thoughts in the format required to ace the Oral Board Exam on the first try.  

We know your time is limited. Many examinees are either working full-time or a busy fellow and may have family obligations. OphthoGenie was designed with this in mind. The OphthoGenie digital platform has several innovative features designed to help you focus your efforts and maximize your study time. Please read more about this below.

In each clinical scenario, or PMP, you are expected to show proficiency in several areas including: data acquisition (description of clinical photograph or video, obtaining relevant clinical history, eliciting important physical exam findings, work-up), diagnosis (differential diagnosis and most likely diagnosis) and management (treatment, patient education, prognosis, follow-up). 

OphthoGenie is designed to lead you through a structured format by breaking each PMP answer into several elements: 

• Description of photograph/video
• Differential diagnosis (with the most likely diagnosis listed first)
• History
• Physical
• Work-up
• Diagnosis
• Management
• Education/prognosis/follow-up

Each topic area contains multiple clinical scenarios set up in this step-wise approach. By using this structured format for each PMP, your presentations will be logical and complete.

As your study journey progresses towards the exam date, the manner in which you utilize OphthoGenie will shift.  Early on, it is helpful to review the material according to topic (posterior segment, anterior segment, optics etc). This allows you to organize your knowledge and identify relative strengths and weaknesses.  As the test date gets closer, it is beneficial to focus on timely presentation of knowledge and make your study session as “test-like” as possible. To optimize this study strategy, OphthoGenie includes both “Beginner” and “Advanced” modes.

When you are ready to begin, select one of the six topics and create a practice exam using “Beginner" mode. This mode will provide you with prompts to help you progress through the PMP. It is critical that as you progress through the PMP elements you speak out loud! This may feel awkward at first but will get more natural with time. Do not worry about the time at this stage- that will come later. 

When you have become familiar with the material and answer format, you can utilize “Advanced” mode. This mode allows you to progress through 10 PMPs of paired-topics, as described above, with a 2.5 minute per case timer. Advanced mode is meant to simulate the exam and does not have prompts.  Remember, speak out loud! 

Practice as many cases as possible and repeat them several times.  By exam day, you will be able to progress through each PMP without prompts and within the allotted time. Make sure you are proficient in cases in which misdiagnosis or mismanagement could be fatal or cause significant morbidity.

The OphthoGenie Method utilizes a scoring feature to give you personalized data and ongoing feedback. At the end of each question element, OphthoGenie will ask you “did you get this right?” and you will select “yes” or “no.” If you answered the majority of the PMP element correctly and did not miss crucial points, mark “yes.” If you missed half or more of the PMP element, or if you missed something crucial, mark “no.” In the end, use your best judgement. 

Remember, this scoring system is for your benefit and you will only be cheating yourself if you score it incorrectly. Used correctly, the scoring feature feature will clarify your relative strengths and weaknesses to better guide your study time. You will be able to see how you are doing according to topic (posterior segment, optics etc) and category (data acquisition, diagnosis and management). You will also be able to see how your scores compare to your colleagues.

A study buddy is invaluable while studying for the oral boards. OphthoGenie is the only oral board guide that allows you to practice with a friend through the Study Buddy feature. This allows you to enhance your knowledge and polish your presentation. 

If you do not have a buddy locally, we recommend you set up a video or phone call. By sharing a link, you and a designated buddy simultaneously progress through the PMPs together. Take turns as “examiner” and “examinee” to simulate the testing environment. The “examiner’s” screen will show the image, question stem and answers. The “examinee’s” screen will only show the image and question stem. As you advance, your buddy should be giving you minimal to no prompts and should not be giving any feedback - this is a realistic simulation of the exam.  If you are in Beginner mode, there is no timer and the examiner will see prompts on his/her screen that he/she can read outloud to help you along. In Advanced mode, there will be a 2.5 minute timer per case and there will be no prompts from the examiner.