residency

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Venns Puzzle 1

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Learning requires us to form robust connections between new information and existing information. I’ve been experimenting with ideas on how to test knowledge and conceptual understanding, and this is one of those ideas.

Unlike a similar party game, in which you have a finite set of categories and the goal is to select two categories for a randomly chosen term, this game presents you with two categories in which there are already terms selected. Your job is to identify the categories based on the terms listed in each circle, and then identify the intersecting terms. The number lets you know the minimum number of terms that should be in the intersection.

Can you solve this puzzle? What do you think of this study approach?

Integrative Reviewing And Some Other Review Ideas

As we get close to another cycle of exams, deciding on how and what to review can be more challenging than the effort of reviewing.

Realistically, there is no feasible way to cram the whole of ophthalmic knowledge in the next 1-3 months to perform well on an exam. Hopefully this time is spent reviewing and solidifying knowledge we’ve accumulated previously, and not attempting to learn concepts for the first time!

So as you gear up for this next cycle of studying, here are a few ideas on how to review:

Daily Study Calendar

Among the many crazy ideas and projects I have bouncing around in my head, I’ve wanted to develop a daily study calendar.

I’ve received a lot of feedback over the years that some of the major challenges to learning ophthalmology include the overwhelming volume and the lack of overall structure in how to study the material comprehensively. Bhullar and Venkateswaran argue this in a 2022 review article (1). While there are many general reading schedules and suggested options available (some here for free!), these still only direct the learner to textbook pages, with little instruction on how and what to study.

So although this is a massive undertaking, I started thinking of how I would design a step-by-step curriculum for a pre-ophthalmology (PGY-1) or first-year ophthalmology (PGY-2) resident. My goals were to:

  • Cover all the major topics in ophthalmology at least once

  • Span around 30-35 weeks (July 1 to OKAP in mid-March is about 37-38 weeks) to allow sufficient time for review

  • Specify learning goals for each day to direct attention to important concepts and topics

  • Allot for an average daily study time of one hour on work days, 3-4 hours on the weekends (including one day off per week for either no study or unstructured study)

  • Incorporate active learning techniques such as generation, elaboration, effortful recall, spaced repetition, and interleaving

The result is a 35-week study calendar that covers the majority of ophthalmology topics 2-3 times. This allows residents who are planning on taking exams in mid-March to start studying at the beginning of July and finish the study calendar with 2-3 weeks remaining for review.

Because learning is an iterative process, the first four weeks are structured as an “introduction to ophthalmology" and covers the afferent visual pathway, eye movements, periocular anatomy and function, and intraocular anatomy and function. These fundamentals are reviewed in subsequent weeks as we dive into most common conditions in ophthalmology (ordered anatomically), and followed by a deeper dive into the “high-yield” topics in each subspecialty.

The challenge with this approach, of course, is that the textbook correlation may be more scattered and voluminous. After all, some sections may reference almost a hundred pages of textbook in a single day, which is not a really feasible prospect.

So, as an attempt to make each day’s reading more accessible (and to the level of detail I was intending), I put together a sample section to see if this would be helpful.

Let me know what you think in the comments below! You can also reach me by email at ophthreview [at] gmail [dot] com, @ophthalmologyreview on Facebook, or @ophthreview on Twitter, Mastodon (@med-mastodon.com), or Instagram.

  1. Paramjit K. Bhullar & Nandini Venkateswaran (2023) Ophthalmology Residency in the United States: The Case for a National Curriculum, Seminars in Ophthalmology, DOI: 10.1080/08820538.2022.2152713

Study Methods Preferred By Ophthalmology Learners

Background

There are a wide variety of options for learning ophthalmology now. There are more textbooks and review books available now than ever before; podcasts, YouTube channels, and many other forms of media also provide new streams of innovative content.

Over the last 6-7 years since I started Ophthalmology Review, I’ve enjoyed trying different methods of developing useful content - from directly translating my notes from residency, to creating tables and picmonics, writing review articles, etc. - I’m constantly thinking of how to teach the incredible field of ophthalmology.

However, sometimes it’s hard to know exactly what people find most useful, and what may be helpful for one person may not be for another. So in my continuous search for content ideas, I wanted to know what study tools the readers of this website find most helpful.

Ophthalmology Study Topic Checklist

Check out a new resource I’ve created - a checklist that covers over 3000+ topics in ophthalmology, with page references from the latest editions of the Basic and Clinical Science Course, Review of Ophthalmology, and Kanski’s Clinical Ophthalmology! If you’re having a hard time getting started with learning/studying ophthalmology or want a handy way of making sure you’ve covered the high-yield topics in ophthalmology, this tool may be really helpful!

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Random Topic Generator

I’m happy to announce that I’ve completed a random topic generator that covers all of the various topics discussed in the AAO’s Basic and Clinical Science Course textbooks (excluding the General Medicine volume). It’s been a while since I’ve coded to this extent so this version is very basic - I’ve included all topics listed in the BCSC (including references such as glossaries and procedure instructions), and I haven’t assigned any priorities to certain topics, which means that there is theoretically an equal chance of getting keratoconus as there is getting molecular genetics testing modalities.

Eventually I’d like to prioritize topics to a certain degree, which may also take into account stage of training (a first-year resident may need to review anatomy a lot more than a recent graduate) as well as type of knowledge (how to perform surgery is probably learned hands-on rather than from a textbook).

I’m working closely with the AAO on projects similar to this, and so eventually this project may be added to one of the resources the Academy offers. Stay tuned for more developments!

If I Had To Learn Ophthalmology From The Beginning Again...

  • I would start with a topic outline

  • I would create a realistic study schedule flexible enough to allow for adjustments

  • I would study several subjects at once instead of focusing on one topic at a time

  • I would utilize practice questions to test my previous knowledge and highlight areas of focus

  • I would utilize mnemonics and other memory tools to help remember details better

  • I would read, create, and review in short bursts instead of cramming in long sessions

  • I would devise quick reviews throughout the workday instead of trying to do it all at the end of the day

  • I would set aside time at the end of each day to reflect on the patients I saw to consider useful learning points and areas of study

  • I would use textbooks as references for study instead of reading them over and over again

  • I would create useful flashcards to review throughout the day

  • I would gamify my learning to celebrate incremental gains in knowledge

(originally posted by me on Twitter)

Last Minute OKAP Review

One of the things I want to do on this site is to provide more finished "products" for you, in addition to the subject/literature reviews, test preparation and study ideas, and book reviews.  These will hopefully include charts, outlines, and other media that will help augment your studies.  I am working on several book-length projects for the site as well, including a mnemonics-style cheat book and a "textbook" of ophthalmology, with the goal of bridging the gap between the traditional high-academic works of the highly reputable textbooks and shorter-length review books.  Since those books are going to take me a considerable time to write and prepare (probably several years at the rate I'm going now), I plan to publish those for sale.  However, I still want to make the bulk of the content free, so the articles won't be hidden behind a paywall.

OKAP Review: Introduction

It's review season!  The OKAP exam and written board exam are coming soon, and to try and push out some useful reviews before the exam, I'm going to publish a series of articles covering some of the major concepts you should probably have mastered for the OKAP and for the written board exam.  Because the OKAP and written board exam cover similar topics, you'll probably find some overlap if you read both sets of articles.  However, there are some key differences, both in breadth of content and in depth of content, that will make these articles slightly different.  For example, you will not be tested over any topics in General Medicine or Fundamentals and Principles of Ophthalmology on the WQE.

I may be a bit too ambitious, but my hope is to have these articles published with enough time for those who are hoping to use this site to help study for the OKAP or WQE in March.  I know, my rate of publication hasn't been stellar this past year, but since these are all adaptations of previous material I made in residency, hopefully I won't have to do as much background research (typically each article takes me around 6-8 hours to research and assemble).

6 Tips For Learning Ophthalmology

Here we are, at the end of September, and for those in residency and fellowship, hopefully you're starting to get used to the lifestyle of the trainee.  By now, the routine of waking up at all hours of the day and night, working on minimal sleep, cramming in study time, etc. should be second nature.

It was around this point during my first year of ophthalmology residency that I began to question the effectiveness of my learning/studying strategies.  It seemed like my peers always had a better grasp on the obscure facts, picking up on subtle clinical findings, or be able to answer questions in lecture while I sat there clueless.

4 Tips For Beginning Residency

Happy early July!  For those who just started residency, congratulations!  Hopefully the first few days of residency have been a smooth transition.

Perhaps some (or many) of you are just getting started with ophthalmology residency.  This week may have been full of firsts, such as your first full refraction, your first dilated fundus exam, your first call, your first consult, etc.  There will probably be many other firsts to come - your first cataract surgery, your first post-cataract 20/20 patient, your first posterior capsular tear, your first vitrectomy, your first open globe, etc.  Okay, not all of these things are going to be super exciting.  But it's the beginning of one of the most rewarding and exciting specialties in medicine.