As we enter review season for OKAP and board exams, I’ve been thinking about a term that we throw around a lot when we’re studying: “high yield.” I use it quite a bit when teaching residents, and include the term in many of the study resources I’ve created over the years. But “high yield” has different meanings for different people.

For example, for the medical student on their first ophthalmology clerkship, “high yield” might mean learning the most common diseases that every doctor should recognize and the very basics of ocular anatomy and physiology.
A first-year ophthalmology resident might have different priorities. For them, more detailed fundamental facts about anatomy, physiology, biochemistry, pharmacology, histopathology, and common or notable diseases might be high-yield. What they may have once studied as a medical student is no longer detailed enough to be “high-yield.”
A senior resident, seasoned by years of study, clinical experience, and several iterations of test-taking, has a different set of priorities as they prepare for board exams. They may find that they prefer to focus on only the minutia required for the test, while fortifying their understanding of ophthalmic disease management.
Finally, a practicing ophthalmologist may find that the high-yield concepts they prioritize are centered around the facts and concepts essential to being an excellent clinician and surgeon.

All of these approaches are equally valid and why there is not a perfect one-size-fits-all approach to studying. After all, the more iterations we have of each concept, the more nuance and expertise we gain about the topic.

““High-yield” means different things depending on your study goals. ”

Understanding that different stages of expertise have different study priorities should inspire us to continue evolving our study approach. I believe this is why many study techniques we employed in medical school are not as effective in residency.

We need to also evolve our study focus based on goals, because the knowledge and proficiency may vary depending on what and how we study. For example, if you only study to pass tests, you may become proficient at knowing specific pieces of knowledge, but struggle clinically. A common response I hear is “I'd be able to pick out the answer if I had multiple choice.” But clinical care isn’t multiple choice!

The opposite situation, being good at clinical knowledge without specifically preparing for a test, may not always yield test proficiency, either. Clinical dilemmas often have the luxury of time — time to look up information, time to consult with colleagues, time to talk with the patient and examine them further. Lacking familiarity with a test format can put us at a disadvantage when taking the exam and also affect our confidence.

As you study, I’d like to challenge you to take a few moments before diving into the day’s topics to consider what you consider to be “high-yield.” If your current study goals are to pass an exam, studying with an emphasis on rapid recall and synthesizing unambiguous, conceptual knowledge may be more efficient. If you are studying to gain fundamental knowledge that will help you grow as an ophthalmologist, you may want to prioritize foundational concepts. If you want to gain expert level knowledge on a topic, reading multiple sources and critically examining all aspects of a single subject may be more effective.

If you approach your studies with intention, I believe figuring out what is “high-yield” for you becomes much clearer.