ABVO CERTIFICATION EXAMINATION INSTRUCTIONS TO CANDIDATES

The examination registration form and payment is due in the ABVO office by 5pm MST, June 15th, 2017. Call the ABVO office (208-466-7624) if you need assistance.


The 2017 Image Recognition and Written examinations will be administered at regional testing centers on July 17th and 18th. Practical examination portions will be held on August 1-4, 2017 at North Carolina State University in Raleigh, NC. These dates are also found in the resident section of the ABVO web site.

The online address to help you locate a testing center near you is: http://www.isoqualitytesting.com/locations.aspx.

Contact the Chair of the Examination Committee, Dr. Amy Rankin at Exam17@acvo.org, with any questions or concerns.


Recommended source material / reading list (pdf) (updated 1/2017)

Blueprint of the distribution for questions on the examination (pdf)

Examination Registration and Score Release Form (updated 2/2017)

Nature and scope of the examination

Slide/Image Recognition examination

Written examination

Practical examination

Explanation of the grading of the examination

Application procedure for examination accommodations

Candidate notification and reexamination procedures

Appeal procedures

Examiners / Examination Committee members

Schedule for the 2017 Examination

2017 Instructions to candidates


NATURE AND SCOPE OF THE ABVO EXAMINATION

The American Board of Veterinary Ophthalmology Certification Examination is given annually to candidates who have successfully completed all requirements dictated by the ABVO Residency and Credentials Committees. The examination process consists of three separate sections: 1) the Image Recognition examination, 2) the Written examination, and 3) the Practical examination. The Image Recognition and Written examinations are given in late July to early August at regional testing centers. The Practical examination is held approximately 1-2 weeks later, usually at a veterinary medical teaching institution. The specific dates for this year’s examinations are listed below under “Schedule for the 2017 Examination”. 

The separate portions of the examination are constructed to evaluate the candidate's proficiency and knowledge of items considered relevant and important to a veterinary ophthalmologist. The Image Recognition examination is designed to evaluate ability to identify, assess, and problem solve (assimilate) clinical material. The Written examination is designed to evaluate knowledge of the current scientific literature and basic sciences relevant to veterinary ophthalmology. The Practical examination portions are designed to evaluate proficiency in surgical techniques.

ABVO EXAMINATION SAMPLE QUESTIONSExamples of questions for the Written and Image Recognition portions of the ABVO certifying examination may be found at the following links:

Sample IR questions

Sample Written questions

These examples are provided to familiarize the candidate with the type and format of questions that may be asked and do not reflect the content distribution of the actual exam, as outlined by the ABVO Examination Blueprint. Also note that the list of acceptable responses listed for the Image Recognition questions is not necessarily comprehensive. They are simply examples of acceptable responses appropriate to the phrasing of the questions posed. It is advisable to review the “Components of the Examination, Image Recognition Examination” section below before proceeding to the sample questions.

COMPONENTS OF THE EXAMINATION

I. Image Recognition Examination

The Image Recognition examination is conducted on-line at regional testing centers and consists of a series of images and corresponding questions in three sections of the eye and related structures: 1) Orbit and Adnexa, 2) Anterior Segment, and 3) Lens and Posterior Segment.

The major demands of the Image Recognition examination include identification, assessment, and problem solving (assimilation) of the appearance and information presented on a photographic image. During the exam, candidates are asked to respond to structured questions with a short answer response while viewing the image. The candidates are given approximately 2 to 2.5 hours to complete each section of the exam. The candidates are generally asked to give several answers for each image.

The images used in this part of the examination include clinical photographs of the eye or patient, fundus photographs, goniophotographs, photographs of imaging techniques, special diagnostic techniques, slit lamp photographs, cytologic specimens, and gross and microscopic (photomicrographs) pathology specimens. Questions on surgical techniques, principles, equipment and complications are also covered in each of these three areas. Questions typically include such items as listing lesions or abnormalities, developing a differential considerations list for the specific disease process, citing the most likely etiologic diagnosis(es) or pathogenesis, listing a morphologic diagnosis, listing appropriate therapy for the specific condition, identifying species on the image, identifying the surgical technique being performed, surgical instrument, or surgical principle relevant to the image, or surgical complication. The phrasing of questions on the Image Recognition examination follows the guidelines outlined in the terminology description below.

As this exam is designed to evaluate recognition and assimilation of clinical material, the candidate can best prepare for this portion during the residency by seeing a full and diverse caseload and developing sound problem solving skills. Preparation for this portion of the exam is also facilitated by reviewing images of the subject content listed above and interpreting the images according to the questions likely to be asked. Working familiarity with the terms and phrases outlined below is highly recommended.

Distribution of Image Recognition Questions
The image recognition portion of the examination is administered in 3 parts, each of which is constructed by anatomic region of the eye, as outlined below. See the ABVO Exam Blueprint for the approximate distribution of questions according to species and region of the eye.

PART I. ORBIT AND ADNEXA

PART II. ANTERIOR SEGMENT

PART III. LENS AND POSTERIOR SEGMENT

Appropriate Terminology for Answers to Image Recognition Examination Section
The following list of terms has been approved by the Examination Committee for use in questions on the ABVO Image Recognition examination. The candidates should familiarize themselves with this list in preparation for the certification examination. Though there may be differences of opinion with regard to the correct usage some of these terms, this is the terminology the Committee has determined to use on the Image Recognition exam. The term to be used on the examination is listed first, followed by synonyms with which the term is often used (these synonyms will not generally be used on the exam), followed by examples of what the term represents:

TERM SYNONYMS EXAMPLES
ABNORMALITY conditions corneal edema
  features keratic precipitate
  lesions retinal detachment
  significant findings granulomatous inflammation
  clinical signs hypolucent area
    hyperfluorescence

Note that abnormality can refer to clinical findings, histopathologic or cytologic findings, and findings in ancillary tests such as gonioscopy, fluorescein angiography, radiography or other imaging techniques, laboratory tests, etc. The question may be stated as, list the "clinical abnormality" or list the "histopathologic abnormality," etc. If asked for an abnormality, the candidates should list what they see, not the interpretation of what they see, and the abnormality should be described in as much detail and to the highest level possible from what is shown on the image. For example, the image may depict corneal edema, and if the examiners felt the image adequately depicted this lesion, the candidate would be expected to list this as an abnormality, not "corneal cloudiness" or "white area in the cornea." Note that with a fundus photograph, which clearly shows a retinal detachment, the abnormality would be listed as a "retinal detachment." However, with an ultrasound the abnormality should be listed as "hyperechoic lines radiating from optic disc and extending into vitreous". In the latter example, retinal detachment would be a DIAGNOSIS. The examiners take these types of terminology overlap into consideration when formulating the questions and assessing the candidate's answers. Do not assume that if the question asks for any abnormalities that one is necessarily present. If no abnormality is present, the candidate would be expected to write "normal" or "no abnormality." Likewise, the question may ask for “the most significant abnormalities” with a number of correct responses accepted. However, if a lens luxation and retinal detachment are present, listing conjunctival hyperemia instead will not be accepted.

TERM SYNONYMS EXAMPLES
DIAGNOSIS differential diagnosis anterior uveitis
  conditions primary glaucoma
  interpretation lymphocytic/plasmacytic anterior uveitis
  disease process melanoma
    internal ophthalmoplegia

Diagnosis refers to an interpretation of the abnormalities or findings. The question may be qualified to ask for a "histopathologic diagnosis," "morphologic diagnosis," "clinical diagnosis," an "ultrasonographic diagnosis," etc. Again, the diagnosis should be listed in the most specific terms possible from the findings on the image and the information given in the question. Diagnosis will generally not be used to refer to a specific cause/etiology.

TERM SYNONYMS EXAMPLES
ETIOLOGIC DIAGNOSIS differential diagnosis E. coli
  syndromes VKH-like syndrome
  causes trauma
  underlying cause systemic hypertension
  causative agent  

Etiologic diagnosis refers to a specific cause for the abnormalities or diagnosis. The question may be qualified and ask for an "etiologic factor," "etiologic agent," a "noninfectious etiologic agent," etc. An etiologic diagnosis is more specific than a clinical diagnosis.

TERM SYNONYMS EXAMPLES
PATHOGENESIS mechanism autoimmune disorder
  account for UV light exposure
  reaction type II hypersensitivity
  pathophysiology fluid vitreous entering subretinal space through retinal tear

Pathogenesis will be used to refer to the cellular events and reactions or other pathologic mechanisms occurring in the development of a disease. It is distinguished from "etiologic diagnosis" by being more specific and referring to mechanism (often cellular) rather than cause (such as a microbe, trauma, etc.).

MISCELLANEOUS TERMINOLOGY:
The following terms are also used on the image exam and are usually qualified in some fashion in terms of the specific answer requested:

TERM EXAMPLE OF QUALIFICATION
PROGNOSIS for remission, for globe, for life (generally the terms poor, fair, good or excellent should be used here)
OUTCOME most likely, expected, long term, etc.
SIGNIFICCANCE for vision, for breeding purposes, for function of eye
THERAPY most appropriate, several possible therapies, generally accepted therapy
DIAGNOSTIC TESTS most appropriate, physical exam, noninvasive, radiographic
IDENTIFY STRUCTURES area generally identified on image

Sample Image Recognition Questions

EXAMPLE 1: A series of images show a Siberian Husky with a splotchy pink and black nose, corneal edema, aqueous flare, and an exudative retinal detachment. The question could ask for any or all of the following:

QUESTION APPROPRIATE ANSWER
Clinical Abnormality vitiligo or dermal depigmentation
corneal edema
aqueous flare
retinal detachment
Most likely ocular, clinical diagnosis panuveitis (with secondary ret. detachment)
Most likely etiologic diagnosis VKH-like or uveodermatologic syndrome
Pathogenesis autoimmune destruction of melanocytes
Prognosis for complete resolution poor

EXAMPLE 2: An image shows a horse with a typical "melting" corneal ulcer. The question could ask for:

QUESTION APPROPRIATE ANSWER
Clinical Abnormality "melting" corneal ulcer (would also likely accept answers such as
"5 mm central corneal ulcer with stromal necrosis," etc.)
Most likely bacterial etiologic agent Pseudomonas aeruginosa
Pathogenesis Collagenolytic, proteolytic destruction of cornea

EXAMPLE 3: An image shows a dog with a dense, black pigmented mass in the posterior chamber, apparently arising from the ciliary body. Questions could include:

QUESTION APPROPRIATE ANSWER
Clinical Abnormality black mass in posterior chamber
Most likely histopathologic diagnosis uveal melanoma
Prognosis for patient's life good, (<5% metastasis rate)

II. Written Examination

The Written examination consists of 250 multiple-choice questions in eight disciplines: anatomy/embryology, physiology, neuro-ophthalmology, surgery, pharmacology, pathology, medical ophthalmology, and diagnostics. The test is designed to evaluate the candidate's knowledge of both current literature and basic science information relevant to veterinary ophthalmology. The content distribution of Written Exam questions approximates the ABVO Exam Blueprint (available on the ABVO website), which details discipline, animal species, and eye region. The exam is given in two sections, 125 questions apiece, and the candidates are allowed 3.5 hours/section to complete the exam.

A suggested reading list from which examination questions are composed is provided (see Suggested Resource Material 2017 ABVO Exam). Appropriate chapters in veterinary medical, surgical, and anatomical, etc., texts should also be consulted. Questions from journal articles are from articles published in the 7 years preceding the year the examination is administered and the candidates should concentrate their study efforts on this more recent scientific literature. Some articles that are considered "classic" articles (i.e., those that provided a major advancement in the knowledge of that particular condition) and are older than seven years should be reviewed, although examination questions will not be directly derived from these articles. A supplemental list of such articles is provided. Much of the information from these articles has made its way into contemporary veterinary ophthalmic texts (e.g., Gelatt's textbook), and this information can to some extent be gleaned from these sources; however, the candidates are encouraged to also review the original manuscripts.

Note that articles in veterinary journals should be reviewed for any disease, condition, or situation that involves ocular, periocular, or neuro-ophthalmic structures of systemic conditions directly relevant to ocular disease in animals. Review of basic science texts and human clinical journals should be limited to those chapters or articles dealing with situations or diseases directly applicable to veterinary ophthalmology, or to those where a common domestic animal is used as an animal model. Review of human clinical conditions or basic science articles or texts unrelated to veterinary ophthalmology is not necessary for exam preparation. Additionally, beginning with literature published in January 2010 or later, no questions on the Written Examination will be derived from articles involving single cases (i.e. single case reports).

III. Practical Examination

The Practical examination consists of two separate stations that are designed to evaluate a candidate's proficiency in surgical techniques. The individual stations and associated time limits are described below.

Extraocular and Intraocular Surgery Stations
The two surgery stations (extraocular surgery and intraocular surgery) involve surgical exercises on cadaver (pig, calf, rabbit, dog, cat, or other appropriate species) eyes. The candidate is asked to perform one extraocular procedure (corneal/conjunctival) and an intraocular procedure. The candidate supplies all necessary instruments, irrigating solution, suture material, blades, gloves, head loupes, etc. An operating microscope for the intraocular surgery section and stands for organizing the instruments will be available.

FAILURE TO BRING NECESSARY SUPPLIES MAY RESULT IN FAILURE. THE EXAMINERS WILL NOT OFFER ANY SUPPLIES INCLUDING DISPOSABLE MATERIALS.

Extraocular surgery (100 points) – The candidate will be given 50 minutes to set up and perform either a lamellar keratectomy and a corneoconjunctival transposition or lamellar keratectomy and a conjunctival pedicle flap.  The specific surgery to be performed will be declared at the time of examination.  An operating microscope will not be available for this procedure. The candidate should describe what magnification he/she would normally use and is advised to bring a portable source of magnification (head loupe).  Observation of sterile technique is not expected. One of the examiners will function as a surgical assistant but will act only upon the candidate’s specific instructions.  The candidate may adjust the chair and surgical light as necessary. As cadaver eyes are soft, the candidate may wish to inflate the globe to a more normal tension by by injecting saline into the anterior chamber or the vitreal cavity. The candidate will be given a 25 and a 10 minute remaining time warning.

Intraocular surgery (100 points) – The candidate will be given 50 minutes to setup and perform an extracapsular cataract extraction (ECCE). An operating microscope will be available and the candidate will be given orientation to its use. The candidate is expected to demonstrate currently acceptable techniques of intraocular surgery and should use techniques with which he/she is familiar.  The candidate will be asked perform a two-step clear corneal incision, continuous curvilinear capsulorrhexis,  extracapsular extraction,demonstrate cortical removal, if needed, by manual techniques, and closure of the corneal incision.  The candidate will be asked to describe the procedure while performing it. It is recognized that this demonstration differs from a clinical situation and the candidate will be asked to discuss these differences and how his/her technique and results differ from a clinical situation. Observation of sterile technique is not expected. One of the examiners will function as a surgical assistant but will act only upon the candidate’s specific instructions. The candidate may adjust the chair and microscope as necessary. As cadaver eyes are soft, the candidate may wish to inflate the globe to a more normal tension by injecting saline into the anterior chamber.  The candidate will be given a 25 and a 10 minute remaining time warning. Although this is not a commonly performed surgical procedure, it contains a number of technical elements that are absolutely necessary in the execution of successful intraocular surgery. One text that provides a description of the ECCE procedure is Eisner Eye Surgery, An Introduction to Operative Technique. Springer‑Verlag. 
  
The candidate should be aware that there are several different types of instruments and surgical techniques that are acceptable for both the intraocular and extraocular surgical procedures.  For example there are a variety of acceptable suture patterns to close the corneal incision following an extracapsular lens extraction.  Candidates are evaluated primarily on using proper surgical technique as well as proper instrumentation.  Knowledge of and experience with proper surgical technique and the common ophthalmic surgical techniques (especially those above) should prepare the candidate for this portion of the exam. The candidate is also strongly encouraged to carefully prepare and to practice the surgical techniques on cadaver eyes (porcine and canine) in preparation for this examination. Since correct (currently accepted) instrumentation, use of instruments, and appropriate suture material will be evaluated, the candidate should bring equipment and supplies as would be used on a client-owned animal (although sterility of the supplies is not required).

Both sections of the practical examination must be passed to successfully complete the examination. Only failed sections must be repeated.

GRADING OF THE EXAMINATION AND DETERMINATION OF PASSING POINT

The Written examination is computer scored and a total score for all 250 questions is generated. Each section of the Image Recognition examination is scored independently by three examination committee members in a masked fashion (without knowledge of candidate identity) and their scores averaged. The score for all three sections is used for the final score. The surgery and animal examination stations are evaluated by three judges observing and independently scoring the surgical and examination technique of the candidate on separate components of the procedure, including appropriate instrumentation and proficiency in the technique itself. The candidate is asked to explain what is being done during the surgeries and some questions may be asked.

The passing points for the Image Recognition and Written Examinations are determined primarily using a modified Angoff method, with further validation of the derived passing point provided by application of the Hofstee method. Because the Image Recognition and Written Examinations are revised regularly, with some items being replaced by newly developed ones, the content and difficulty level of the Examinations change. As a result, the passing point for each Examination is unique. The passing points for the Practical Examination stations are determined through the Hofstee method. Passing points determined by the Hofstee method are informed by both criterion-referenced and norm-referenced factors, the latter of which includes actual candidate performance on the exam .  

CANDIDATE PLEDGE

The candidates taking the examination are not to discuss any portion of the examination, either during or following the examination, with other or future ABVO examination candidates. Any evidence of discussion of the examination during the examination will lead to disqualification of the candidate and initiate a report to the ABVO Appeals Committee.
  
Immediately prior to the examination, the candidates will be required to sign that they have read and agree to the following:

“I hereby acknowledge that the American Board of Veterinary Ophthalmology certification examination is a secure examination duly copyrighted under the laws of the United States of America.  I further acknowledge that any reproduction or transmission in any form or by any means of the contents of the questions contained in the examination is strictly prohibited.  I understand that reproduction or transmission of the contents of these questions contained in this examination may jeopardize membership in the American College of Veterinary Ophthalmologists.  I will not reproduce or transmit any part of this examination without the prior written consent of the American Board of Veterinary Ophthalmology. On my honor, I have neither given nor received unauthorized aid, directly or indirectly, on the certification examination.  I have not observed other candidates receiving unauthorized aid on this examination which has not been reported in writing by me to a Proctor.”

APPLICATION PROCEDURE FOR EXAMINATION ACCOMMODATIONS

In compliance with the Americans with Disabilities Act (ADA), the ABVO shall offer its exams in manner that accommodates individuals with disabilities, including persons with learning disabilities.

A candidate who has a disability, but has completed the credentialing requirements of the ABVO, may request accommodations in taking the Written and Image Recognition portions of the ABVO certifying examination. The original application and documentation as outlined in the official Accommodations Policy, must be submitted no later than 90 days prior to the beginning of exams. Due to the nature of the Practical portions of the certifying examination (which include the Intraocular Surgery, Extraocular Surgery and Animal Examination stations), accommodations in the form of time extension or altered setting are not provided for these portions of the exam.

Requests for the full Accommodations Policy and submission documentation should be submitted to the ABVO at (208) 466-7624 or by e-mail at ABVO office)

CANDIDATE NOTIFICATION AND REEXAMINATION PROCEDURES

Candidates for the Examination are notified of their results by the Examination Committee Chair within eight weeks of the end of the Practical examination.  DO NOT EMAIL OR CALL the Examination Committee Chair regarding exam results.  Exam results WILL NOT be given over the phone or emailed to you, your mentor, or anyone else – YOU MUST WAIT FOR THE OFFICIAL NOTICE. The candidates are informed of their specific scores and minimum passing point on each section of the examination.  If unsuccessful on one or more portions of the Practical portions of the examination, candidates are also provided comments specific to their performance on those stations at which they were unsuccessful.  Unsuccessful candidates are subsequently provided a diagnostic report outlining their performance on the Written and/or IR portions of the examinations relative to the distribution of questions specified by the examination blueprint.

A candidate need only retake that portion of the examination for which an unsuccessful score was rendered. The portions of the practical examination are considered separate sections as related to reexamination (i.e. only unsuccessful stations need be repeated, not the entire practical examination).

The candidate has four calendar years from the time his/her credentials are initially approved to pass all portions of the exam regardless of the number of attempts made to pass the exam (i.e. if for whatever reason a candidate does not take the exam in consecutive years, the four year limitation continues to run). After that time, the candidate must take all portions of the certifying examination. Re-application to begin a new four calendar year cycle is not permitted until the cycle initiated by the candidate’s initial credentials application has expired.

PROCEDURE FOR REAPPLICATION TO REPEAT THE EXAMINATION
Re-applicants must submit and comply with all requirements as outlined by the Credentials Committee in order to repeat any portion(s) of the certification examination. Previous satisfaction of Credential Committee requirements does not insure successful reapplication.

APPEAL PROCEDURES
Candidate appeal of failing scores on the certification exam may be made according to the ABVO Appeals Procedure outlined in the current “ABVO Policies and Procedures” document.

If you have questions regarding the logistics of the written, image, or practical examinations, you may contact the examination committee chairpersons:

Dr. Amy Rankin
Chair, ABVO Examination Committee
Department of Veterinary Clinical Sciences
Kansas State University
Veterinary Health Center
111 B Mosier Hall
Manhattan, KS 66506
Phone: (785) 532-5690
exam17@acvo.org


Dr. Dan Binder

Co-Chair, ABVO Examination Committee
42 Benefit Street
Warwick, RI 02886
Phone: (401) 738-7337
exam17@acvo.org

Examiners for the 2017 ABVO Examination
The following is a list of the examiners who will be present during the 2017 Examination. If you feel there is ANY possible conflict of interest in having any of these individuals evaluate your performance at the surgical or animal examination stations, please inform the examination committee chair and appropriate adjustments will be made. Mentors are automatically excluded for evaluating their own resident(s).  Examples of recognized conflicts would be an individual who is in practice within the same area as a candidate or an individual who was involved in the training of the candidate.

Dr. Daniel Binder (Huntingtown, MD)
Dr. William Crumley (Philadelphia, PA)
Dr. Kathryn Diehl (Athens, GA)
Dr. Brian Gilger (Raleigh, NC)
Dr. Heather Kaese (Overland Park, KS)
Dr. Lou Laratta (Nashville, TN)
Dr. Mary Lassaline (Davis, CA)
Dr. Amy Rankin (Manhattan, KS)
Dr. Bernhard Spiess (Zurich, Switzerland)
Dr. Erica Tolar (Simpsonville, KY)
Dr. Daniel Ward (Knoxville, TN)

Schedule for the 2017 Examination
The deadline for receipt of the Examination Registration Form and examination fee in the ABVO Executive Director’s office is June 15th, 2017. Late registration and payments will not be accepted. The 2017 Image Recognition and Written examinations will be administered at regional testing centers on July 17 and 18, respectively.  Location of regional testing centers can be found at: http://www.isoqualitytesting.com/locations.aspx.

Passage of the Image Recognition and Written examinations are not a pre-requisite for taking the Practical examination. When a candidate’s materials have been approved by the Credentials Committee, the candidate will be contacted by the chair of the Examination Committee at the address he/she provided to the Credentials Committee and assigned a preliminary date and time for the Practical examination portions.  This date and time will become finalized when the chair of the Examination Committee receives confirmation from the ABVO office management that the Exam Registration Form and examination fee has been received. The Practical examination portions will be held on August 1 - 4, 2017 at the Veterinary Teaching Hospital at the North Carolina State University in Raleigh, NC.  Candidates are advised to arrive approximately 30 minutes before they are scheduled to begin the Practical examination portions.  Candidates are responsible for familiarizing themselves with the location of the examination. 

Hotel/Arrival
The closest major airport to North Carolina State University is Raleigh-Durham International Airport, which is approximately 15 minutes from campus.

There are numerous lodging options in Raleigh and it is the candidate’s responsibility to make hotel arrangements. The Ramada Raleigh is located within walking distance to the veterinary school. A block of rooms will be allocated for ABVO examinees at the Ramada Raleigh (1520 Blue Ridge Rd.) on July 31 - August 4 2017. You must call the Ramada Raleigh directly at (919) 832-4100 to secure a reservation, group code: GCACVO17.The hotel provides free WiFi, breakfast and parking. (note - block of rooms will be released by July 17th, 2017.)

Security Passes
Each candidate may be required to wear a name badge when in the VTH, which will be provided upon arrival at the VTH.  

If you have questions regarding the logistics of any portions of the examination, please notify Dr. Amy J. Rankin, Examination Committee Chair or Dr. Daniel Binder, Examination Committee Co-Chair.