How I Prepared for the OCS exam

Here is an outline of how I prepared for the OCS exam back in 2007-2008. When reading this please keep in mind that we all come from different physical therapy backgrounds and our experiences can vary greatly. We also bring different life circumstances that may benefit or serve as a disadvantage when studying for this exam. Study tactics that work for one candidate might not for another. What might be overkill of information for one candidate might be grossly inadequate for another.

When I prepared for the OCS exam in 2007-2008 I had just recently completed my transitional doctor of physical therapy through the University of St. Augustine for Health Sciences. My curriculum focused heavily on orthopaedics, and I was conditioned to prepare for exams and take multiple choice tests.

Another advantage came from the fact that at the time I was not married and had yet to have any children. Other than my work as a physical therapist, I had an infinite amount of time to set aside and prepare for the exam without distractions. This is something that could not occur now.

To summarize, I recently completed a transitional doctor of physical therapy that was heavily focused on orthopaedics, I was in exam preparation and multiple choice test taking mode, and I had a significant amount of free time to dedicate to this exam.

However, with all these advantages I still needed to read various pieces of literature related to the practice of orthopaedic physical therapy, and set forth a defined study plan to meet my individual needs.

The first things I did were:

  • Join the Orthopaedic Section of the APTA (was already an APTA member)
  • Purchase Current Concepts of Orthopaedic Physical Therapy from the orthopaedic section of the APTA
  • Review the OCS exam content outline

Just like today, Ortho section members in 2008 paid significantly less than non-members for Current Concepts of Orthopaedic Physical Therapy, and non-APTA members pay even more. The cost of the OCS exam and application review is also almost half price for APTA members as well. An added bonus was subscriptions to the Journal of Orthopaedic and Sports Physical Therapy and Orthopaedic Physical Therapy which are both included with ortho section membership. You will have access to past editions of these journals, and their articles could serve as reference material for your review process. Joining the Ortho Section of the APTA is a no-brainer if you are taking the OCS exam. I joined the Ortho Section of the APTA on April 2nd, 2007.

After becoming a member of the orthopaedic section of the APTA I was able to purchase Current Concepts of Orthopaedic Physical Therapy at a reduced rate. The monographs were purchased on October 2nd, 2007, and once I had them in hand I was able begin my comprehensive OCS exam preparation plan.

The first thing I did was glance over the OCS exam content outline. This allowed me to become familiar with the knowledge areas that were tested on the exam, and what percentages of questions were devoted to each body region. From the content outline I was able to see that of the 8 knowledge areas tested on the exam 40% of questions would come from Examination and Procedural Interventions. In terms of body regions it was also evident that 70% of the questions would come from the Cervical Spine, Lumbar Spine, Shoulder, Knee, and Ankle/Foot. The following body regions were minimized on the exam, Cranial Mandibular, Thoracic Spine, Elbow, Wrist/Hand, Sacroiliac, and Hip, as collectively they only made up 30% of the exam. It was clear that studying priority should be given to the body regions that made up the majority of the exam.

I then set out and read all the monographs contained in Current Concepts of Orthopaedic Physical Therapy cover to cover. I also made sure I answered the questions following each monograph. During this review and made sure I completely understood the material contained in the “High Priority” body regions, while not spending much energy on the body regions that collectively made up only 30% of the exam.

High Priority Monographs (70% of Questions from these Body Regions):

  • Cervical Spine
  • Lumbar Spine
  • Shoulder
  • Knee
  • Ankle/Foot

Low Priority Monographs (30% of Questions from these Body Regions):

  • Temporomandibular Joint
  • Thoracic Spine and Ribs
  • Elbow
  • Wrist/Hand
  • Sacroiliac
  • Hip

After reading each monograph cover to cover, I decided to convert the material into a more manageable format. I essentially outlined each monograph and pulled out the information that I felt would be important to know and understand. This was typed up in a word document, and was usually about 4-6 pages per monograph. Now I was able to read and review the information contained in each monograph, in just a couple of minutes. Again, the majority of time was spent on the high priority areas. I remember having a difficult time with the biomechanics of the ankle and foot.

An added bonus of the monographs was the ability to earn 84 continuing education hours by scoring 70% or better on a 48 question multiple choice final exam that was included with the monographs. The questions were based on 12 case scenarios that corresponded with the 12 monographs, and each case scenario contained 4 questions. The questions helped test my ability to recall the information presented in the monographs, and somewhat prepare me for the level of difficulty that I would face on the OCS exam. I returned my answers to the orthopaedic section office in early December 2007, and received word on February 4th, 2008 that I received an 88% on the exam and earned the 84 continuing education hours.

Once I had a firm grasp of the material presented in the monographs, I knew it was time to begin reviewing other sources of information if I wanted to pass this exam.

The next thing I did was review the following, none of this would be considered advanced information but something that most physical therapists often forget without practice. This information can be obtained from virtually any source, and would serve as a foundation to answer the more advanced clinical questions.

  • Muscular anatomy, including attachments and innervation
  • Peripheral Nerve Distribution
  • Myotomes and Dermatomes
  • Joint arthrokinematics including open and closed packed positions.
  • Orthopaedic Special Tests
  • Visceral Pain Referral Pattterns
  • Critical Inquiry Including Research Design, Statistical Tests and Measures

Just like the monographs I converted this material into a more manageable format, which was typed up in word documents by subject area. Again this allowed for quick review, and could be studied almost anywhere.

I then performed an orthopaedic special topic review.

I obtained and reviewed Orthopaedic Physical Therapy Secrets. I did not read this text cover to cover, as some of the information presented in this book was in other sources that I already studied. This would have represented a duplication of study material and a poor use of my time. So, what I did was glance over the table of contents and read chapters and excerpts that contained information that I was yet to review. I continued to pull out information and compile it into more concise word documents allowing for quick review.

Some of those were:

  • Pharmacology in Orthopaedic Physical Therapy
  • Evaluation of Medical Laboratory Tests
  • Manual Therapy
  • Orthopaedic Neurology
  • Pediatric Orthopaedic Physical Therapy
  • Women’s Health Issues
  • Orthopaedic Radiology
  • Fractures of the Humerus
  • Nerve Entrapments of the Shoulder
  • Nerve Entrapments of the Elbow and Forearm
  • Nerve Entrapments of the Lower Extremity

The next thing I did was perform a review of pathology. I owned a copy of Pathology Implications for the Physical Therapist 1st Edition, but also used internet searches to supplement that text.

I paid particular attention to Pathology of the Musculoskeletal System:

  • Genetic and Developmental Disorders
  • Metabolic Disorders
  • Infectious Diseases
  • Musculoskeletal Neoplasms
  • Soft Tissue, Bone, and Joint Disorders

As always I pulled out the information I deemed valuable and compiled it into more manageable word documents.

Given that 40% of the exam dealt with the spine (Cervical, Thoracic, Lumbar), I felt that it was imperative that I knew the anatomy, physiology, biomechanics, and pathophysiology inside and out. In fact, the exam content description indicated that those areas that I mentioned represented approximately 24 questions or 12% of the entire exam. I pulled some of this information out of the Current Concepts of Orthopeadic Physical Therapy monographs, but also consulted various other sources to get a complete picture.

  • Spinal Anatomy
  • Spinal Physiology, Biomechanics, and especially Arthrokinematics
  • Diskogenic Pain and Nerve Root Involvement
  • Spinal Stenosis
  • Scoliosis
  • Spondylolisthesis
  • Spine Fractures

The last thing I reviewed was a collection of “random” topics. These were obtained from various texts, internet searches, and sources of information I deemed reputable.

I reviewed the titles and abstracts of the last 5 years of the Journal of Orthopaedic and Sports Physical Therapy to get a feel for the type of research being presented. Access to JOSPT is included with orthopaedic section membership. I then further investigated articles which I felt might be represented on the exam.

Additional Topics Reviewed Were:

  • Orthopeadic Surgeries, Post-Operative Precautions, Evidence Based Interventions
  • Common Fractures seen in Orthopaedics
  • Neural Mobilization, Selective Nerve Tension
  • Neurogenic Vs Vascular Pain
  • Modalities (Brief Review)

After compiling all this information I was left with approximately 100 pages of study material contained in word documents. I printed this all out, grouped them by category, and whenever I had free time I reviewed a section. I made sure I knew all this information verbatim.

Since there is no official study guide for the OCS exam, the hardest part was creating my own. That required information gathering, pulling out the important information, and then typing it up in a more manageable format. STUDYING THE MATERIAL WAS EASY.

Now during this time I also had a colleague who was preparing for the OCS exam, so we met several times to review the material and teach each other. I’ve always felt that I learned best when I had opportunities to teach material to others, and the OCS was no different. We would often quiz each other, and developed a series of open ended practice questions to test our comprehension of the material.

Answering practice questions tests your knowledge, comprehension, and ability to recall key points. Practice questions also clearly identify deficits in your knowledge base, and suggest areas that need further review. Additionally, understanding the rationale behind correct/incorrect answers will reinforce the requisite information of the OCS exam and aid in comprehension. A candidate should expose themselves to as many OCS practice questions as they can find before sitting for the actual exam.

The more practice questions you can expose yourself to, the better your chance of success.

As the exam date approached, I felt I had a good grasp of my study material, and focused all my review efforts on the high priority sections.

Remember 70% of the OCS exam comes from these body regions:

  • Cervical Spine
  • Lumbar Spine
  • Shoulder
  • Knee
  • Ankle/Foot

I took the computer based exam on March 7th, 2008. It was at a Sylvan Learning Center in Tampa, Florida, which was about an hour away from my house. It made for an early start to the day. There was about 15-20 other people at the center taking various exams via the computer. I found the exam to be fair but rather difficult, and obviously the pressure was on, as this was the real thing.

After finishing the OCS exam, I felt the same way I did after the National Physical Therapist Examination, which was a “Toss Up”. I could have passed, or failed, and I was not leaning either way. So, I basically had to hope for the best, as I couldn’t change anything now. It seems like many of my colleagues have had these feelings after the NPTE and OCS exam, which essentially reflects the nature of the material being tested. It’s difficult.

After waiting a little over 3 months, I received my score report from the American Board of Physical Therapy Specialties on June 19th, 2008. I was reluctant to open up the package, but I soon dove right in and found…..

Dear Mr. Grella:

Cogratulations! The American Board of Physical Therapy Specialties (ABPTS) is pleased to inform you that you have been certified as a Clinical Specialist in Orthopaedic Physical Therapy.

At that moment I was elated that I became OCS certified. My score report indicated however, that I really did not have that much room to spare.

  • My Score 508
  • Minimum Passing Score 500


After looking over the feedback by content area it was clear that I performed best in comparison to the average score in the following areas:

  • Critical Inquiry/Evidence based practice
  • Orthopaedic Medical/Surgical Interventions
  • Examination

My weakest areas were:

  • Movement Science
  • Procedural Interventions
  • Evidence Based Orthopaedic Theory and Practice

Clearly if I had failed the OCS exam, I would have spent a great deal of time reviewing information from my weakest areas, particularly procedural interventions as this represents 20% of the exam.

Looking back on my performance as an older and wiser individual, it is clear that my relative lack of performance in the area of procedural interventions could have represented a fatal flaw. Together examination and procedural interventions represent 40% of the exam, and my relatively strong performance in the area of examination offset the weak performance on procedural interventions. Had I scored just average in the area of examination I probably would not have passed the test. So the message is really simple, prioritize the body regions that represent 70% of the OCS exam, as well as the examination (testing the critical thinking processes related to examination) and procedural interventions as they represent 40% of the questions for those body regions.

I began preparing for the OCS exam on October 2nd, 2007 and took the test on March 7th, 2008. Total study time was slightly over 5 months.

Summary:

  • Joined the Orthopaedic Section of the APTA (was already an APTA member)
  • Purchased Current Concepts of Orthopaedic Physical Therapy from the orthopaedic section of the APTA.
  • Reviewed the OCS exam content description.
  • Read Current Concepts of Orthopaedic Physical Therapy cover to cover, paying more attention to high priority areas. Summarized each monograph in word documents.
  • Reviewed scientific foundations of Orthopaedic Physical Therapy.
  • Performed a “special topics” review. Reviewed the text Orthopaedic Physical Therapy Secrets, Reviewed Pathology, Reviewed the spine inside and out.
  • Performed a “random topics” review. JOSPT articles, Orthopaedic Surgeries, Fractures, Neural Mobilization, and Modalities.
  • Compiled all the information into an approximately 100 page word document.
  • Continuously studied this document.
  • Reviewed the material with a colleague who was also taking the OCS exam.
  • Took and passed the OCS exam.
  • LESSON LEARNED: Do not neglect Examination and Procedural Interventions as they represent 40% of the questions on the exam related to each body region.
  • Began studying in October 2007, took the exam in March 2008, and received my score in June 2008. Total was 5 months preparation and study time.

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