The Structured OCS Examination Preparation Plan

All ABPTS OCS exam candidates want to pass the examination on their first attempt and become OCS certified. Currently, the application review fee is $515, and the examination fee is $800 for APTA members, which equals a total of $1,315 in costs. The fee for Non-APTA members is almost double. Failure to pass the exam results in additional financial costs which can be significant. An APTA member who fails the exam will have to pay a $150 reapplication fee as well as the $800 fee to take the examination. After 2 consecutive exam administrations, you must submit an entirely new application and the initial applicant review fee of $800 to apply for specialist certification.

A structured OCS exam preparation plan and as well as study material represents an investment in your certification and minimizes your chances of incurring these additional costs in order to become OCS certified. The cost of exam preparation material pales in comparison to the retake costs.

Failure of the examination due to lack of preparation material is being penny wise and dollar foolish.

When reading this plan 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.

The following preparation plan should benefit most if not all candidates.

The first things to do:

  • Join the Orthopaedic Section of the APTA if you are not already a member
  • Purchase Current Concepts of Orthopaedic Physical Therapy 4th Ed. from the orthopaedic section of the APTA
  • Review the OCS exam content outline

Ortho section members pay significantly less than non-members for Current Concepts of Orthopaedic Physical Therapy 4th Ed, and non-APTA members pay even more. The cost of the OCS exam and application review is also almost half the price for APTA members as well. An added bonus is 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 APTA and Ortho Section of the APTA is a no-brainer if you are taking the OCS exam, and are not already a member.

Current Concepts of Orthopaedic Physical Therapy, 4th Edition is published by the orthopaedic section of the APTA.

These 12 monographs serve as an excellent starting point to begin a comprehensive OCS exam preparation plan.

Each monograph represents a thorough review of anatomy and biomechanics of each body region, application of specific tests and measurements, musculoskeletal pathology, and effective treatment strategies. Recognized experts share evidence-based techniques in orthopaedic physical therapy evaluation, assessment, and intervention. The first monograph describes the multifaceted process of clinical reasoning and utilization of evidence-based practice physical therapy management. The remaining monographs each cover a major joint region of the body, from the cervical spine and temporomandibular joint to the foot and ankle. Each monograph concludes with case scenarios that require clinical problem solving and allows readers to compare their answers with the experts’ rationale.

Reading the OCS exam content outline will allow you to become familiar with the knowledge areas that are tested on the exam, and what percentages of questions are devoted to each body region, and knowledge area. From the content outline you will 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 will also be evident that 70% of the questions will come from the Cervical Spine, Lumbar Spine, Shoulder, Knee, and Ankle/Foot. The following body regions are minimized on the exam, Cranial Mandibular, Thoracic Spine, Elbow, Wrist/Hand, Sacroiliac, and Hip, as collectively they make up only 30% of the exam. It is clear that studying priority should be given to the body regions that make up the majority of the exam, as well as examination and procedural interventions.

After you have performed these first 3 things you will be ready to begin your comprehensive orthopaedic review and preparation plan.

During your study process, always adhere to the following principles supported by evidence from the field of cognitive psychology.

  1. Space your OCS studying out over time. If you study something such as the biomechanics of the foot and then study it again right away, it’s fresh in your mind the second time. You’ll probably feel like you’ve learned it well and will move on, but don’t be fooled. Instead of restudying right away, wait a while, such as a day or even a week and then study it again. You’ll retain much more information. Spacing your studying works because when something’s fresh in your mind you don’t learn much from studying it; you learn more when you’ve had time to forget it, which allows you to reinforce the memory. Studies show that some level of forgetting is actually necessary in order to improve the “retrieval strength” of a new memory. As time goes by, each piece of information you can recall becomes more and more bulletproof to forgetting on the exam.
  2. Test and quiz yourself. Candidates test themselves when they study with flashcards, and answer practice questions. When an OCS candidate reads from a textbook, monograph, journal article, or other source, they often neglect to test themselves. This is detrimental. Testing gets us actively involved in the learning process and helps us retrieve information from our own memories. Answering practice questions tests your knowledge, comprehension, and ability to recall key points. A candidate should expose themselves to as many OCS practice questions as they can find before sitting for the actual exam.

Second, learn to focus your attention towards the right things.

  1. Selectively Read. Reading every word in a text, journal article, or other source may not be the best strategy. Learn to scan headings, introductions, summaries and keywords. Read actively, searching for the main points. You can easily get caught up in the minutia of the OCS material and miss the take home message. This can impair your ability to comprehend and recall what you have read at a later time.
  2. Take Good Notes. There is a wealth of information to review in order to prepare for the OCS exam, and none of this is contained in one place. So taking good notes is crucial in order to prepare and review for the OCS exam. Your review process will be extremely inefficient without an organized collection of notes. Record the main points and concentrate on key principles.

You are now ready to begin reading all the monographs contained in Current Concepts of Orthopaedic Physical Therapy 4th Ed. Make sure you answer the questions following each monograph. During this review make sure you completely understand the material contained in the “High Priority” body regions, while not exerting as much time and energy on the body regions that collectively make up only 30% of the exam.

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

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

Other Monographs (30% of Questions from these Body Regions)

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

Once you have a firm grasp of the material presented in the monographs, it is time to begin reviewing other sources of information if you want to pass the OCS exam.

You will need to perform a review of “Foundational” information as this is considered requisite knowledge. Most physical therapists learned this information in school but it can easily be forgotten if the memories are not consistently retrieved. A candidate would not want to miss an exam question as a result of not knowing this information. This information can be obtained from virtually any source.

Review the following, add or omit items based on your current situation.

  • Muscular anatomy, including attachments and innervation.
  • Peripheral Nerve Distribution
  • Myotomes and Dermatomes.
  • Joint arthrokinematics including open and closed packed positions.
  • Manual Therapy
  • Human Growth and Development
  • Kinesiology, Biomechanics, Gait
  • Tissue healing and repair
  • Orthopaedic Special Tests
  • Visceral Pain Referral Patterns
  • Critical Inquiry Including Research Design, Statistical Tests and Measures

After this it is wise to perform what I call an orthopaedic special topic review.

Read and review the most current version of every ICF Clinical Practice Guideline published by the orthopaedic section of the APTA. These guidelines are free and can be found on the orthopaedic section’s website. The guidelines include but are not limited to, Low Back Pain, Neck Pain, Adhesive Capsulitis, and Ankle Sprains.

The following are represented on the OCS exam and should be reviewed as they relate to orthopaedics.

  • Imaging
  • Pharmacology
  • Laboratory Values and Testing
  • Modalities
  • Orthotics
  • Pediatrics
  • Women’s Health

Next you will need to perform a review of pathology of the musculoskeletal system. Pathology Implications for the Physical Therapist is a good text, but virtually any resource will do.

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

Lastly, it is wise to obtain and review Orthopaedic Physical Therapy Secrets which is a good source of information. I recommend that you glance over the table of contents and read chapters and excerpts that contain information that you have not yet reviewed.

Once you have this completed perform a focused review of the highest priority area of the OCS examination. Given that 35% of the exam deals with the spine (Cervical/Lumbar), which is approximately 70 out of the 200 questions, it is imperative that you know this material inside and out.

Spine (Cervical/Lumbar) 35% of the exam

  • Anatomy
  • Physiology
  • Kinesiology
  • Biomechanics – arthrokinematics
  • Pathophysiology – Diskogenic Pain and Nerve Root Involvement, Spinal Stenosis, Scoliosis, Spondylolisthesis, Spine Fractures, etc
  • Differential diagnosis
  • Surgical and non-surgical medical interventions – imaging, labs, tests, pharmacology
  • Therapeutic exercise
  • Manual therapy

The last thing to review is a collection of “random” topics. These can be obtained from various texts, internet searches, and sources of information that you deem reputable.

First review 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. Further investigate the articles which you feel might be represented on the exam.

Additional suggested topics can include but are not limited to:

  • Orthopeadic Surgeries, Post-Operative Precautions, Evidence Based Interventions
  • Orthopaedic Non-Surgical Interventions
  • Common Fractures
  • Neural Mobilization, Limb Tension Tests
  • Neurogenic Vs Vascular Pain

The aforementioned review should provide you with very solid foundation for the OCS exam. But remember, in order to retrieve this information come exam time, you must routinely test and quiz yourself.

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

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.

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

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

Summary

  • Join the APTA plus the Ortho Section of the APTA if you are not already a member
  • Purchase Current Concepts of Orthopaedic Physical Therapy 4th Ed. from the orthopaedic section of the APTA.
  • Review the OCS exam content outline
  • Space your OCS studying out over time and routinely quiz and test yourself
  • Read Current Concepts of Orthopaedic Physical Therapy 4th Ed. cover to cover, pay more attention to the high priority body regions.
  • Review “Foundational” information, add or omit items based on your current level of recall. This can be obtained from virtually any source.
  • Read and review the most current version of every ICF Clinical Practice Guideline published by the orthopaedic section of the APTA.
  • Perform a “Special” topics review as they relate to orthopaedics. Imaging, pharmacology, labs, orthotics, etc.
  • Review orthopaedic pathology
  • Obtain and review Orthopaedic Physical Therapy Secrets. Focus on material that you have not yet reviewed.
  • Perform a “Focused” review of the Cervical and Lumbar spine (35% of Exam)
  • Review the titles and abstracts of the last 5 years of JOSPT, to get a feel for the type of research being presented.
  • Perform a “Random” topic review, varies per candidate.
  • Routinely Quiz and Test Yourself, the more practice questions you can expose yourself to, the better your chance of success.

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