The Patient Assessment and Management (PAM) examination consists of 40 simulated patient cases and is administered in a single 4-hour session. Each case begins with a scenario in which the patient history and clinical data are presented. These data usually include at least one visual (e.g., color ophthalmic photographs, contact lens fluorescein pattern; spectacle frame fitting problem; visual field plots; other instrumentation printouts).
The scenarios for 30 of the 40 patient cases are followed by 3 multiple-choice test items; 10 of the scenarios are followed by 4 multiple-choice test items. Each test item contains as many as 10 options, only one of which is correct. The combination of a scenario and the accompanying test items comprise a patient case. The 30 3-test item patient cases will focus either on issues related to diagnosis and assessment, or issues related to treatment and management. The 10 4-test item patient cases focus on diagnosis/assessment and treatment/management issues. There are 4 sample PAM patient cases cases available on the web site.
Two blank PAM Patient Case Templates are available as exam preparation resources for Disease/Trauma and Refraction/Functional Conditions cases. These templates should be viewed as examples, since some patient cases on the exam may include additional clinical findings. In multiple cases on the exam, "BVA" data are included in the patient scenarios. The abbreviation "BVA" refers to "best visual acuity" or "best-corrected visual acuity" measurement, which may be accomplished by refraction, pinhole testing, etc. Thus, all BVA entries refer to the best achievable visual acuity by the patient depicted in the scenario. If the BVA is reduced (eg, worse than 20/20), no pinhole entry will be included in the BVA clinical data entry since it is implied via the BVA terminology that this has already been done. In addition, some patient cases in the PAM exam may include normal clinical photos and/or visuals. Thus, it is anticipated that Candidates will review and appropriately interpret the visuals included in the patient cases.
To reduce the verbiage within test items, individual drugs included on PAM are referenced by generic or trade name, but not both. The PAM examination booklet will include two lists of generic drugs and their trade name equivalents. The first list alphabetizes the drugs by their trade name and that list is printed on the inside front cover of the test booklet. The second list alphabetizes the drugs by their generic name and that list is printed on the inside back cover. These lists do not include every drug used on PAM; rather, they include those drugs on the test that have commonly utilized trade names. These two lists may be used as resources throughout the test.
In addition, and similar to clinical care notation, commonly utilized abbreviations are included in the PAM patient cases consistent with a prepared abbreviations list. A copy of the PAM Examination Abbreviations List will be included in the examination booklet and may be used as a resource throughout the test.
The matrix below describes the content of the case items in the major content areas of Disease / Trauma and Refractive Status / Sensory Processes / Oculomotor Processes. The subsequent PAM Conditions Outline describes the distribution of cases within the major content areas. Scoring the PAM examination involves differential scoring weights for the test items within each patient case. For details regarding PAM scoring and standard setting, click here.
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Diagnosis,
Data Interpretation, Etiology,
Clinical Correlation |
Treatment,
Pathophysiology / Etiology,
Follow-up, Prognosis
|
|
Disease/
Trauma
23-27
Cases
|
1. Select most appropriate diagnosis
2. Indicate data supporting the diagnosis
3. Indicate correlation of potential additional
data
4. Indicate pathophysiology / etiology
5. Select next clinical procedure needed
6. Indicate additional data needed to
support or clarify the diagnosis
|
1. Select most appropriate treatment
2. Indicate pathophysiology / etiology
3. Indicate why treatment likely to be effective
4. Indicate additional data needed to treat the
condition effectively
5. Follow-up / management
6. Prognosis
7. Patient education
|
|
Refractive/
Functional
Conditions
13-17
Cases
|
1. Select most appropriate diagnosis / etiology
2. Indicate data supporting the
diagnosis / cause
3. Indicate correlation of potential additional
data
4. Select next clinical procedure needed
5. Indicate additional data needed to
support or clarify the diagnosis / etiology
|
1. Select most appropriate treatment
2. Indicate additional data needed to treat
effectively
3. Follow-up / management
4. Prognosis
5. Patient education
|
PAM Conditions Outline
Disease / Trauma (23-27 cases):
- Lids / lashes / lacrimal system / ocular adnexa / orbit
- Conjunctiva / cornea / refractive surgery
- Lens / cataract / IOL / pre- and post-operative care
- Episclera / sclera / uvea
- Vitreous / retina
- Optic nerve / neuro-ophthalmic pathways
- Glaucoma
- Emergencies
- Systemic health
Refractive Status / Sensory Processes / Oculomotor Processes (13-17 cases):
- Ametropia
- Ophthalmic optics
- Contact lenses
- Low vision
- Accommodative / vergence / oculomotor anomalies
- Amblyopia / strabismus / color deficiency
- Perceptual anomalies
