The Philippine Board of Ophthalmology Residents’ In-Service Examinations (PREX) are more than just another examination in the middle of residency – they are an opportunity to benchmark your knowledge, identify areas for improvement, and build the foundation for the Diplomate Examinations. Who better to share practical advice than those who have successfully navigated the journey?

To help guide your preparation, we gathered insights, key resources, and proven strategies from Dr. James Michael Suarez, Dr. Jose Martin Velasco, IV, and Dr. Trisha Riego de dios-Garcia—the top three performers in the recent Philippine Board of Ophthalmology Diplomate Examinations. Although every resident follows a unique study approach and schedule, their shared experiences highlight fundamental principles for a more structured, effective, and targeted study plan.

1. Start early—and make a schedule you can actually follow.

Preparation begins with having a plan.

Dr. Trisha Riego de Dios-Garcia started preparing for the Diplomate Examinations as early as October of the preceding year. Her first step was to create a schedule for the entire review period, allotting approximately one week per subspecialty before returning to her notes during the final month.

Dr. Mac Velasco similarly worked backward from the examination date and adjusted his preparation according to his personal schedule and other commitments.

The important lesson is not necessarily to start a year in advance. Rather, know how much time you personally need and plan accordingly.

As Dr. Velasco puts it, “If you take a while to study then start earlier but if you’re a crammer then take that into account as well.”

2. Find the study technique that works for you—and capitalize on it.

There is no universal “best” way to study.

Dr. Velasco prefers quickly reading through notes multiple times rather than spending a long time trying to memorize material in one sitting. Dr. Suarez used a combination of reading, highlighting, flashcards, and repeated passes through his references. Dr. Garcia has relied on essentially the same strategy since high school: quickly reading the material, identifying important information, and reviewing her notes and highlights before the examination.

Her advice is simple: “Find the study technique that works for you and capitalize on that.”

The goal is not to adopt someone else’s study method simply because it worked for a topnotcher. Understand how you learn best, then build your review around it.

3. Read repeatedly instead of trying to master everything in one pass.

One theme that emerged strongly from the topnotchers was the value of multiple passes.

Dr. Velasco described an initial quick read to refresh his knowledge, followed by progressively faster reviews focused on high-yield information and concepts he had difficulty retaining. By the time the boards approached, he had gone through his material more than 20 times.

Dr. Suarez similarly aimed for three to four passes: the first focused on understanding, the second on identifying difficult concepts and creating flashcards, and subsequent passes on memorization and rapid review.

Repeated exposure allows information to become increasingly familiar without requiring you to memorize every detail immediately.

Don’t aim for perfection on your first read. Aim to see the material again and again.

4. Build your foundation during residency, not just during review season.

PREX preparation does not begin when you open your review notes. Residency itself is your first and longest review course.

Dr. Suarez emphasizes maximizing clinical rotations. Rather than simply following a treatment plan given by a senior resident or consultant, residents should ask why a particular diagnosis was made, why a certain investigation was ordered, and why a specific management strategy was chosen.

Dr. Garcia similarly credits her consultants as an important guide in identifying high-yield topics, “I really listened to what my consultants would repeatedly mention or discuss.”

Every patient encounter, referral, case presentation, and consultant discussion is an opportunity to learn something that may eventually appear on an examination.

5. Know the common diseases exceptionally well.

With the enormous breadth of ophthalmology, it is tempting to spend hours studying rare syndromes and obscure diseases. But the topnotchers repeatedly emphasized the importance of mastering the conditions that residents encounter most often.

Dr. Velasco advises, “Go with the most common and what we see at the OPD.”

Dr. Suarez likewise observed that the written Diplomate Examinations, like the PREX, focused more heavily on common diseases and deeper mastery of key conditions rather than simply testing obscure facts.

Dr. Garcia also advises residents not to dwell on topics that are rarely discussed.

The message is clear: master the bread-and-butter of ophthalmology first. Know the common diseases, their presentations, differentials, investigations, and management thoroughly before spending excessive time on rare disease entities.

6. Use the PBO Curriculum to prioritize your review.

It is unrealistic to expect a resident to master every single piece of information within the enormous scope of the PBO Curriculum.

Dr. Suarez reflected that, in hindsight, spending time at the beginning of his review to go through the PBO Curriculum would have helped guide his preparation.

The curriculum can serve as your checklist: What topics are expected of you? Which areas are you comfortable with? Which ones require additional work?

Use it not simply as a list of things to memorize, but as a framework for identifying gaps in your knowledge and prioritizing your study time.

7. Make your own high-yield notes.

Instead of repeatedly rereading an entire textbook or set of references, create a condensed collection of information that you can repeatedly return to.

This was particularly important for Dr. Garcia, whose strategy was to quickly read the material, identify important points, and return to her own notes and highlights closer to the examination.

Dr. Velasco similarly wrote down information he repeatedly failed to retain during successive readings.

As Dr. Garcia explains, “This way, I don’t have to keep rereading the whole text.”

Your notes don’t need to be beautiful or comprehensive. They need to contain the information you personally need to remember.

8. Practice with questions—and learn from what you get wrong.

Reading alone is not enough. You also need to practice applying what you know.

Dr. Suarez recommends answering the AAO BCSC sample questions, which he found useful in familiarizing himself with the style of questioning used in the written examinations.

Dr. Velasco incorporated sample questions into his final month of preparation and used them to identify new information worth adding to his notes.

Questions should therefore be treated not simply as a test of how much you know, but as another learning tool. Every wrong answer is a clue telling you what deserves another look.

9. Protect your study time—but don’t forget to rest.

Balancing residency with examination preparation requires deliberate sacrifices.

Dr. Garcia acknowledged that preparing for the examinations meant “sacrificing a lot of time meant for leisure.”

Dr. Suarez, however, also emphasized that rest was part of his preparation. There were days when he did not feel like studying, and he allowed himself time to unwind, take naps, or simply take a break.

The goal is not to eliminate rest. It is to protect meaningful study time while recognizing when you need to recharge.

A sustainable schedule will take you further than an intense schedule that leaves you burned out.

10. Study smarter, not harder—and don’t let PREX define you.

Perhaps the most important advice from the topnotchers can be summed up by Dr. Garcia’s words, “Study smarter, not harder.”

You do not need to study exactly like your co-residents. You do not need to read every reference available. And you do not need to spend equal amounts of time on every topic.

Dr. Velasco similarly advises residents to “study the way you know how, not how you think you’re supposed to because that’s what others are doing.”

At the same time, Dr. Suarez reminds residents that PREX is ultimately a benchmark, not a verdict on their abilities as ophthalmologists. A high score should not lead to complacency, while a disappointing score should not be a reason to doubt yourself.

Instead, use the examination to identify your weak areas, improve them, and track your progress throughout residency.

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The journey to becoming a diplomate is not won during a single review season. It is built gradually through clinical encounters, consultant discussions, deliberate study, repeated review, and honest assessment of one’s weaknesses.

The advice of the three topnotchers is remarkably consistent: know yourself, plan your time, master the fundamentals, learn from your clinical experiences, prioritize high-yield topics, and review repeatedly.

Most importantly, don’t confuse studying harder with studying better.

PREX is an opportunity to measure where you are—not to define who you are as an ophthalmologist. Use it as a benchmark, learn from it, and let every examination bring you one step closer to becoming the ophthalmologist you want to be.