Part II PAM® / TMOD®

Patient Assessment & Management

The Part II PAM Patient Assessment & Management exam assesses candidates’ clinical thinking and decision-making with a particularly heavy emphasis on diagnosis and treatment.

The Part II PAM examination consists of 350 items, approximately 120 of which are categorized as TMOD items (see Embedded TMOD Exam link on this page). The exam is two sessions in length administered on a single day, each session consisting of 175 items. Candidates will have 3.5 hours to complete each session. The morning session includes an additional 15 minutes devoted to a tutorial and the reading and signing of a non-disclosure agreement (NDA). There is an optional break of up to 45 minutes between the morning and afternoon sessions.

The earliest date for a student candidate to take the Part II exam is the December administration during the candidate’s academic year of graduation, thereby allowing two opportunities to sit for the exam prior to graduation.

The examination is in an image-intensive, case-based format. Each case consists of a patient presentation including demographic data, chief and secondary complaints, personal and family ocular and medical history, and clinical findings. Between 3 and 6 items will be included in each case.

Items on the exam are targeted to assess entry-level competence. Therefore, cases generally focus on either typical presentation of relatively high frequency conditions or conditions with low frequency but high criticality. When low frequency, high criticality cases are presented, they will be portrayed in a pathognomonic manner.

To reduce the verbiage within cases and test items, individual drugs included on the Part II PAM are referenced by generic or trade name, but not both. During the exam, candidates have access to a searchable drug list. You may search for a drug by its trade name or generic name. Candidates should note that the list will include drugs used on other NBEO exams; therefore, significantly more drugs will appear on the list than appear on the Part II PAM exam.

In addition, commonly utilized abbreviations included on the Part II PAM can be found on a searchable abbreviation list. The drug and abbreviation lists may be accessed from any page of the exam by clicking on the corresponding tab at the top of the screen.

A tutorial for the Part II PAM can be found in the “EXAM INFORMATION” tab. Candidates are strongly encouraged to review the tutorial prior to their exam day to familiarize themselves with the mechanics of taking the exam by computer. Candidates will have 10 minutes to go through the tutorial on exam day.

Links to the Part II PAM Content Matrix and Part II PAM Content Outline can be found in the "EXAM INFORMATION" tab.

Approximately 120 of the 350 items on the Part II PAM exam are categorized as Treatment and Management of Ocular Disease (TMOD) items. A TMOD breakout score and pass-fail decision will be determined based on these items. In order to be classified as a TMOD item, the content of the item must pertain to one or more of the following:

  • Formulation of most appropriate disease diagnosis which will be treated and/or managed
  • Selection of treatment/management, including systemic considerations
  • Dose, form, schedule, and duration of treatment
  • Contraindications and side effects of medication, including systemic considerations
  • Follow-up and prognosis, including reassessment of diagnosis after initiating treatment
  • Treatment and management of ocular emergencies and urgencies