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 on the Part II PAM examination. 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 majority of 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 medical history, and clinical findings.

The Part II PAM exam consists of 45-55 full cases, 15-20 solo items, and 15-25 minicases. Items on the exam are targeted to assess entry-level competence. Therefore, patient 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 in the Part II PAM patient cases 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.

Links to the Part II PAM Content Matrix and Part II PAM Content Outline can be found in the “Helpful Links” tab.

Approximately 100-120 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
  • Clinical correlation of basic science principles related to disease diagnosis and treatment
  • 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
The registration fee for the Part II PAM is $950.