Student-to-Student Advice: One PCO Student’s NBEO Tips

The National Board of Examiners in Optometry (NBEO) exam is a series of comprehensive, high-stakes assessments required for optometric licensure in the United States. These exams ensure entry-level competence in optometry by testing cognitive, psychomotor, and clinical skills.

At the Pennsylvania College of Optometry (PCO) at Drexel University, faculty and staff continue to strengthen students’ NBEO preparation through expanded mock exams and more intentional coaching around test-taking strategy and readiness.

According to recent Doctor of Optometry graduate, Madison Edwards, OD ‘26, she felt well prepared going into the process.

“We take many, many exams in optometry school so I felt like I knew how to very effectively take an exam and do well on it,” she said. “And, then we had a full mock board leading up to the actual part one exam, which was really helpful in figuring out my own pacing, knowing where I was in studying, and just understanding what test day would feel like.”

For PCO students preparing for the NBEO, Dr. Edwards emphasizes steady, consistent preparation and balance.

“You don't have to start studying really hard early on, but just every day, do a little bit of reviewing, a little bit of practice questions and it will help you feel calmer as you get into the closer timeframe of the exam,” she said.

She also stresses the importance of maintaining mental and physical well-being while studying for the exam.

“It can be easy to kind of get bogged down by all the pressure and the many hours that you take studying,” she said. “So, it's really important to take care of yourself because the best studying that you do is whenever you're actually physically and mentally well. Don’t study yourself into the ground.”

As Doctor of Optometry students know, the exam consists of three main parts. The Applied Basic Science (ABS) section is a written exam covering anatomy, physiology, biochemistry, optics, and systemic disease. The Patient Assessment and Management (PAM) section is a computer-based exam that tests clinical decision-making, patient diagnosis, and management, including the Treatment and Management of Ocular Disease (TMOD) component. The Clinical Skills (PEPS), section is a practical, in-person examination assessing patient care skills (e.g., binocular vision, biomicroscopy). 

Drawing from her own experience preparing for and completing the NBEO exams, Dr. Edwards shares the following advice and perspectives for current optometry students navigating the board process.

Here are some tips on how to prepare the exams:

General Advice:

• Begin preparing as early as possible - start light reviews months in advance.
• Use the National Board of Examiners in Optometry (NBEO) content matrix to structure your studying.
• Combine passive review (notes, textbooks) with active recall methods:
  • Flashcards
  • Practice questions
  • Quizzing classmates or self-quizzing
• Take breaks and prioritize self-care:
  • Spend time with family and friends
  • Eat healthy
  • Exercise regularly
  • Focus on mental and emotional well-being
• Remember all classmates are experiencing similar stress and anxiety. 

Part 1 (Applied Basic Science):

• Covers optics, ocular anatomy, physiology, pharmacology, systemic health, binocular vision, and more.
• Often considered the most nerve-wracking of the three exams.
• Studying for months is normal; manage burnout carefully.
• Exam format: computer-based, multiple-choice, 8 hours, 350 questions.
• Celebrate your accomplishment after finishing the exam!
• Scores are released about seven to eight weeks after the exam - be patient. 

Part 2 (Diagnosis and Management of Ocular Disease):

• Focuses on case-based multiple-choice questions.
• Most students take this during clinical externships, which naturally reinforces learning.
• Practical, hands-on experience can be a substitute for extensive studying at home. 

Part 3 (Clinical Skills and Patient Encounters):

• In-person exam held at NBEO headquarters in Charlotte, North Carolina.
• Showcases clinical skills and patient management learned during optometry school.
• Mock exams and practical assessments in school help reduce nerves.
• The hardest part is managing anxiety during real-time proctoring.
• Scheduling is flexible: take anytime from August to May of your final year.
• Make the experience enjoyable: explore the city and celebrate completing the exam.

Mindset Tips:

• Each exam feels more manageable after passing the first one.
• Focus on practical application of knowledge, especially in clinical settings.
• Passing the boards is a milestone—celebrate and recognize your hard work.