The orthopedic certified specialty exam is a grueling 200 question, 6 hour multiple choice examination covering what is seemingly an endless universe of orthopedic physical therapy topics.


To ace the OCS exam it takes preparation and mastery of test taking strategies.

  • Scroll to the very end of this post for links to videos of what Ryan Balmes DPT and Mike Reinold have to say about the OCS exam.

How to start the battle:

What do you do when confronted with the various vignettes and multiple choice questions the exam holds?

  • My goal is to provide you with a brief review of test taking strategies and question make-up
  • Help improve your comfort level with OCS type questions
  • Help to guide you toward being able to answer questions you otherwise might have missed

The Three Test Taking Strategies to Ace The OCS Exam:


#1 Making sense of the question/ vignette

  • Skim question – provides idea for what question the vignette will be answering
  • Read vignette – pick out clues and avoid distractors
  • Read question – Carefully
  • Read all answers – Mark definite wrong answer choices to narrow options
  • Answer question – Some you will just not know!


#2 Vignette Make-Up

  • Clues – Information required to answer the question (i.e. age, gender, clinical patterns)
  • Neutral Info – Not a distraction and not key information (i.e. fluff)
  • Distractors – Objective info that should not change decision making (i.e. obscure clinical measures, evidence and data overload not needed for answering question)


#3 Deductive Reasoning: What happens if I just do not know the answer?

  • Guessing leaves you with approximately 25% chance of answering correctly
  • Deductive reasoning to narrow choices increases your odds
  • Avoid absurd options (i.e. outside of practice, contraindicated action)
  • Rule out similar options (there are not two correct answers)
  • Watch out for degree of qualification (i.e. always or never)
  • Go with your gut and do not change your answer, as second guessing tends to change a correct answer to a wrong answer
  • Check questions to return to as you might stumble upon an answer during test


BONUS POINT: Get into the head of the item writers (Yes they are real people)

  • Few clinicians answer / write questions in the same way due to practice variability
  • Key words in language can guide the test taker to the perspective of the item writer (i.e. A MDT based practitioners may use terms like derangement, dysfunction, and postural syndromes)
  • Take time to review the varying points of view and treatment approaches to help better understand these differences (i.e. McKenzie vs. Maitland vs. EBP in the spine)


Finally, take the time to take practice exams and answer sample questions similar to those found in Ortho PT Questions: Pass The Test Without Breaking The Bank.


In the words of Effie Trinket,

“May the odds be ever in your favor”


Post written by Ken Kirby, PT, DPT, OCS @kkirbydpt


Still here?

Check out the sample questions from the Orthopaedic Specialist Certification Candidate Guide.

  • Scroll to page 11 to take the 14 practice questions



See what Ryan Balmes DPT and Mike Reinold have to say about the OCS exam.

  • Skip to to the 9 minute and 18 second mark for Mike Reinold’s video.
  • Ryan Balmes discusses ways to prep for the OCS exam.
  • Mike Reinold and his colleagues discuss the pathway to getting to the point of taking the OCS exam (i.e. residency or no residency).


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