Patient encountersand performance skills.
Part III puts you in front of standardized patients: ten encounter stations that test your reasoning and two skills stations that test your hands. It replaced the Clinical Skills Examination in August 2024.
At a glance
Part III PEPS
- Stations
- 12
- Per station
- 15 min
- Skills
- 5
- Categories
- 9
- Where
- NCCTO
- Since
- 2024
Administrations for the 2026 to 2027 cycle began in August 2026. Register at least 30 days before your exam date.
Format
How the dayruns.
Twelve stations with standardized patients: ten encounters that test your clinical reasoning and two skills stations that test your hands.
The numbers
- 12Stations
- 10 patient encounter stations and 2 performance skills stations, all with standardized patients.
- 15 minPer station
- After 3 minutes with the station overview on your device.
- 5Skills
- Biomicroscopy, Goldmann applanation tonometry, 4-mirror gonioscopy, BIO and dilated fundus biomicroscopy.
- 9Categories
- One encounter from each clinical category, plus a tenth drawn at random from the nine.
- NCCTOWhere
- NBEO's National Center of Clinical Testing in Optometry in Charlotte, North Carolina.
- 2024Since
- PEPS replaced the Clinical Skills Examination in August 2024.
01
Standardized patients
Every station uses a trained standardized patient, so how you communicate counts alongside what you find.
02
3 minutes, then 15
Before each station you get 3 minutes with an overview on your device, then 15 minutes for the encounter or skills.
03
One case per category
The ten encounters cover each of the nine clinical categories once, plus a tenth drawn at random. The 2026 to 2027 candidate guide notes that one encounter is used for data collection only.
04
Five scored domains
Items are scored on whether you did them and how well, across five domains weighted from 29 for clinical assessment down to 11 for communication.
05
Two skills stations
Anterior: biomicroscopy, Goldmann applanation tonometry and 4-mirror gonioscopy. Posterior: BIO and dilated biomicroscopy with a non-contact fundus lens.
06
In person in Charlotte
PEPS is given at NBEO's National Center of Clinical Testing in Optometry in Charlotte, North Carolina. Register at least 30 days before your exam date.
Blueprint
What PEPSweighs.
NBEO weights the encounter categories by how common and how critical each kind of diagnosis is, and scores every station across five domains.
Encounter categories
Blueprint weights for the nine clinical categories
- Anterior segment disease17
- Posterior segment disease16
- Glaucoma14
- Systemic disease11
- Refraction11
- Neuro-ophthalmic disease9
- Contact lenses8
- Binocular vision8
- Pediatrics6
Scoring domains
Weights for the five competency domains
- Clinical assessment and interpretation29
A focused history, then gathering and interpreting the findings that lead to a diagnosis.
- Management and documentation25
A specific plan with treatment, referral and follow-up, written up so another clinician could continue care.
- Skills22
Your performance at the anterior and posterior segment skills stations.
- Patient education13
Explaining the condition and the plan in words the patient understands.
- Communication and professionalism11
Rapport, empathy, clear language and professional conduct from start to finish.
Skills station 1 · 15 minutes
Anterior segment station
- Biomicroscopy
- Goldmann applanation tonometry
- 4-mirror gonioscopy
Skills station 2 · 15 minutes
Posterior segment station
- Binocular indirect ophthalmoscopy
- Dilated biomicroscopy with a non-contact fundus lens
Strategy
How to preparefor Part III.
PEPS rewards smooth technique and clear communication as much as knowledge. Practice all three out loud.
- 1
Drill technique until it is boring
Five skills, done the same way every time. Use the station drill below with a partner and a timer.
- 2
Talk to the patient, not the chart
Introduce yourself, explain what you are doing and check comfort. Communication and patient education together are 24 points of the blueprint.
- 3
Practice the full encounter arc
A focused history, targeted testing, a clear assessment, a specific plan, then education and follow-up in plain language.
- 4
Be specific in management
Drug, strength, dose, frequency, duration and follow-up interval. Starting a drop is not a plan.
- 5
Rehearse full days
Run all 12 stations back to back at least once so the 15-minute rhythm feels natural.
Station drill
Fifteen minutes,on the clock.
Pick a station, start the 3-minute prep, then work through the checklist while a partner plays the patient. Tick each step as you do it.
Anterior segment station
Biomicroscopy, Goldmann applanation tonometry and 4-mirror gonioscopy.
3:00
Ready when you are
Checklist
These checklists follow standard clinical technique to structure your practice. NBEO publishes its own evaluation forms for each station, so practice against those as well.
Key dates
BookingPart III.
Administrations for the 2026 to 2027 cycle began in August 2026. Register at least 30 days before your exam date.
NBEO does not list PEPS dates on its calendar the way it does for Part I and II. Administrations for the 2026 to 2027 cycle began in August 2026 at the National Center of Clinical Testing in Optometry in Charlotte, North Carolina, and registration closes 30 days before the exam date you book.
From NBEO's 2026 to 2027 exam calendar. NBEO notes that dates can change.
Check the official calendarPart III PEPS question bank
14 questions with full explanations
Study notes
High-yield notes for Part III.Read, then practice.
Get started
Hands steady,words clear.
Run a timed station with a partner, then sharpen your reasoning with PEPS questions on skills, encounters and patient education.