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Background  To determine which resident and program characteristics correlate with ophthalmic knowledge, as assessed by resident Ophthalmic Knowledge Assessment Program (OKAP) performance.    Methods  An online survey was sent in June 2017 to all US ophthalmology residents who took the OKAP in April 2017.    Results  The survey response rate was 13.8% (192/1387 residents). The mean respondent age was 30.4 years, and 57.3% were male. The mean [SD] self-reported 2017 OKAP percentile was 61.9 [26.7]. OKAP performance was found to have a significant positive correlation with greater number of hours spent/week studying for the OKAPs ( p  = 0.007), with use of online question banks ( p  < 0.001), with review sessions and/or lectures arranged by residency programs ( p  < 0.001), and with OKAP-specific didactics ( p  = 0.002). On multivariable analysis, factors most predictive of residents scoring ≥75th percentile were, higher step 1 scores (OR = 2.48, [95% CI: 1.68–3.64, p < 0.001]), presence of incentives (OR = 2.75, [95% CI: 1.16–6.56,  p  = 0.022]), greater number of hours/week spent studying (OR = 1.09, [95% CI:1.01–1.17,  p  = 0.026]) and fewer hours spent in research 3 months prior to examination (OR = 1.08, [95% CI: 1.01–1.15,  p  = 0.020]. Lastly, residents less likely to depend on group study sessions as a learning method tended to score higher (OR = 3.40, [95% CI: 1.16–9.94,  p  = 0.026]).    Conclusions  Programs wishing to improve resident OKAP scores might consider offering incentives, providing effective access to learning content e.g. online question banks, and adjusting the curriculum to highlight OKAP material. Step 1 scores may help educators identify residents who might be at risk of not performing as well on the OKAP.    Electronic supplementary material  The online version of this article (10.1186/s12909-019-1637-4) contains supplementary material, which is available to authorized users.

Resident and program characteristics that impact performance on the Ophthalmic Knowledge Assessment Program (OKAP)