AKT -

Going for GOLD

But it’s only an exam…
 The AKT is a licensing exam
 You have 200 questions to prove to me (RCGP)
that you have the breadth and depth of
knowledge required to be a safe UK GP
◦ That means enough to treat me and my family....
◦ Take it seriously
 Requires more knowledge than medical finals
◦ How much cramming did you do for finals?
 The next sitting is about 75 days away....
Four chances only…

 We have had ST3s run out of attempts

- never waste one….
 If you fail in ST2, DO NOT REBOOK
without approaching your PD
 Two fails = seriously worry and
talk to PD (dyslexia assessment)
 Ill before – look at exam regulations
 Ill on the day – talk to a marshal.
AKT – The Exam
The AKT is designed to test the application of knowledge and
interpretation of information

3 hours 10minutes, 200 item multiple-choice test

80% clinical management
10% critical appraisal of EBM
10% administration & management

1. Do read the information on the RCGP website,

including the presentations
2. Do look at the information on the VTS website
3. Do consider study groups.
AKT – The Basics
Exam date: 26/10/16 25/01/17 26/04/17

Bookings
13/09/16 28/11/16 07/03/17
Close:

Three sittings each year

You are restricted to 4 sittings
Are you ready to enter? – Use website scores as a guide
Overall pass rate is about 72%
ST2 82% of first-time takers passed
ST3 73% of first-time takers passed
94% have passed by 3rd attempt in ST3.
How do our ST2s perform?
Pre-2009 Very few sitting in ST2

2010-11 Disappointing ST2 pass-rate (40%)

2011-12 Much better ST2 pass-rate (75%)

2012-15 Very impressive (85%)

2015-16 Problem with repeat fails. A blip??.

How do our ST2s perform?
Those who failed:
Low scores across all 3 areas
Clinical Management best “predictor” (80% of marks)
◦ No-one who failed CM passed the overall exam

Suggestion:
Low CM scores (<60%) on test-papers?

Then you are not ready…

Topics for Today
1. Exam Technique
2. General Preparation Tips
3. Tips for Administration & Management
4. Tips for EBM & statistics
5. Tips for Clinical Management
- Organising learning sets.
Exam Technique
RCGP website: AKT Tutorial, Preparation Guide, Podcast

Use the cover test:

- cover the answers. If your first thought is on the list, likely it is correct

Mark answer spot carefully

Time management is vital

- watch the countdown clock on the computer
- average of 55 seconds per question

Skip difficult questions rather than waste time

- electronically highlight the ones you have left out
- use electronic review to return to unanswered questions 2nd time
- do not leave any questions unanswered – make an educated guess

Check for silly mistakes if you still have time.

General Preparation
 Learning is always best cemented on experience
Check the guidelines and reference material for
patients that you see day by day

 You must create time for “book-work”

◦ 2-3 month run-in (1 month per year post foundation)
◦ You should aim to do revision work most days
◦ You can take up to 3-5 days of private study leave
 Not necessarily week of exam or week before exam…

 Websites, guidelines, study groups – more later

◦ FPH Library: 3 month access to onexamination.
Administration & Management
 MRCGP is an licensing exam work in UK
◦ Questions are based on working in UK
◦ Detailed legal questions are unusual
 AKT: 10% of total = 20 marks
 Target score 70% = 14 marks

 Covered well via on-line MCQ banks

 See also “Suggested topics & web resources”
◦ Work through these and you should score 70%.
EBM & Statistics
 Old MRCGP exam had one written question
plus MCQs on stats & data interpretation
 AKT: 10% of total = 20 marks
 Target score 70% = 14 marks

 Score 25% on stats & management?

◦ 10 marks out of 40 (70% target was 28 marks)
◦ 18 marks to make up = deficit of 9%
◦ Means you now need 79% in clinical management.
EBM & Statistics
The questions focus on definitions and
interpreting results/ graphs

1. On-line MCQ banks will drum a lot into you

2. “Basic statistics” guide on the VTS website
- section on definitions & terms
- learn the “screening test grid” by heart.
Clinical Medicine
 80% of the questions
◦ SBA, EMQ, complete an algorithm, pictures
 Question writers are all GPs
 Questions “die” within 3-4 years
◦ New material?
 CKS, NICE & SIGN guidelines, BNF,
 RCGP educational material (InnovAIT, EKU)
 Covering key areas in Wednesday half-days
 Checklists - Curriculum Map
RCGP AKT Content Guide.
Clinical Medicine
Don’t rely just on on-line question banks
Examiners give feedback after each AKT sitting
Read the “Collated Feedback” on the website
Not hard to spot the themes:
Think what has been topical?
Read guidelines – especially new ones (6 month cut-off)
EKU tells you what the RCGP thinks is important...
Read Good Medical Practice

There is an attempt to spread the exam questions evenly across

the clinical areas of the GP Curriculum.
Clinical Medicine
Common, low impact Sore throat, otitis media,
impetigo

Rare, high impact Child abuse, meningitis

phaeochromocytoma

Topical Capcity & consent, dementia.

Preparation Resources
Knowledge & reference NICE - New Guidelines Within each curriculum area, you should actively
websites look for appropriate NICE Guidelines

CKS Mini NICE guidelines on minor & major topics

MUST READ…
SIGN - New Guidelines If a clinically important topic does not have NICE
Guidelines, then check SIGN
Patient.co.uk Patientplus section is directed towards Health
Professionals. Personally I find it more in-depth
and useful than GP Notebook
GP Notebook Tried, tested, trusted
Does now require (free) registration
Lacks graphics...

Knowledge modules & self- RCGP Essential Knowledge Increasingly comprehensive resource - see
test sites Updates (EKU) Curriculum Map
A lot of podcast material for those of you with
car journeys
InnovAIT “Courses” Available to AIT's.
Log-in and select the InnovAIT journal
60-70 modules available - read the article from
InnovAIT and then take a test

Question-only websites Onexamination.com FPH Library Access

1500 questions More realistic, more expensive
“Management" questions are better
Passtest Large question bank
More medicine focus, less GP
Works well as a phone app
Passmedicine.com 2500 questions
Harder questions, can set a 2hr exam
Very good for O&G, Paeds, child development
How to Prepare A Topic
If I was revising “Respiratory”, then I would:
1. Check if covered yet on Wednesday half-day teaching
a) Read the Respiratory curriculum statement
b) Check a summary - curriculum map/ AKT Content Guide
c) Read any examiner’s feedback
2. For each topic/ line on the curriculum map:
 Revise knowledge
 Read any CKS/ NICE guidelines
 Read up patient.co.uk
 Focus on the obviously important
(e.g. Respiratory – COPD vs. Asthma)
 Take any knowledge tests on EKU/ InnovAIT
3. Run through questions on onexamination & passmedicine.
Learning Sets
Small groups (3-6 best), trainee-led
Meet weekly for about 2 hours
GP post – after Wed pm teaching
Now - AKT preparation
Later - CSA preparation.
AKT Learning Sets
Decide how many meetings between now & the exam

For each learning-set week:

- Timetable a core curriculum topic

- Allocate a lead trainee

Ahead of their allocated meeting, the lead trainee prepares that curriculum topic
(see my suggestion)

At the meeting, the lead trainee presents to the group an annotated curriculum
map showing key guidelines, useful reading, useful online modules

During the next few days, everyone else then works through this material and
runs self-test questions

Feedback by all at the start of the next meeting.

Any Questions?
Exam date: 26/10/16 25/01/17 26/04/17

Bookings
13/09/16 28/11/16 07/03/17
Close:

 Pick your target slot

 Consider timing with a GP post if possible
 Remember run-in guide (1m per 1y post foundation)
 Remember access to onexamination via the library
 Do more than e-learning - write things down
 Look at the guides on the VTS website
 Consider study groups
 If you fail, talk to PD before re-sitting
 ST1/2 Half Day Programme
Year 1 Year 2
Major Topic Minor Topic Major Topic Minor Topic
August Induction & AKT Induction & AKT
September Eye Problems Portfolio ENT & Facial Portfolio

October Cardiovascular Ethics Cardiovascular Professionalism

November Communication Skills Day Communication Skills Day

December Dermatology ESR Preparation Drugs & Alcohol ESR Preparation

January Mental Health Professionalism Respiratory Changing behaviour

February Women’s & Sex Health Contraception Metabolic & Endocrine Investigations

March Men’s Health Cancer Neurology Learning Disability

April Paediatrics Statistics Paediatrics EBM/ Critical appraisal

May Digestive Screening Digestive Genetics

June Communication Skills Day Communication Skills Day

July Rheumatology & MSK Complementary Rx Elderly Care Driving & DVLA