AKT – Going For Gold
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 only 56 days away....
AKT – The Exam
The AKT is designed to test the application of
knowledge and interpretation of information
Three hour, 200 item multiple-choice test
80%
10%
10%
clinical management
critical appraisal of EBM
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:
30/10/13
29/01/14
30/04/14
Bookings
Close:
18/09/13
04/12/13
10/03/14
Three sittings each year
You are restricted to 4 sittings
Are you ready to enter? – Use website scores as a guide
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%)
2012-13
Very impressive (85%).
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
Demonstration module - how the Pearson-VUE system works
Use the cover test:
- cover the answers. If your 1st 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 54 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 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
• 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
– Score 20% reduces overall mark by about 5%
– Score 60% reduces overall score by about 1%
• See “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 20% reduces overall mark by about 5%
– Score 60% reduces overall score by about 1%
• Score 50% on stats & management?
– Loses you about 5%
– Means you now need 75% in clinical management.
EBM & Statistics
The questions focus on definitions and
interpreting results/ graphs
1. Mock question websites 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.
EBM & Statistics
True Diagnosis
Positive
Positive
a
(TP True
Positive)
b
(FP False
Positive)
Type 1 error
c
(FN False
Negative)
Type 2 error
d
(TN True
Negative)
Sensitivity
a/a+c
Specificity
d/b+d
True Result
Negative
Negative
Positive
Predictive
Value
PPV = a/a+b
Negative
Predictive
Value
NPV = d/c+d
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?
• NICE & SIGN guidelines, BNF,
• RCGP educational material (InnovAIT, EKU)
• Consider using Curriculum Map as a
checklist.
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:
Child development
Immunisations
Screening
Think what has been topical?
Read guidelines – especially new ones
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
MRSA, T2DM management.
Preparation Resources
Knowledge & reference
websites
Knowledge modules &
self-test sites
Question-only websites
NICE - New Guidelines
Within each curriculum area, you should
actively look for appropriate NICE Guidelines
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...
RCGP Essential Knowledge
Updates (EKU)
Increasingly comprehensive resource - see
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
Onexamination.com
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 “Neurology”, then I would:
1.
2.
3.
4.
Read the Neurology curriculum statement
Check the summary on the curriculum map
Read any examiner’s feedback
For each topic/ line on the curriculum map:
• Revise knowledge
– Read any NICE guidelines
– Read up patient.co.uk
– Focus on the obviously important
(e.g. Respiratory – Occupational lung disease vs. Asthma)
• Take any knowledge tests on EKU/ InnovAIT
5. Run through questions on onexamination & passmedicine.
Learning Sets
Small groups (6-8 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.
Summary - Any Questions?
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Exam date:
30/10/13
29/01/14
30/04/14
Bookings Close:
18/09/13
04/12/13
10/03/14
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
Look at the guides on the VTS website
Consider study groups