IT is a challenge that all GP trainees will face during their training and one that tests time management skills almost as much as a knowledge of general practice.
Successfully completing the Applied Knowledge Test (AKT) of the MRCGP is intended to demonstrate your ability to apply knowledge and interpret information as an independent GP.
Only candidates in ST2 or above are eligible to take this exam which lasts for three hours and consists of 200 questions. It normally takes place at Pearson Vue test centres across the UK three times a year (in January, May and October). The questions are made up of a variety of single best answers, extended matching questions, data interpretation, picture/video, table/algorithm and also free text.
Approximately 80 per cent of the questions are on clinical medicine, 10 per cent on organisational, ethical and legal issues and the remaining 10 per cent on critical appraisal and evidence-based practice.
A few months before…
Once you have decided to take the exam ensure that you apply online as early as possible as allocation of exam sessions and venues is on a first come, first served basis. I would suggest preparing well in advance – at least three months before you intend to sit the exam. Make sure that you are familiar with the RCGP curriculum and read up on any weak areas. It’s important to identify your personal learning needs and target your learning accordingly. There are many good revision resources available online and Onexamination, Pastest and Pass Medicine have a large bank of practice questions. I also found many of the AKT revision books on the market very useful.
I also recommend using other key resources such as the Oxford Handbook of General Practice, the British National Formulary, BMJ, BJGP and the RCGP’s publication for GP trainees Innovait. It is also advisable to familiarise yourself with GMC guidance, NICE and SIGN guidelines and to follow the RCGP Essential Knowledge Updates.
Draw up a revision timetable to address topics set out in the curriculum. Personally I found that short periods of reading and self-testing, rather than long sessions, worked very well in conjunction with using prior clinical experience and the resources mentioned above. If you prefer working through topics in groups then it might be useful to form a study group. You can also ask your trainer to help guide your learning, perhaps in the form of tutorials, or you could request to cover topics that you are struggling with in your VTS sessions.
The RCGP website has a helpful section providing information on the AKT. This allows you to browse feedback on recent exams and means you can find out exactly which areas candidates struggled with. For example, in the recent exam in April 2012 candidates had difficulty in areas such as quantitative research and confidentiality. The RCGP website also offers a presentation for trainees and I would recommend taking a look at this. Make sure you try out the tutorial on the Pearson Vue website to familiarise yourself with the system beforehand.
On the day…
Make sure you know where the centre is, arrive early and ensure you have brought the necessary documents required – this usually includes a valid passport or UK photocard driving licence and something showing your name and signature such as a credit card.
Read all the questions carefully and make sure you enter your chosen answer correctly. If you are stuck move on to the next question and you can go back to it. Remember there is no negative marking so if you do not know, guess (there is nothing to lose!) If you have time left then go back and check your answers. I always feel if after reading the question you have an answer in mind and it is an option then it’s probably correct.
The most important tip I can offer is time management. Ensure you watch the clock, 200 questions in three hours is 54 seconds for each question but some questions will be quicker, others longer. Remember that most people pass first time. Good luck!
Dr Chirag Mehta is a GP and co-author of Succeeding in the MRCGP AKT
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