MRCGP AKT BASICS AIMS What is the AKT

MRCGP AKT - BASICS

AIMS What is the AKT? Why do I need to do it? When do I need to do it? Where do I need to do it? How much does it cost? How do I prepare for it? ? any other burning questions

What is the AKT? APPLIED KNOWLEDGE TEST � Summative Assessment � The AKT is designed to test the application of knowledge and interpretation of information. � Candidates who pass this assessment will have demonstrated their competence in applying knowledge at a level which is sufficiently high for independent practice. � Each question is intended to explore a topic of which an ordinary GP could be expected to have a working knowledge. � It is mapped to the latest RCGP Curriculum

200 item Multiple Choice Test ◦ The test takes the form of a 190 MINUTE machine-marked test – 57 seconds per question ◦ Approximately 80% of question items will be on clinical medicine ◦ 10% on critical appraisal and evidence based clinical practice and ◦ 10% on ethical and legal as well as organisational structures that support UK General Practice ◦ Delivered on a computer terminal at an invigilated test centre ◦ Offered three times a year: Jan/Feb, April/May, Oct/Nov. ◦ All questions will address important issues relating to UK general practice and will focus mainly on higher order problem solving rather than just the simple recall of basic facts. ◦ All trainees will be expected to attempt this exam at least twice whilst in training.

Clinical The broad topic of clinical medicine is subdivided into groups of body systems, in approximately equal numbers Each group will comprise questions on disease factors symptoms investigation management

Clinical Cardiovascular Musculo-skeletal Dermatology Neurology Endocrinology Ophthalmology ENT Paediatrics Gastroenterology Renal Genetics Reproductive male/female Haematology Respiratory Immunology Therapeutic indications and adverse reactions Infection Mental health & learning disability

What is the AKT? Question writing… � Scenarios derived from clinical work � Practice issues � Topical � All questions are referenced and the draft questions are then carefully scrutinised by a panel of experienced question writers. � Remember that all question writers are working GPs. The writers do not write for any commercial organisations!

What is the AKT Question format…. � Single Best Answer (SBA) � Extended Matching Questions (EMQ) � Table/Algorithm � Picture/Video Format � Data interpretation � Free text – eg typed one word answers

Exam Construction Relevance: the AKT should be relevant to general practice e. g. GMC guidance, management of type 2 diabetes High prevalence: any topic covered can be one which occurs commonly e. g. sore throat, otitis media, impetigo High impact: or one which is significant but less common e. g. child abuse, meningitis, pheochromocytoma

What is the AKT Research, epidemiology and stats! Understanding the principles of audit and its application in assessing the quality of care. Understanding the application of critical appraisal skills which will be tested in a number of formats including: the interpretation of research data using results in published papers the understanding of terms used in both statistics and evidence based medicine understanding epidemiology relevant to general practice

What is the AKT Administrative and Management NHS organisation Legal aspects e. g. DVLA Medical certification e. g. death certificates Professional regulation, e. g. GMC Business aspects e. g. GP contract Prescribing e. g. Controlled drugs Appropriate use of resources e. g. drugs Health & Safety e. g. needle stick injury Social services e. g. safeguarding Ethical e. g. Mental capacity, consent

What is the AKT Scoring All question formats have equal weighting Each correct answer-1 mark Total score is the number of correct answers given. No negative marking - ‘Fear factor’ It is important to answer all the questions If a question performs poorly across the whole exam it will be removed from the scores of ALL candidates.

Where? Pearson VUE Centers https: //www 7. pearsonvue. com/testtaker/registration/Select. Test. Center. Proximity/RCGP/64 1805 Pearson Professional Centres- Pearson Professional Centres. UK Ipswich UK Colchester UK Chelmsford Pearson Professional Centre Wellington House Crown House Butt Road 1 st Floor Grosvenor House Crown Street Colchester 51 New London Rd Ipswich CO 3 3 DA Chelmsford United Kingdom IP 1 3 HS CM 2 0 ND United Kingdom

When do I take the AKT? � Offered three times a year- Oct/Nov, Jan/Feb, April/May � Only trainees in the ST 2 and ST 3 stages of training will be eligible to take the AKT. � A maximum number of four attempts will be permissible in the AKT. � AKT passes obtained after 1 August 2010 will no longer be subject to a three-year validity limit � Nobody is recommending that you should take until you have done at last 6 m in General Practice � Do not take it until you have had time to look at GP related medical knowledge as well as management and research � Do not take it after you have had a period away from work (e. g. pregnancy), as you need to have kept up to date on NICE and SIGN guidelines and how these are implemented in practice

When to take AKT ? later College advice most appropriate point, and highest chance of success, will be whilst working as a GPSt. R in the final year of their specialty-training programme (ST 3). Taking once is cheaper than taking it twice When everybody else on the scheme is taking it? ? so it is easier to prepare together Knowledge base for AKT helps with CSA so take together

How to take it? Time management – this is everything Keep watching the countdown clock on the computer Skip difficult questions rather than waste time (electronically highlight the ones you have left out)

How to take it? Exam tips Cover test – can you answer the question with the option list covered? It’s probably the correct answer Mark answer carefully Go through unanswered questions 2 nd time round using electronic review Do not leave any questions unanswered – educated guessing is worthwhile Check for silly mistakes if you still have time

How to prepare? -resources used to devise AKT GP Curriculum Content Guide for the AKT (AKT website) BNF GMC Good Medical Practice RCGP Essential Knowledge Updates Cochrane NICE SIGN BMJ Review articles & original papers BJGP Vaccine update (www. gov. uk) / Green Book

How to prepare? Give yourself enough time Familiarise yourself with GP curriculum-particularly 3 domains Learn from your clinical experience – check the guidelines and references of cases you come across Exam website feedback, sample material Other resources to guide learning/practise questions Prepare with peers

How to prepare Possible Resources Oxford Handbook of General Practice by Chantal Simon and Hazel Everitt (1 st few chapters for primary care & admin) Innovait magazine (matches to GP curriculum-also has sample questions) Scheme has an account !! Medical Statistics made easy. Michael Harris, Gordon Taylor. How to Read a Paper: The Basics of Evidence-Based Medicine. Trisha Greenhalgh. Other books n. MRCGP Practice Papers: Applied Knowledge Test. by Rob Daniels NMRCGP Applied Knowledge Test Study Guide: Sample Questions and Explanatory Answers by Aalia Khan, Ramsey Jabbour, and Almas Rehman

How to prepare online resources www. passmedicine. com offers 1000 s of MCQs at a cost (£ 30 for 4 months, £ 40 for 6 months ) On examination from the BMJ group http: //www. onexamination. com/exams/generalpractice/mrcgp#Question. Browser is more expensive (£ 82 for 3 months) but some have found that it reflected the type and standard of MCQ in the AKT better than above. Past test- http: //www. pastest. co. uk (£ 59 for 3 months). Plus there is an app for the phone.

How to prepare? Courses Don’t feel it is needed-save your money for CSA!. But if you really want to , , GP update course, NB medical course, Emedica course, Local courses

Practicalities Candidates MUST bring identity documents WHICH MATCH their application details Candidates should arrive in good time Candidates who either arrive late or fail to provide matching ID, will NOT be admitted to sit the AKT Security at each centre will be robust: Identity checks Invigilated Video monitoring Separate morning and afternoon sittings with a ‘quarantine’ period at lunchtime. Morning candidates will not be allowed to leave before the end of the test

MRCGP AKT EXAM WEBSITE Please look carefully at RCGP website http: //www. rcgp. org. uk/training-exams/mrcgp-exams-overview/mrcgp-appliedknowledge-test-akt. aspx The ‘How to prepare for the AKT’ section contains helpful resources, including: Innov. Ai. TAKT Podcast ‘Preparing to take the AKT’ pdf 50 AKT Sample questions with answers The ‘AKT Summary Reports from October 2007 to April 2017’ section should help guide your revision plans

Statistics – AKT 30 (April 2017) AKT 30 pass mark = 137/199 (68. 8%) Overall pass rate = 72. 1% After reviewing question performance, one question from the 200 in the exam was suppressed from the final scoring total. Scores in AKT 30 ranged from 84 to 192 out of 199 questions with a mean overall score of 74. 1%. Cumulative pass rate after four attempts for all those who take AKT is approximately 95%

Statistics – April 2017 The mean scores by subject area were: ● ‘Clinical medicine’ 73. 2% (160 questions) ● ‘Evidence interpretation’ 81. 7% (20 questions) ● ‘Organisational’ 72. 9% (19 questions) The pass mark for AKT 30 was set at 137 with pass rates as below: Candidates (numbers) Pass rate All candidates (1485) 72. 1% ST 2 first-time takers (1037) 77. 3% ST 3 first-time takers (112) 73. 2%

Statistics – April 2017 SINGLE MOST likely Candidates will note from the sample questions that the question stem frequently includes the phrase “Which is the SINGLE MOST likely. . ? ” referring to a list of options. When the question is about a single most likely diagnosis, candidates should consider the prevalence of a condition when identifying the correct answer. The most serious condition listed may not necessarily be the correct answer if this is less common as it will not be the MOST likely. Option lists All the AKT question formats, apart from the free text, require the candidate to identify the best answer(s) from a list of plausible alternatives, using all of the information in the question. There may be other answers which are not included in the option list, but the candidate should focus on the best available answer for the specific question asked; in other words, focus on the options given, and not what is absent.

Areas That Caused Difficulty in Last Sitting 3. 01 Healthy people, promoting health and preventing disease • National childhood and adult vaccination schedules, especially as childhood immunisation schedules are frequently changing. 3. 06 Women’s Health • Serious side effects of COC, management of common side effects of HRT, investigation of infertility, amenorrhoea. 3. 17 Care of people with metabolic problems • Diagnosis and management of diabetes 3. 19 Care of people with respiratory problems • Asthma management (see changes in 2016 BTS/SIGN guidance) and COPD management. 3. 21 Care of people with skin problems • Common problems associated with GP minor surgery

Areas That Caused Difficulty in Jan/Feb Sitting The GP in the wider professional environment End of Life Care, death reporting and certification • Care of children and young people Diagnosis and investigation of suspected cancer in children • Women’s Health ‘Quick start’ and emergency contraception, HRT, urinary incontinence • Care of people with eye problems Eye emergencies • Care of people with mental health problems Medication for anxiety and depression: interactions, safety, monitoring • Care of people with metabolic problems Type 1 diabetes management during infection: sick day rules • Care of people with skin problems Fungal skin infections

Areas That Caused Difficulty 1 year ago Care of acutely ill people Management including drug treatment of life-threatening conditions in adults and children • Care of children and young people Cancer recognition/investigation • Care of people with ENT problems Hearing loss, infections and conditions where no active treatment needed • Cardiovascular Erectile dysfunction, treatment of prostatic conditions • Patient safety and quality of care Monitoring requirements for commonly prescribed psychiatric drugs, stewardship antibiotic

Resources http: //www. rcgp. org. uk/training-exams/mrcgp-exams-overview/mrcgp-appliedknowledge-test-akt. aspx http: //mrcgpexamprep. co. uk/store/sign-mrcgp-examprep? gclid=EAIa. IQob. Ch. MIs. Iv. Alc. S 91 g. IVjcqy. Ch 1 K 7 A 3 f. EAAYAi. AAEg. Ki. H_D_Bw. E http: //www. rcgp. org. uk/training-exams/gp-curriculum-overview/using-thecurriculum. aspx http: //www. rcgp. org. uk/publications/innovait. aspx http: //www. rcgp. org. uk/gp-training-and-exams/gp-curriculum-overview. aspx http: //www. rcgp. org. uk/training-exams/mrcgp-exams-overview/mrcgp-appliedknowledge-test-akt. aspx

Innovait AKT Podcast http: //hwcdn. libsyn. com/p/4/0/3/4032 c 0 dd 3031 f 319/INO__Finished_RCGP_AKT_podcast. mp 3? c_id=10093701&expiration=1506261322&hwt= 794 f 68 c 5 ab 36 c 8 a 0 aacc 7 ea 725 e 64 eea Preparing to Take the AKT http: //www. rcgp. org. uk/training-exams/mrcgp-exams-overview/

Essential Knowledge Updates (RCGP) http: //elearning. rcgp. org. uk/course/index. php? categoryid=2