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nMRCGP tips: How to get through the AKT

In the second of her series of tips on how to pass the nMRCGP, Dr Una Coales gives some essential advice on how to pass the Applied Knowledge Test. Including the value of wearing an old jumper!

In the second of her series of tips on how to pass the nMRCGP, Dr Una Coales gives some essential advice on how to pass the Applied Knowledge Test. Including the value of wearing an old jumper!

The next Applied Knowledge Test (AKT) exam is looming on April 29 2009 for more than 1,000 specialist UK GP trainees and the pressure is on to pass this licensing exit exam. With the training year ending in August, the next AKT exam is not until October. Pass and you may seek employment in August. Fail and you face unemployment between August and November. So to help, this month I shall focus on AKT tips.

Ask for study leave to revise for 150 hours to achieve a merit pass score of ? 80%. Your score is based on how many hours you dedicate to revision. Simply put: 100 hours equates to a score of 70%. Not so good for those who sat in October 2008 when the pass mark was set at a record high of 71.21%. But very good for those who sat in Jan 2009 when the pass mark was set at a low 65.15%. So best to revise for 120-150 hours. One successful GP took 10 days study leave and revised for 15 hours a day.

Access nPEP which is free with your AiT number for sample AKT questions. The peer average score is 97%. If you fall below this mark, no Easter eggs for you!

Practice with the 50 sample AKT questions on the RCGP website.

The unofficial answers are posted on DNUK.

Read the BNF. Memorise the first 36 pages and then familiarise yourself with the main drug classes and recognised side-effects. Which drugs? Analgaesics, anaphylaxis, antibiotics, (do keep going past A though!) If you are sitting your 4th AKT, your livelihood depends upon digesting all 978 pages.

Practice with question books.

The following books have been recommended by a GP who scored 94.95% in 2008:

nMRCGP Practice Papers: AKT by Daniels

nMRCGP AKT Study Guide by Khan, Jabbour and Rehman

AKT for the new MRCGP by A-Ali

Get Through nMRCGP: AKT module by Coales (yes, that's my book).

Memorise the DVLA "At A Glance Guide for Medical Practitioners to the Current Medical Standards of Fitness to Drive and the Fitness to Fly guidances.

Memorise as much of the NICE and SIGN guidances as you can. Favourite topics include asthma, COPD, diabetes, heart failure, (well, all of them really) Check out the Pulse bitesize NICE guides in the clinical tools section for quick guides to some of the guidelines.

Read the RCGP feedback from previous exams. The feedback is feeding you the topics!

Read the OHGP, the OHCS (clinical surgery), the OHCS (clinical specialties), and the OHCM (clinical medicine) to fill your knowledge gaps. I did say 150 hours of revision and I meant it!

GP trainees with MRCP always pass. That means read the book MRCP doctors read: Essential revision notes for MRCP by Kalra.

Know your stats. ‘Medical Statistics Made Easy' by Harris will get you past the ‘common entrance' maths questions but also master postgraduate medical statistics. Professor Greenhalgh's ‘How to read a critical paper' is a must bed-time read and explains the Forest Plot.

Speed read by scanning diagonally across the page. The AKT is a 3-hour exam to complete 200 questions or 54 seconds per question. Between slow servers and lengthy questions, it is essential that you read diagonally down the page and ignore distracters. It is an exam skill that comes with practice.

No excuses. Think positively. One GP said he could not study as his children were too noisy so I suggested a pair of ear-plugs, and he passed. One GP said she was going to fail as she was too old for exams, so I told her repeatedly ‘you will pass' and she did.

Try exam courses before you give up a career in medicine. Yes those who face their umpteenth attempt lose faith. Do try a peer-reviewed AKT course to help with exam technique and knowledge gaps before you give up a lifetime spent in medicine.

Wear an old jumper to the AKT exam held at your local DVLA centre. You are given a whiteboard to do your sums, so instead of holding up your hand for an invigilator to clean your board each time you wish to start writing afresh, wipe the board with the sleeve of your old jumper. Saves seconds in a timed exam!

Good luck!

Tips on how to pass the nMRCGP by Dr Una Coales About Dr Una Coales

In 1993, as a US surgeon, I sat my first ruthless UK postgraduate exam, the PLAB exam with its 5-modules, fail one module, re-sit all policy. I made a promise to write a book on this exam if I ever passed!


As I progressed through most of the UK postgraduate exams (including the masochistic FRCS exams), I wrote exam books along the way to help colleagues. In 2002, as I sat the MRCGP exam at the Royal Horticultural Hall amidst 400 GPs, I wondered what exactly had I revised over 6 weeks as nothing seemed relevant to the actual MCQ paper in front of me.


There were no RCGP courses or books on the Simulated Surgery module and not surprisingly, the RCGP published pass rates between 56% and 60%. These GPs (who could not video-tape) needed help and so between 2004 and 2009, I have been teaching all 5 modules of the old MRCGP (MCQ, written, oral, video and simulated surgery) and now solely on the new MRCGP exam (AKT and CSA).


Visit www.mrcgpcourses.co.uk for a full list of courses and books.



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