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MRCGP AKT Preparation
Learning objectives
• Know what to expect in the AKT exam
• Know how to prepare effectively
• Know common pitfalls that lead to failure and
how to avoid them
• Know the habits of high scorers / keys to
success
• Know how we can support you with AKT
• Kickstart your AKT preparation!
MRCGP AKT Preparation
MRCGP AKT Overview
• ST2 onwards, available 3 times a year
• Maximum 4(+1) attempts
• Computerised test ~ 200 questions / 190min
– 80% - Clinical Medicine (GP)
– 10% - Evidence interpretation – Stats / EBM
– 10% - Organisational / admin
• EMQ / SBA main format
• MBA, algorithm, picture, seminal trials, short
answer, video
© Emedica Ltd www.emedica.co.uk MRCGP AKT Essentials 1
MRCGP AKT Preparation
Hypertension – NICE 2019
• Investigations recommended
• Urine dipstick for haematuria
• Urine sample to LAB for ACR / proteinuria
• Blood sample for
– U/Es + eGFR
– HBA1C
– Lipids
• Fundoscopy for hypertensive retinopathy
• 12-lead ECG
MRCGP AKT Preparation
Bell’s Palsy
• Acute, unilateral, idiopathic, facial nerve paralysis
• Most make a full recovery within 9 months
• If present within 72 hours, prednisolone can improve
recovery
• Refer to ENT if
• Bilateral Bell’s palsy
• Recurrent Bell’s palsy
• Diagnosis unclear
• No improvement within 1 month
© Emedica Ltd www.emedica.co.uk MRCGP AKT Essentials 2
MRCGP AKT Preparation
Meibomian cyst / chalazion
• Chronic inflammation/blockage of the
meibomian gland
• Resolve spontaneously or with conservative
treatment - warm compress / massage
• Antibiotics not indicated unless co-existing
conjunctivitis
• Consider referral if no improvement after 4
weeks on conservative treatment
© Emedica Ltd www.emedica.co.uk MRCGP AKT Essentials 3
MRCGP AKT Preparation
Clinical questions relate to:
• Disease factors
• Making a diagnosis
• Investigations
• Management plans (including referrals)
• Prescribing
• Emergency care in general practice
MRCGP AKT Preparation
Questions include:
• Low impact, common conditions
• High impact, rarer conditions
• Common reasons for consulting
• Areas identified as problems in past
– Exam statistics – marks by area
– Examiners’ feedback reports
© Emedica Ltd www.emedica.co.uk MRCGP AKT Essentials 4
MRCGP AKT Preparation
Pass mark and rates
• Pass mark and rate variable
• Pass standard increased after AKT7
• Pass mark – 66 – 72% - mean = 68.4%
• Pass rate long term mean: ~ 71%
• Last 9 exams: Pass rate: 67% ~ 1 in 3 fail!
• Clinical medicine: 74%
• Evidence interpretation: 74%
• Organisational: 71%
MRCGP AKT Preparation
AKT Mini Mock!
• Chance to try some AKT level questions
• Calculators allowed
• ~55 seconds per screen
• Slides will move forward automatically
• 7 questions – please note answers at home
• We will go through answers afterwards!
© Emedica Ltd www.emedica.co.uk MRCGP AKT Essentials 5
MRCGP AKT Preparation
Mortality Data
Number of deaths
Mortality RATE
Area 95% CI
Public Health England. Public Health Profiles. 24/02/2021 https://fingertips.phe.org.uk © Crown copyright 2021
MRCGP AKT Preparation
Gestational Diabetes
• GD increases risk of diabetes
• Postnatal check at 6-13 weeks
– If at <13 weeks, use fasting glucose
– If at >13 weeks, use fasting glucose OR HbA1c
– OGTT not routinely recommended
• Ongoing annual screening using HbA1c
© Emedica Ltd www.emedica.co.uk MRCGP AKT Essentials 6
MRCGP AKT Preparation
Opioid Conversion
Analgesic Dose Notes
Morphine sulphate 10mg Oral - universal opioid
Morphine sulphate 5mg IM, SC
Oxycodone 6.6mg Suitable where morphine
not tolerated
Diamorphine 3mg I.M. or subcut.
Tramadol 100mg Oral
Codeine 100mg Oral
MRCGP AKT Preparation
Assessing Hypertension – NICE 2019
Clinic BP: Up to 3 readings
• Up to 3 readings - lower of 2nd and 3rd readings
• <140/90 - normotensive - repeat within 5 years
• 140/90+ - offer ABPM or HBPM
• 180/120+ - consider immediate treatment / referral
© Emedica Ltd www.emedica.co.uk MRCGP AKT Essentials 7
MRCGP AKT Preparation
GMS – General Medical Services
• Nationally agreed contract
• Most common NHS GP contract in UK
• Essential services – all GMS practices
must provide
• Additional services – usually provided, but
can opt out (lose some funding)
• Enhanced services – may be able to opt in
for additional funding
MRCGP AKT Preparation
Common reasons for failure
• Rushing to sit the exam (or to resit)
• Not allowing enough time
– Not covering the curriculum
– Poor clinical topic coverage
– Not up to date with recent guidance
• Focusing on just one source for learning
• Poor confidence with stats / admin
• Poor exam technique
© Emedica Ltd www.emedica.co.uk MRCGP AKT Essentials 8
MRCGP AKT Preparation
How to prepare for the AKT
• Active learning – reading + questions
• Allow enough time to prepare
– 3 months minimum recommended
– 4-6 months may be better
• Focus your revision to maximise marks
– Statistics / evidence interpretation – 10%
– Organisational areas – 10%
– Examiners’ feedback on weak / key areas
– CLINICAL – 80%
MRCGP AKT Preparation
RCGP Curriculum Topic Guides
• Curriculum updated in 2019
• AKT questions mapped to curriculum
• Reference
© Emedica Ltd www.emedica.co.uk MRCGP AKT Essentials 9
MRCGP AKT Preparation
High yield topics
• Topics that appear frequently in the exam
• Topics highlighted as weak areas
• Topics highlighted as important
• Derived from examiners’ feedback
© Emedica Ltd www.emedica.co.uk MRCGP AKT Essentials 10
MRCGP AKT Preparation
Emedica AKT High Yield Topics
2022
MRCGP AKT Preparation
Key reading 1
© Emedica Ltd www.emedica.co.uk MRCGP AKT Essentials 11
MRCGP AKT Preparation
Reading - Guidelines
• National guidelines e.g. NICE – NICE CKS
• Clinical Case Cards
• 112 topic reviews
• Investigations
• Diagnosis
• Prescribing
• Management
• Emergencies
MRCGP AKT Preparation
www.emedica.co.uk/casecards
© Emedica Ltd www.emedica.co.uk MRCGP AKT Essentials 12
MRCGP AKT Preparation
AKT practice questions
• Emedica
– 2150+ questions covering all 3 domains
– Mapped to RCGP curriculum
– Revision videos and topic summaries
– High challenge questions
– Similar layout to the real exam
– Includes a full 200 question AKT mock exam
– £49 (1 month) -£119 (12 months)
• www.emedica.co.uk/aktonline.html
MRCGP AKT Preparation
© Emedica Ltd www.emedica.co.uk MRCGP AKT Essentials 13
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1month:£49
2months:£69
4months:£99
6months:£109
12months:£119
www.
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prep
MRCGP AKT Preparation
RCGP GP Self Test
MRCGP AKT Preparation
Other AKT question banks
• Passmedicine.com
• Onexamination
© Emedica Ltd www.emedica.co.uk MRCGP AKT Essentials 14
MRCGP AKT Preparation
Emedica AKT - Free Support
• Join the GP Training Support FB Group
– 27,100+ doctors – largest GP training group
• AKT 30 day challenge videos
• National VTS webinars
– Free monthly GP trainee teaching
• AKT high yield revision webinar
– 15 high yield AKT questions + topic review
• Lockdown learning webinar recordings
– Emedica YouTube channel
MRCGP AKT Preparation
GP Training Support FB Group
27,100+ doctors!
© Emedica Ltd www.emedica.co.uk MRCGP AKT Essentials 15
MRCGP AKT Preparation
Emedica Youtube Channel
MRCGP AKT Preparation
Emedica AKT Courses / Webinars
• AKT Pass Guarantee Programme – 225+ hrs
• AKT Pass+ bundle – 130 hrs
• AKT preparation course – 7 hours
– + access a full 200 question mock afterwards
• AKT 200 Question Crammer course – 8hrs
• AKT Masterclass webinars – 3.5 hours each
– Statistics made simple
– Organisational domain organised
– High yield clinical crammer 1 + 2
© Emedica Ltd www.emedica.co.uk MRCGP AKT Essentials 16
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MRCGP AKT Preparation
MRCGP AKT Preparation
© Emedica Ltd www.emedica.co.uk MRCGP AKT Essentials 17
MRCGP AKT Preparation
Habits of High Scorers:
7 Keys to AKT Success
1. Plan ahead
2. Cover the curriculum
3. Understand the exam
4. Master stats and admin
5. Learn the subject, not the question
6. Revise all the high yield topics
7. Work on exam technique
MRCGP AKT Preparation
Summary - AKT
• Applied knowledge – relevant to GP
• Organisational area weakest for GPRs
• Evidence / Stats can offer easy marks
• Clinical most important domain
• Examiners’ feedback valuable for revision
• Cover the curriculum systematically
• Allow enough time: prepare and you WILL
succeed!
© Emedica Ltd www.emedica.co.uk MRCGP AKT Essentials 18
MRCGP AKT Preparation
Finally…
千里之行，始於足下
“A journey of a thousand miles
begins with a single step”
Laozi
© Emedica Ltd www.emedica.co.uk MRCGP AKT Essentials 19
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