READ THIS FIRST: Introduction to the AKT

[AM]

Official RCGP page:

http://www.rcgp-curriculum.org.uk/nmrcgp/akt.aspx

he Applied Knowledge Test is a summative assessment of the knowledge base that underpins independent general practice in the United Kingdom within the context of the National Health Service. Candidates who pass this assessment will have demonstrated their competence in applying knowledge at a level which is sufficiently high for independent practice.
 
Whilst candidates will be eligible to attempt the AKT at any point during their time in GP specialty training, it is anticipated that the most appropriate point, and that providing the highest chance of success, will be whilst working as a GPStR in the final year of their specialty training programme (ST3).

Format of the test

The test takes the form of a three-hour multiple-choice test of 200 items. It is computer-based and delivered at 150 Pearson VUE professional testing centres around the UK.
 
Approximately 80% of question items will be on clinical medicine, 10% on critical appraisal and evidence based clinical practice and 10% on health informatics and administrative issues. 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.

The application process is outlined on the RCGP page, I'm not going to bore you with that here.

[AM]

Additional (hopefully) useful information:

Three hours, 200 MCQs.
 - 80% problem solving in GP
 - 10% critical appraisal and evidence based practice
 - 10% ethical and legal issues as well as organisational structures that support UK general practice

Delivered on a computer terminal at a test centre.

Question formats:

Single Best Answer
Extended Matching Question
Tables and algorithms (for completion)
Picture format
Data interpretation
Seminal trials (familiarity with major trials that have shaped clinical practice)

NO NEGATIVE MARKING.

Offered 3 times a year: Oct/Nov, Jan/Feb, April/May

Interesting statistics April 2009:

Passmark - 126/199 (63.3%)

Overall Pass rate:
ST3 - first time takers 83.8%
ST2 - first time takers 86.3%

Cumulative pass rate for ST3 after 3 attempts approx 94%.

Just makes you think whether the AKT is better being sat during ST2? Food for thought...

Areas answered poorly:

Prescribing for children
Child development
Chronic disease management in children
Clinical governance
Infectious disease and use of antibiotics
Contraception
Acute and emergency medicine in primary care
Certification and fitness to drive

[AM]

Common reference material:

Cochrane
BNF
GP Curriculum
NICE
SIGN
BMJ papers
BJGP
GMC - good medical practice

From experience, I found what worked well was:

1. www.passmedicine.com
2. read around the passmedicine questions using guidelines/bnf/gpnotebook.co.uk
3. nPep - free 150 AKT questions. Quite a lot easier than passmedicine
4. People have given me mixed reports about the Pastest AKT questions book by Rob Daniels
5. BNF prescribing guidelines (at front)
6. OHGP this is currently still an old-ish issue but the first chapters are very useful for GP contracts/PCB/SHA etc
7. GMC good medical practice documents

Also have a read of the PDF attached. It's a guide distributed by the MPS.

[AM]

Subject Content

Clinical medicine:

Cardiovascular
Dermatology
Endocrinology
ENT
Gastroenterology
Genetics
Haematology
Immunology
Infection
Mental health
Musculoskeletal
Neurology
Ophthalmology
Paediatrics
Renal
Reproductive medicine
Respiratory
Adverse reactions

Research and statistics

Principles of audit
Application of critical appraisal skills - interpretation of research data
Understanding terms used in inferential statistics and evidence based medicine

Administration and Management

Regulatory frameworks
Legal Aspects - DVLA/fitness to fly
Social services - sick notes/benefits
Professional regulation - GMC good medical practice
Business aspects - contracts etc
Prescribing - controlled drugs & rules on storage, registers etc
Appropriate use of resources - e.g generic drug usage
Health and safety - needlesticks/HIV PeP/Hep B
Ethics - mental capacity/consent

[tajmahal11]

I am a ST1 trainee. I am doing GP as my second placement in ST1.  I want to know what is your advice if AKT is taken in ST1 year (next date is april 2010) This is because my ST2 placements are in a very busy hospital and I have two small children. I may not be able to study well at that time.

[AM]

Apologies for the late reply, inundated with work currently!

Ultimately, the choice of when to take the AKT is yours, but let me outline some advantages/disadvantages.

Although it is very helpful to get the AKT out the way, I feel ST1 may be a little too early, as the knowledge you might amass (NICE guidelines etc) you would probably forget by the time you come to ST3 and the CSA. It is true you do not need to know as much factual knowledge for the CSA as compared to the AKT but some is necessary.

However, on the other hand, if you feel ST2 would be a bad time and you would be happy to revise the material again in ST3 for the CSA, sitting the exam in April may be a good proposal!

Sorry I can't give a direct answer either way, but you must do what is best for your circumstances! I think the main point to consider is whether you would have enough time to study some of the AKT material again (in particular the clinical areas) in ST3 in preparation for your CSA?

Hope that helps a little at least?