Dr Abdalla Ahmed passed the MRCGP AKT with 90% overall. In this article he shares his experience of preparing for the exam, discusses his tips for revision, the resources he used and those that he found most helpful in his preparation.
I am Abdalla M. G. Ahmed, currently in GP training in Kettering, East Midlands. I sat for the MRCGP Applied Knowledge Test, (MRCGP AKT) in October 2021 during the first rotation in my second year of training (ST2). I passed it with an overall score of 90% (90% in clinical, 95% in admin and 85% in statistics). This article covers my experience with this exam and it will be both descriptive and prescriptive (I will share my experience and also include some advice about what I found useful and things I think that can be optimized). To make it easier, I will break it down to the following parts:
1. Understanding the task
2. Putting a plan together
3. Choosing the tools (resources)
4. Allocating time and doing the job
6. Maintaining your wellbeing
7. The last few weeks before the exam
8. The exam and after the exam
You can read the parts in order to get a full picture, or you can jump directly to the part that is most relevant to your questions or interest.
Passing an exam is a task like any other task. It is just a bit more complicated and needs more planning, resources and work. To be able to do it in the best possible way, you need to understand it first. This is what I started with. I started by using Google, and searching for information about the exam, then went to YouTube and watched the videos I could find about it. A lot of useful resources are out there, the most useful were those 3 free videos from the Emedica YouTube channel (each one is about 10 minutes long):
- MRCGP AKT – What To Expect and How To Prepare for the AKT:
- MRCGP AKT – question formats + sample AKT revision questions:
- MRCGP AKT – Common mistakes that can lead to failing the AKT + how to avoid them:
And the contents of this webpage from the Bradford VTS website:
Then I started to search for and read other trainees experiences with the exam and speak with the people I know who sat for the exam and passed or failed in it and listen to their experience and their advice to see what resources they used and what would they do if they had a chance to redo the test again.
Failing to plan is planning to fail. A very common saying that is quite true especially with big endeavours and big challenging exams like AKT. From everything I read and every conversation I had with people who had passed and people who had failed AKT, nothing seemed as necessary to pass as having a good plan and carrying it out.
One of the most critical points is when to sit for AKT. I have discussed with a lot of people and read a lot of experiences, and from everything I gathered:
- You need to study for 3 to 5 months for the exam.
- You need good time for revision in the last month of your preparation and to be able to take days off for that in the time before the exam.
- You need to have a steady work and life in the last few months before the exam so you can plan your study.
From all that, it seemed to me it is best to sit for AKT during a GP placement. My first placement in my second year was a GP placement, so I planned to take my exam in October 2021. I needed to start 5 months before that, so I started studying from May 2021, while I was doing an A&E rotation. I had 2 months of study while in A&E, then continued to study for 3 months in my GP placement.
The second thing to have in the plan is what to cover. One of the challenges in preparing for AKT is the HUGE body of knowledge you need to master. This reflects the challenge in general practice where you need to have knowledge in almost every branch. In addition to this, you need to have good knowledge of relevant topics in stats, research and evidence based medicine, admin, and laws and regulations related to GP day to day work.
Admin and stats are 10% each of the exam total questions and marks, and clinical knowledge is the remaining 80%. Marks are easier to score in admin and stats as topics are limited, but people are unfamiliar with them, so those definitely need to be covered well and maybe from one than one source.
Clinical knowledge is so huge that it is impossible to go over everything and then revise everything in the final month. From what everybody shared and explained, it seemed like there are two types of clinical knowledge:
- Core knowledge: things you must know and know well, and they have very probability of coming in the exam
- Peripheral knowledge: things that are less important, can come but are not very likely.
The core knowledge is topics which are the “bread and butter” of GP day to day work. Things like diabetes, hypertension, asthma, COPD, IHD, commonly used medications, common eye conditions, ENT conditions, skin conditions and things like suspected cancers symptoms and presentations and their referrals, ect. In addition to the topic highlighted by examiners reports from the previous sittings for the AKT as they keep repeating them. Other things that are very uncommon and not life threatening or differentials to common presentations, are the peripheral knowledge.
The best collection for most important core knowledge topics is a free document compiled and shared by Emedica called the “MRCGP AKT High Yield Topics Checklist”.
Those seemed to be the topics that I will need to cover very well, revisit regularly and review in the last few weeks before the exam.
In addition to those, the curriculum wide learning assessment which is available for free in GP self test for all the GP trainees in UK as a part of the subscription they have with RCGP seemed quite useful as it covered the entire curriculum and the result had a breakdown by speciality and it highlighted the areas I was weakest in and needed to focus on more.
3. Choosing the tools (useful AKT resources):
That is the question I get the most. There is a wealth of resources available for preparing for AKT, and people use different combinations of them. I will comment briefly on the free and paid ones that I am aware of and then mention the ones I used.
The free resources are question banks (like RCGP GP Selftest which is available for any trainee with RCGP subscription/AiT Membership), videos on YouTube channels of both Emedica and Arora medical. From the Emedica channel, I found both the lockdown webinars and National VTS videos useful (one hour long webinars with AKT type questions in clinical, admin and stats and having CSA/RCA related consultations with them) and Arora clinical videos by specialty and Stats and admin videos from a YouTube channel called Dorky Docs. All are free and can be found by a quick search. In addition to those, some deaneries run a variety of teachings for AKT like free stats teaching for example done by our deanery.
I used the free resources I mentioned above, and went with Emedica mainly for the paid resources, having tried a lot their products in the past and have watched all the free lockdown webinars and national VTS webinars on their YouTube channel, plus having read about their webinars and programs from many experiences for people who passed the test and heard from people I knew who tried them. The one I went with was a program called the “AKT Pass Guarantee Programme” or PGP in brief. It had a good discount on a huge collection of courses (Admin, stats, clinical crammers, mock tests, question bank access, clinical revision cards, study group, 9 live webinars, 2 full day courses, regular follow up and so on). Plus, it perfectly fitted with the plan that I had on my mind already (was 5 months long, had a clear structure, good time for revision at the end, repeated coverage of the high yield topics, covered doing two question banks which were Emedica one and the GP selftest one, reviewing my weakest areas and the important topics in the last few weeks and so on). It had daily emails with readings from the Oxford Handbook of General Practice (OHGP), daily question sets to do and submit, weekly tasks that could be question sets, videos to watch or summaries to submit, plus multiple webinars spread over the 5 months which covered different high yield topics. It also had multiple full mocks and also mini mocks. All the data from the performance in the first 4 months was compiled to make a personalized revision plan for the last month which was very useful and saved me the trouble of making that myself.
In addition to the Emedica AKT pass guarantee program, I bought Arora courses on admin and stats as I wanted to cover them earlier in my study, plus I wanted to cover them from two different sources. I also bought Arora clinical cards which were useful. I tried Passmedicine in my last month of preparation, but stopped after a few days as I found from doing it that what I have done with the Emedica AKT question bank and GP self test was enough. I also did a couple of mini mocks and full mocks from other sources, but stopped as I found I was scoring well already and we had many mocks in the Emedica PGP that I had to catch up with. I found that the mocks I got from Emedica that we were doing in the PGP were really useful, and in hindsight, these were the closest to the real exam.
This is a very tricky and challenging part of the preparation. The problem is that the best plan with the best available resources will not help you to pass unless you put in the hours and do the job. The other problem is that our lives are complicated with work, families, training requirements, and other commitments.
What can be quite helpful is to have a clear idea on what tasks do you want to get done everyday and how much time would you roughly need. I usually do that planning before I start studying. This time, I had that already sorted by the program I was in. I knew that I needed to put 1 to 1.5 hour every other weekday and 2-3 hours everyday on the weekend in the first four months of preparation, and then I will need to have more intense focus in the last month. I recommend doing the same. Having 5 months to prepare was quite helpful. If doing this in 3 months, that would have required more intense preparation with more hours per day and work almost every single day.
Still, finding the hours and time was challenging, especially when I was working in A&E. Plus, I had my own materials to cover as well in addition to the emedica program. So, I was trying to use my time in the best possible way, for example:
- Studying in my breaks in A&E shifts.
- Waking up early half an hour or an hour even on the weekend day to have some extra time to study in.
- Listening to the materials I wanted to listen to during driving. I used this to listen to things like the lockdown webinars, national VTS teaching videos, Arora courses of stats and admin, arora short clinical videos, Emedica webinars for the course.
Also, having a certain mindset was quite helpful to keep me going and keep me doing the work, but I will explain this in the coming section.
Studying for an exam like AKT can be quite challenging and stressful, plus it needs a lot of commitment. There are few things that were a part of the mindset that I had and found helpful to keep going. I will explain some of them down below:
- This is a marathon, so slow and steady is good to be able to keep going.
- I already don’t know a great deal of the material, or else I wouldn’t have been wasting my time and money doing the studying and preparation for this exam, so no need to panic with poor scores or difficulty found when I am dealing with the questions/practices/tasks.
- There will be days when I fail or slip or don’t feel like it, just like what happens when trying a diet or going to the gym or doing anything that needs long term efforts and focus. I just need to be kind with myself and let it go, and start again when this improves and I feel better.
- The scores in the mock exams and questions sets don’t correlate at all with my expected score in the exam. Those are teaching tools and I am doing them to learn. The more questions I get wrong, and then read their explanation and learn their topics, the better it is for me as this means I will get those ones right when the time of the real exam comes.
- Everyone has struggled. The ones who have passed all had to do the same effort and go through the same moments of frustration and anxiety. It is normal and human. They kept pushing and that is why they made it, I need to keep pushing and working, so I can make it as well.
I also seek motivation and inspiration from quotes, videos, and re-reading other people’s stories with the exam. I loved sport motivation, those are two videos to illustrated the thing I am speaking about, one from a channel I like, the other is for an inspiring personality I hugely admire:
That was for me but it doesn’t matter, just find what inspires you and motivates you to keep going and keep working, and use it when you feel low or not feeling like doing the job.
AKT is important, but it is only a test. You need to maintain your wellbeing to be able to study for it, while taking it and after taking it. Overstressing over it, will do more harm than good and can impair your function at home, work and damage your wellbeing.
Everybody has their own things to keep their wellbeing. For me, I enjoy replaying old Playstation one video games for example. I did that when feeling very stressed or tired from studying. Spending time with my wife who is also a GP trainee and was preparing for the same exam with me was quite useful. Doing things, going out with my wife, visiting other towns and cities, having dinner and movie nights out, having dinner and watching an episode of a show (during AKT time, it was the blacklist) every night while preparing was helpful to relieve the stress and break the routine and keep both of us going.
Being a part of a study group is helpful as well. In every exam I take, I look for a group to join. This time, I was in the emedica AKt program group which was quite helpful and supportive. Having peers who are going through the same journey, struggling with the same things and pushing through was quite inspiring and motivating, plus, it allowed me to be able to speak with people who can understand what I am going through, which was quite useful and relieving.
One of my professors in medical school once said something to me, it was like: If you don’t revise what you studied before the exam, it will be as if you have not studied it at all. During the years, I found a great amount of truth in what he said. In the last few weeks before the exam, it is not the time to learn anything new, just revise the important topics and do mocks and review the difficult concepts that you struggle with. Usually, I make my own plan for revision and have a list of topics and things to go over. This time, I had that sorted already for me by the program I was in.
One thing that is worth mentioning about those few weeks. Don’t panic. It is quite normal to feel that you have forgotten everything or get low scores in tests and mocks, especially the hard ones, but just keep going. Forget about the outcome, and just focus on the process. If you get the process right, the outcome will take care of itself as they say.
The exam itself is just like any other exam. The stress, the surprising difficult questions from time to time, the questions that want to swallow your precious time as they are quite difficult. For me, the graphs were surprising. Haven’t seen anything like them in any resource or practice test or mock before, but that didn’t matter. I knew the drill, think of the question, if I know I answer, if not, then I just guess the answer, flag it for review and move on, as easier questions might be waiting after it or at the end of the test and I will definitely miss them I dwelled on any question too long.
After the exam, it is quite exhausting, worrying about your performance, remembering the questions you got wrong. What I do and have always worked for me is to never review or discuss anything. Just let it go. Enjoy your time, have fun, spend more time with family and friends to recover and try to focus on the next thing in your life, training, career.