The MRCGP AKT is a challenging exam, with many doctors needing to sit it more than once to get get through (the mean pass rate over the last 3 years has been about 67%). In this article, Dr Aarthy Sadanandam discusses how she approached her preparation the 1st time, and what she changed to help her pass her resit with a huge improvement in her overall score of more than 25%!

My first attempt at the AKT

My first attempt was in January 2020 after preparing for 4 months. I used practice questions, NICE guidelines, CKS guidelines, materials from regional GP teaching, BNF summaries and GP self-test. I was training part time (60% LTFT) in my paediatric posting as I was struggling to find time being a dual medic family with two young children. After 4 months of preparing, I felt confident that I had covered all the topics and felt prepared to write the exam.

As I started, the exam seemed extremely tough and I was a little anxious by all the complicated graphs. During the exam, I felt my confidence decreasing with every question, when I did two or more question wrong in a row, automatically I started to assume that I will not know the answer to the next question. I couldn’t even remember the questions when I came out of the exam and felt that I won’t pass. The results confirmed it and I failed badly (probably would have felt better if I failed marginally) with an overall score of 61%, clinical 61.88%, Evidence based medicine 65% and organisation & management 50%. I felt hopeless, depressed and defeated by the results, I told myself that I will never pass the exam regardless of the number of attempts.

How I started my resit preparation

I didn’t know where to start, I expressed my feelings to my educational supervisor and she advised me to get feedback from the AKT course conductors on how to improve. I emailed Dr. Rahman and I was grateful that he replied to me immediately in spite of his busy schedule. He advised to focus the most on improving my clinical score and aim to get more than 70% in all domains. I felt that my previous preparation for the exam was not all wasted, I told myself I just needed to put in a little extra effort to reach my goals. I decided to appear for the April 2020 exam, but the exam got cancelled due to the pandemic. I felt this was a good sign for me to prepare a little bit more. However, I wasn’t been able to prepare intensely for the next two sittings due to the stress around the pandemic and the ward was also getting busier due to colleague’s absence.

After failing my January attempt, I enrolled to take the Emedica masterclass webinars with the intention to prepare to write the exam in April. Emedica was very understanding and flexible, they understood the busy lifestyle of doctors during the pandemic and gave me an option to attend or defer the course for a later date. I decided to attend the masterclass webinars in April because it would give me plenty of time to revise the materials again. The course was an eye opener for me, many of my fundamental concepts got cleared. In fact, I kept recollecting questions from the exam and told myself “[so] this was what they were asking in the exam!” The Emedica statistics webinar decoded those scary graphs in the exam. The Emedica admin / organisational webinar gave ample information which I couldn’t gather from my previous resources for the admin topics in the exam. I then purchased clinical case cards and started reading one or two topics daily at work to prepare.

My Approach for the 2nd Attempt

My plans to write the exam in April got pushed, therefore I decided to sit in the October exam which gave me adequate time to prepare. I started a study group with a few trainees I met on Facebook, we formed a group on WhatsApp and met over the weekends on Zoom. Each one of us prepared a topic on a system and we all discussed on it. The preparation started becoming interesting as we used to discuss everything we knew about the topic together. For example if we were to discuss hypertension, we would discuss the management, DVLA guidelines around it, management of hypertension in pregnancy and side effects of hypertension medication. This way the Zoom meeting started becoming interesting and interactive. Some group members had attended other courses of Emedica like the AKT Pass Guarantee Package, AKT Pass+ Bundle, AKT 200 Mock Crammer etc. They shared their knowledge which was not only helping them to retain information better but it was also helpful for others like myself to fill the gaps in our knowledge.

Last 4 weeks before the Exam

When the exams were nearing my preparation intensified. We had Zoom meetings twice a week, I started revising all the topics and consolidated the knowledge. I was picking up the challenges and started solving questions wherever I could find them such as on Innovit and EKU challenges etc. I kept a track of the information posted on the Emedica Facebook page and listened to the AKT 30-day challenge before going to bed. I revised the first few pages of the BNF and Oxford handbook of general practice. For specific topics like endocrine, there are good refreshers in the oxford handbook as it is very concise and simple. I went through the recent AKT feedback report from the RCGP site and covered the missed topics, I found that many of them were covered by Dr Rahman in the National VTS teaching webinars. I went through Emedica High Yield AKT Revision topics and made sure that I knew them all. I reviewed the video recordings of the Emedica masterclass webinars, and I replayed the difficult topics a few times. I revised statistics and admin domains again 2 weeks before as I felt I could retain this information better for the exam.

Exam Day & My Results

I was nervous initially but got comfortable as I started doing questions. Graphs were less scary although few were decodable. I felt I did better than my previous sitting. I passed with an excellent score with an overall 86.93% (from 61%), evidence base 80% (from 65%) and organization 80% (from 50%). I am extremely happy with my results and gained my confidence back!

My Exam Day Tips

One of Dr. Rahman’s short video explained the importance of a good and healthy breakfast before the exam. He is just amazing and proved to be an excellent GP with a holistic approach towrads exam preparation. My top 5 exam day tips would be to:

1. Keep track of time – you want to try to attempt all the questions and keeping a close eye on the time was very helpful!
2. Don’t get scared with the look of the graph– they are solvable if you have revised the key stats topics. 
3. Read the questions carefully – often a few keywords will give you a clue to the right answer.
4. Have a good sleep the night before the exam – concentrating for 3+ hours is tough!
5. Stay confident in your knowledge – If 2-3 questions are going wrong in a row don’t lose confidence. Remember you have worked hard, and so focus on the next question – you are allowed to have a certain number of questions wrong and still pass (roughly 60 questions – a big number actually).

Finally – build resilience… you will bounce back… If I can do it, anybody can! Best wishes with your revision and the exam!