Dr Metcalf passed her MRCGP AKT in January 2023 on the 1st attempt with an overall score of 80.5%, with 95% in statistics, and 90% in the admin domain. In this article she shares her experience of preparing for the AKT, tips on things she found helped her prepare with dyslexia, and useful resources.

How I felt about AKT before I started

I was very apprehensive about sitting the AKT as I had heard many stories from my colleagues that it was a very difficult exam covering a huge curriculum and there were many doctors who failed the exam with each sitting. I have dyslexia that was diagnosed in school and I spent a lot of time considering how was best for me to approach this AKT as I have always struggled with reading huge volumes of information and retaining it adequately to do well in exams.

There were a few different things I had heard about the AKT:

1.     You need to prepare for 3-5 months to be able to have the right knowledge base to pass the AKT

2.     It is important to read widely

3.     Exam technique is important as the exam is very time pressured

4.     The stats and admin domains are easier marks in comparison to the clinical questions, so it is important to try to cover these areas well to boost your score.

My initial thoughts about the AKT were ‘As I have dyslexia I will need longer to prepare for the AKT’ ‘The curriculum is massive, I don’t know where to start’ ‘I am not sure I have the ability to read widely and take in and retain the depth of knowledge to pass the AKT’ ‘ I do not want to be one of those who fail because I have dyslexia’.

If I am completely honest I was very worried about the AKT.  I was at a very busy time of my life and I wondered how I may be able to juggle attending work with preparing for the AKT and how I would keep myself sane during the process! I could not find much information on how those with dyslexia tackled the AKT, in fact I often came across information that mentioned sometimes that people who were struggling to pass the exam were later diagnosed with dyslexia. I was determined to pass the AKT, but had prepared myself that despite my best efforts I may still possibly fail and have to re-sit.

Planning ahead – when to sit the AKT

For me, the timing of sitting the AKT was important. I wanted to give myself the best possible chance of passing the AKT so decided to sit the exam after being in a GP placement for 12 months. I made a conscious effort after each clinic to review relevant guidelines that were relevant to each patient I saw. I found this to be a very useful passive way of preparing myself for the AKT in the first 6 months of my GP placement and looking back on this now I think it did wonders for my general knowledge and was an excellent base for when I started to revise more actively for the AKT.

About 6 months before the exam I found myself in a bit of a panic, I was not sure how to tackle such a large curriculum, trying to decide which question bank was best to prepare myself best for the exam, taking into consideration what question banks I had completed in the past, and how to structure my revision. After much deliberation I decided that I would sign up to the 150 day Emedica Pass Guarantee Programme to take the stress out of revision planning and I could focus on the learning. I was initially a bit apprehensive about this as it required ~2 hours work [which I knew would be more like 3 hours for me!] each day we got sent work. I felt that the 150 day programme was better suited better to me than the 90 day programme for this reason as I was able to split the daily work over two days for the majority of the programme, making the workload more manageable. This also allowed me to time to still play sports in the evening/ socialise at weekends.

Resources used: Emedica AKT Pass Guarantee Programme – this included the Emedica AKT course, Emedica AKT 200 mock crammer, Emedica Masterclass webinars for stats, admin, high yield clinical, Emedica AKT question bank + mocks, AKT curriculum checklist, links to relevant NICE CKS guidelines, RCGP Self test questions, Medical Statistics Made Easy 4th Edition, Emedica AKT 30 day challenge YouTube videos, Emedica Clinical Case Cards. There was also reading from the Oxford Handbook of GP 5th Edition

Managing my time and finding balance

I chose to reduce my working hours to 80% LTFT to help me maintain my mental health throughout the revision period as 5 months is a long time to have your head stuck in a book for. I found this invaluable for managing my stress levels.

I felt that the programme was very well structured and did suit my style of learning. There was a lot of reading expected of us during the programme but it was reasonably varied and was followed up with relevant clinical questions meaning I was able to reinforce my reading. The programme also undoubtedly improved my exam technique and I picked up many useful exam tips and recognised the sorts of silly mistakes I was prone to – this allowed me to avoid them in the actual AKT.

My study routine: The 1st 4 months of the programme – we received an email with work / tasks every 48 hours which included a question of the day, reading, online question sets, case cards, and a weekly task which varied. In the last month, we received work / tasks every day.

– the first day I read the required reading in the evening. I tended to do the question of the day over my lunch break and read the attached link / guideline. 

– the second day I did the questions that were set and spent time going through all the answers and making sure I understood why I got something wrong (or right!) I made sure I wrote down short points about what I learnt from each question set. I then reviewed all these short points in the week before the AKT. 

– I looked at the clinical flash card over my lunch break on the second day. 

– I tended to leave the weekly tasks until my day off (due to being LTFT) or to my SDL session in GP practice. I found the videos a lot easier and less time consuming than the GP self test days. I found it took me a long time to go through all the online modules before doing the set of questions. I felt I learnt a lot more completing the modules than just doing the question sets alone. 

Time it took me to do the work:

– required reading – 1.5-2 hours (sometimes more sometimes less depending on how familiar I was with the topic I was reading) 

– question set – 1.5-2 hours (what took time was reading and understanding why I got questions right/ wrong and making note of important parts- but this was worth the extra time as it meant I revisited all the bits I found difficult in the week before the exam) 

– Clinical case card – 5 mins 

– Question of the day + reading – 5-10 mins 

Live interactive teaching sessions

I found all the interactive teaching sessions very helpful and easy to learn from. Dr Mahibur Rahman was excellent at explaining the clinical knowledge/ admin & statistics in a way that I remembered, and if I was ever unsure I had the support of the Emedica team who were able to help me understand topics I was struggling with/ advise where to do further reading etc.

Visual summaries

I found that in the lead up to the AKT I made a lot of visual one page summaries of guidelines and high yield topics as I went along that I later found very handy to revisit closer to the exam. The process of summarising guidelines in a succinct manner was one of the best ways I found to process the information and this was then supplemented by a set of relevant questions to test my understanding of the reading we had completed.

Exam day

My exam was in the afternoon so I spent the morning reviewing a few of my key notes but then tried to relax and give myself a break so I was in the best frame of mind for the exam. I found the exam horrendous and despite completing several timed mocks I found it difficult to stick to my timings as I had practiced. Many of the questions were really quite lengthy and I really felt needed my extra time. I only had ~10 minutes at the end of the exam to re-visit questions I had flagged for review. I changed a couple as I had come across the correct answers elsewhere in the exam but the rest I left as my first instinct best guess.

There were questions on topics I felt I had perhaps not covered so well, there were weirdly worded questions and there were graphs that I had never seen before despite my extensive preparations. Looking back on the exam, these were the questions I remembered and I tried not to dwell on them or try to look up the answers. I did not feel confident I had passed after the exam and felt quite frustrated at myself and the AKT. What I did know was that I had put in the work, I had certainly learnt a lot of very useful information for my clinical work and I had put all my effort into preparing for the AKT and I couldn’t ask myself for more. I tried to put the AKT behind me – I had planned a holiday for immediately after the AKT to decompress, celebrate the end of revision and revitalise myself before going back to work. This was much needed and would recommend this to anyone.

Top tips for preparing for the AKT with dyslexia – these are the things that I found helpful (many of these will apply for anyone preparing for the exam):

• Do not stress about having to ‘read widely’ / the amount of reading needed to pass the AKT. I surprised myself during the revision period with the volume I did manage to read. For me reading (even if I did not retain it all) helped me to revisit topics on a regular basis and I then managed to retain the information by testing myself with question banks. Having a regular and structured approach with set topics to cover each day will help you stay on top of your reading.
• Understand why you get questions wrong – don’t just shrug it off and move on (I know this can be easy when worried about the upcoming AKT). If you get a question wrong don’t worry, but instead take it as a learning experience and try to understand why you were wrong. I found these were the times I retained the most information. I can’t say I ever scored particularly well in question banks in the run up to the AKT but I learnt from each one I got right and wrong. 
• Organisation is key – I would recommend trying to file notes by topic so it is easy for you to review topics quickly and effectively close to the exam. 
• Make your own summaries – take time to make good summaries of topics you are less familiar with (making sure you use techniques that help you learn) – this will make it easier to revise them quickly in the last few weeks
• Know how you retain information and use it to your advantage– personally I learn from being tested and also from watching videos. Having access to the recordings after all the live teaching courses and webinars allowed me to revise specific topics using the videos. I also used plenty of colour, drawings, flow charts and saved many YouTube links during my revision period. 
• Give yourself enough time to prepare– it is better to give yourself more time than panic and try to cram- remember there is a lot to cover!
• Don’t forget to take time off to spend with friends/family– If you start early it allows for you to take some time off here and there which makes the revision period that much more manageable! 

Results day

As I was logging onto my Fourteen Fish portal for my results I was really nervous and was sure I was going to see a bad outcome. I was amazed to see that I had passed the AKT first time around. My overall result was 80.5% with 77.5% in clinical knowledge, 95% in statistics and 90% in admin. I was in disbelief and it took me a few days for the results to sink in. I did work really hard and tried my best to accommodate my learning style. I would highly recommend the Emedica AKT 150 day programme to anyone!

I hope that I may be able to give some hope to those who, like me, have dyslexia and are also preparing for the AKT.

Dr Metcalf joined the Emedica 150 day AKT pass guarantee programme and passed her MRCGP AKT in January 2023 on the 1st attempt with an overall score of 80.5%, with 95% in statistics, and 90% in the admin domain.