THE AKT EXAM: what it is and how to prepare
Dr. Aman Arora – Arora Medical Education
What is covered in this article?:
- What is the AKT?
- When should I take it?
- 3 things to do before preparing
- How should I prepare?
- What happens on the day?
- My own experience
- Our AKT courses and resources
- On a final positive note
What is the AKT exam?
The AKT (applied knowledge test) is one of the three components of the MRCGP qualification – necessary to complete GP training in the UK. It aims to test your application of knowledge and problem solving – it is not simply a test of how much you know or can retain.
It is a computer-based test that lasts 3 hours and 10 minutes. It consists of 200 questions giving you an average time of 57 seconds to answer each question. There is a timer visible on screen.
The AKT can be taken from your ST2 year onwards and can be sat three times a year (usually January, April and October). You can sit it at over 150 Pearson VUE professional testing centres across the UK and have a maximum of 4 allowed attempts.
Three areas are tested:
- 80% of questions are on clinical medicine.
- 10% of questions are on health informatics and administrative issues.
- 10% of questions are on critical appraisal and evidence-based practice (statistics)
Questions can come in several types – the main being:
- Single best answer (SBA): choose only one answer eg. 1 from 5.
- Extended match questions (EMQ): longer list of answers, 2 or 3 scenarios, choose only one answer.
- Multiple best answer (MBA): choose more than one answer from a selection.
- Free text answer: need to type an answer.
An online calculator is available to use if needed.
The pass mark varies from exam to exam but tends to range from a percentage between high 60’s and early 70’s. There is no negative marking.
The current exam fee is £450 (providing you registered as an RCGP Ait after July 2015).
Exam booking occurs through the RCGP website – application periods usually open 7-8 weeks before the exam and remain open for 5-6 days.
Once you have booked and paid, you then select your preferred test centre.
When should I take it?
I have seen a trend towards taking AKT earlier and earlier. Many now attempt it at the first opportunity in ST2 and it can be a nice feeling to get one exam under your belt. I have also however seen many people struggle to get through when sitting too early for a few possible reasons:
- The job they are in doesn’t allow for effective preparation due to shift patterns/fatigue eg AMU, A&E.
- Their lack of GP experience through not having done a job in Primary care.
- Underestimating the exam and not putting in enough work; it is often perceived as the easier of the two exams.
- People taking their first attempt as a ‘feeler’ attempt – ‘lets just give it a go’.
There is no right or wrong time but if you can pass AKT in ST2, your ST3 year will certainly be a little less crowded. GP placement experience can make a difference as many questions require you think in a ‘GP mindset’ – several answers may feasibly be correct, but the most likely one from a GP perspective may be the correct one.
From experience I would say 2-4 months of proper revision seems to be average for those taking the AKT – once you decide and feel ready to sit, clear planning is required to maximise your chances of getting through.
Three things to do before you start preparing:
1) Print the RCGP AKT content guide. This document should become the guide to your preparation. The RCGP have outlined which areas will be tested in the AKT – not going through this will lead to surprises on the day. It is a long document but if you plan things well it will ensure you cover everything.
2) Review past RCGP AKT reports. After every AKT exam the RCGP produces a report including which areas candidates struggled with. It is important that you go through these for at least the 3-4 before your own exam as it is likely that these areas will be re-tested. Make sure you plan to cover these areas well before your exam date.
3) Make a timeline. Planning is vital given the huge amount of material to cover for AKT. Work out how long you have between now and your exam, and break down your revision accordingly. Which topics to have covered by when, how many questions to complete per week? etc. Lack of this may lead to haphazard preparation and an overwhelmed feeling.
How should I prepare?
For a full review of tips for AKT preparation see our article: 10 Power tips to Pass the AKT.
From my own experience with trainees preparing for AKT there are two main chosen approaches – question-bank based and ‘formal revision’ based – and I am often asked which is best. My simple answer is that relying on one alone leave can leave you a little short. No question bank can cover every aspect of the AKT, whilst purely reading books and guidelines will not given your brain question exposure. If planned well, both should be used hand-in-hand as both have advantages in terms of improving retention and performance.
Another very common question that I get asked is ‘which question bank should I use?’ I have not had experience of banks on the market all but there is one that the majority tends to use. All I say is try and have some variety. Often people rely on one bank and get very used to a certain style of question-writing – doing the same style of question 3-4000 times is bound to trigger your brain to think in a certain way and it can be very confusing when another style is suddenly encountered in the exam. Whether you have two question banks, or whether you simply hire a few AKT question books from the library, try at least two sources.
A few key references to familiarise with and keep referring to throughout preparation:
- RCGP Content Guide.
- NICE CKS guidelines.
- BNF and Paediatric BNF.
- RCGP InnovAiT journals.
- Oxford Handbook of General Practice.
On the day:
You will need to take two documents for ID on the day:
- Photographic ID (passport of driving licence photo card)
- Secondary ID (credit/debit card showing name and signature)
You wont be able to take anything into the exam room (you will be allowed to leave for water and toilet breaks).
Before you start there will be a short tutorial that gives you a feel for how the computer system works (you can also do an online tutorial at home beforehand at any time).
Results are normally published around 3 weeks after the test date via your portfolio. You will be told your overall score, the pass mark and your breakdown in the three separate areas.
My own AKT experience:
Although I passed AKT first time with a good score, my revision could certainly have been better planned! I sat AKT early in ST2 and initially underestimated how much preparation was needed. I signed-up to the usual online question banks and then didn’t do much for a few weeks. It was only after I started questions that I realised the vast amount of material that I needed to cover. After a few weeks of doing random questions here and there I took a day out and fully planned my next 2 months - holidays, break days, on-call days – all were factored in and I had a date in mind where I had to have covered everything (I was eventually one day late!)
The day itself was very reminiscent of my driving theory test! I arrived just in time after an accident blocked the road (very stressful) and hurried through my identity checks. I am sure I rushed through the first 10-12 questions due to adrenaline of nearly missing the exam but after that I settled in. I had an idea of where I should be at 1 and 2 hours and pretty much managed to stay on track. I didn’t have much time to check answers at the end but luckily didn’t feel rushed at the end (I know many people do so try and get used to timed mocks!)
I walked out as most seem to – with no idea how I did. I felt that there were quite a few ‘random’ questions and I went through periods of being 100% confident and then 0% confident during the long wait for results. Eventually I found out that I had passed and luckily I was able to leave AKT behind….only to start worrying about CSA!
Our AKT courses and resources:
1) Our flagship ‘big Mock AKT course’. Held in Birmingham, Manchester and London, we run a results-focused immersion AKT course. Experience the ‘pressure’ of the AKT with a full 200-question mock exam. Following this is 5-6 hours of complete exam breakdown. Why did you get that answer wrong when you had the knowledge? How does exam technique make a difference? Which areas do you now need to focus on?...We teach key points from all major clinical guidelines, common clinical areas that people struggle with, breakdown statistics to its most basic and cover all focal admin and management areas – minimum of 1200 learning points to focus your final revision period. In addition to this you get a full 200-slide presentation with all learning points and key revision areas.
2) Our AKT Statistics webinar. 2.5 hours of key AKT statistics in an intense, live teaching webinar from the comfort of your own home. Question examples, all the important graphs, all the key equations and overview of clinical trials and evidence-based practice.
3) Our 60-day AKT revision poster. A step-by-step guide to your AKT revision. What to revise, key areas not to miss, breakdown of key stats and admin areas. Designed for complete coverage, in full colour, large A1 size for your wall.
4) Our free AKT videos. Subscribe to our YouTube channel for some key step-by-step AKT revision videos including:
5) Our free AKT/CSA Support group on Facebook. Daily revision snaps, bites, images and videos designed for quick and efficient retention. We hit those areas that people always struggle with.
On a final positive note:
Most people get through AKT. You will get through AKT. It does however take a little planning and concerted effort. If you start early, you’re efficient in your preparation and don’t rely on one method of preparation, you have every chance of flying through this exam.
Good luck in your preparation!