akt top tips sanju joy & gareth smith. what’s so scary? medical statistics is there enough...

AKT Top TipsSanju Joy & Gareth Smith

What’s so scary?

Medical Statistics

Is there enough time?

Driving guidelines

What questions will be asked on primary care admin?

For me it was…..

Are there any things in particular that worry you?

What will be cover today?- Structure of AKT

- Applying for the exam

- How to prepare

- Where did other candidates struggle?

- Example questions

Aims & OutcomesYou should be able to…

- Identify when would be best for you to sit the exam

- Recognise the need to set aside some £££

- Understand the structure of the AKT exam & how to apply

- Recall AKT revision resources

Structure of the AKT

The AKT test- Is a 3 hr 10 mins computer-based test- Consists of 200 question items

- 80% clinical medicine- 10% critical appraisal & evidenced based

clinical practice- 10% health informatics & administrative

issues

Can anyone work out the math?(Works out at 57 seconds per question)

Clinical Medicine- Biggest part of the exam (160 questions)

- Covers practically everything…..- low impact & common conditions (e.g. sore throat,

URTI’s)- high impact & rarer (e.g. Child abuse, meningitis)

Tip:- Look at topical things (read new NICE guidance,

check BMJ/BJGP)

- Refer to GP curriculum

Medical Statistics- Only 10% of exam (i.e. 20 questions)- Keep in perspective….

- YES…difficult to pass exam if do not get any of these marks

- BUT…shouldn’t revise medical statistics to the detriment of clinical medicine

- Make sure you know the basics- Mean/mode/median- PPV/NPV- Sensitivity/specificity- Standard deviations

From Oct 2014 there is an on-screen calculator available

Tip:

Health informatics &administrative issues- Another 10% (20 questions)- Includes….

- Legal aspects (e.g. DVLA)- Social services (e.g. Certification)- Professional regulation (e.g. GMC)- Business aspects (e.g. GP contracts)- Prescribing (e.g. Controlled drugs)- Health & safety (e.g Needle stick injuries)- Ethical (e.g. Mental capacity & consent)

How many pass?

How difficult do you think the AKT is to pass?

April 2015

(i.e. 65%)

Applying for the exam

When should I take it?

You need to prepare for AKT so think about when would be best for you…

Applying- Can be taken during or after the GPST2- A maximum number of 4 attempts will be

permitted(On your e-portfolio)

Applying (2)- Apply through the RCGP website

- AKT costs £530(or £477 if you are an AiT member)

Though as part of your AiT you ‘build a fund’ which you can put towards the cost of your exam

Where to take the test

Tip: Apply early to avoid disappointment!!

How to prepare…

RCGP Content guide

Available at:

http://www.rcgp.org.uk/training-exams/mrcgp-exams-overview/~/media/D96EB4E0188E4355BCC9221B55859B08.ashx

(54 pages telling you what could be in the exam)

Demonstration tutorial

The RCGP strongly recommends that candidates familiarise themselves with this on the Pearson VUE website…

http://www.pearsonvue.com/rcgp/

Common reference materials- GP curriculum- BNF- GMC Good Medical Practice- RCGP Essential Knowledge Updates- NICE Guidelines- SIGN Guidelines- BMJ review articles & original papers- BJGP

Other revision toolsInternet:- Pastest (£55 until Oct, £85 for Jan)- BMJ On examination (£50 - £120 for 1 – 6 months)- Pass medicine (£25 for 4 months, £35 for 6 months)- RCGP has sample Q’s with answers

Books:- Succeeding in the MRCGP AKT, C Mehta, M

Williams and M Mehta (£19.99)- Medical Statistics made easy, M. Harris & G. Taylor

(£16)

What did I use?

BMJ On examinationOxford Handbook GP

Medical Statistics Made Easy

Dermnet NZ DVLA Guidance

When should you start revising?- Everyone’s different

- BUT….remember there is a lot to cover

- The earlier you start the more you get out of Pastest/On examination

On the day TIPS…- Don’t forget your identification

documents!

- Arrive early

- Keep a close eye on the time!

(Time is everything! – better to skip questions you struggle with rather than wasting time)

On the day TIPS…- Don’t leave any questions unanswered –

there is NO negative marking

- (If you have time) check through your answers to avoid silly mistakes

Question Types

The questions- All written by working GP’s

- All reference to NATIONAL not local guidelines

- Are not opinion – they can be supported with reference to facts & guidelines

Question types- Single Best Answer (SBA)- Extended Matching Questions (EMQ)- Multiple Best Answer (MBA)- Table/Algorithm- Picture format- Drag and drop- Data interpretation- Free text- Rank ordering

Picture FormatPicture Format  THEME: Eye problems A 42-year-old woman who has previously had

treatmentFor cervical CIN 2, has had a lump affecting herleft upper lid for three months. It is asymptomatic.  What is the single most likely diagnosis in this

patient?

Select one answer only A entropionB meibomian cystC metastatic depositD styeE xanthelasma

Data InterpretationA meta-analysis examines whether giving a new dietary supplement to patients who've recently had a myocardial infarction can help prevent a further attack. The meta-analysis consists of four randomised controlled trials and is summarised below:

What is the most appropriate interpretation ofthe data?

A. There is publication bias in studies looking into this questionB. There is a non-significant trend that taking the supplement reduces the chance of a further myocardial infarctionsC. There is a non-significant trend towards no benefit from taking the supplement in terms of reducing further myocardial infarctionsD. Taking the supplement reduces the chance of a further myocardial infarctionsE. Taking the supplement increases the chance of a further myocardial infarction

Data Interpretation (2)A rapid finger-prick blood test to help diagnosis deep vein

thrombosis is developed. Comparing the test to current standard techniques a study is done on 1,000 patients:

What is the specificity of the new test? A. 680/880 B. 200/220

C. 680/780 D. 680/700 E. 200/300

DVT present DVT absent

New test positive 200 100

New test negative 20 680

Scoring- All question formats have equal weighting

- Each correctly answered question is awarded one mark

- Total score on the paper is the number of correct answers given

- No negative marking – it is important to answer all the questions

Where did others go wrong?

Vital statistics – AKT January 2015

AKT 23 pass mark = 143/200 (71.5%)

Overall pass rate = 75.8%

ST2 first-time takers pass rate = 83.2%ST3 first-time takers pass rate = 67.3%

Cumulative pass rate after four attempts for all those who take AKT is approximately 95%

Areas of difficulty in Jan 2015- Promoting health and preventing disease

National screening programmes, immunisations

- Care of acutely ill peopleAcute but rare illness, anaphylaxis, CPR

- Care of children and young peopleSerious but rare, asthma management

- Women’s healthContraception e.g. ‘quick-start’

- Care of people with neurological problemsManagement of different types of headache

Types of question that caught me out…

Consultation ModelsWhich one of the following consultation models advocates

managing the presenting complaint, managing ongoing health problems and modifying health seeking behaviour?

 A. Neighbour B. Fraser C. Pendleton

D. Stott and Davis E. Stewart

BNF QuestionsThe following symbol appears in the British National Formulary:

  What does it mean?

A. Newly licensed medicine B. Not prescribable on the NHS C. Denotes a preparation that is less suitable to prescribe D. Should only be prescribed by a specialist E. Controlled drug

Example Questions

Over to Sanju…

Take home messages- Think about when would be best for you

- Start revising early

- Remember ‘Time management’

- Prepare and pass first time!

Thanks.Any questions?

And….GOOD LUCK