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The Applied Knowledge Test

The Applied Knowledge Test (AKT) is a summative assessment of the knowledge base that underpins independent general practice in the United Kingdom within the context of the National Health Service. Candidates who pass this assessment will have demonstrated their competence in applying knowledge at a level, which is sufficiently high for independent practice. The AKT can only be taken during the ST2 stage of specialist training or later.
The latest information about the AKT can be found on the College website - http://www.rcgp-curriculum.org.uk/mrcgp/akt.aspx

There is also a FAQ document here - http://www.rcgp-curriculum.org.uk/Docs/AKT%20FAQs%20and%20answers(final)%20v3.DOC

Latest dates for the AKT are on the VLE.

Eighteen top tips on passing the AKT exam

Adapted from Dr Aimee Lettis 'Top Ten Tips'

  1. Be aware of other resources which are thought to be most helpful – NICE/SIGN guidelines and the Oxford Handbook series
  2. Be prepared! Do the online Pearson Vue tutorial so you know how the computer works. On the day of the exam, make sure you know how to get to the Pearson Vue centre and when you need to be there. Get there early and then (try to) relax!
  3. Clinical update courses like the GP Update Courses are an excellent way of ensuring that you are exposed to the very latest research and evidence. The GP Update courses also provide you with an excellent 400-page handbook outlining the results of the most important research relevant primary care over the last 5 years. Handbooks like this are an excellent resource document for current needs and future reference. Delegates also receive free online access to the handbook for twelve months. 
    We have negotiated a reduced price for these courses for GP trainees from the East Midlands – they can be funded via your study leave budget.
  4. Derive a study plan from your patients by using a PUNs and DENs approach to identify areas for development and possible further reading
  5. Do it at the right time. Everyone's different but candidates generally do less well when attempting the exam too soon, certainly never take AKT before you have done a GP placement
  6. Ensure you have an effective exam technique. Be aware of common exam pitfalls, mainly poor time management, and focussing too long on questions you do not know! (200 questions in 3 hours is a mean of 54 seconds per question). Get feedback from your Programme Director team or chat to other trainees if unsure and make sure you do practise questions under exam conditions
  7. Focus on learning primary care knowledge and evidence-based guidelines related to a particular topic area rather than reading textbooks cover to cover!
  8. Give preparation for the organisational and evidence interpretation components of the exam a high priority. Trainees often struggle with these questions. You may find you need to spend disproportionately longer revising them. Remember that doing well here could be the difference between passing or not!
  9. Hard work is important, as is being organised. Consider a revision timetable or forming a study group
  10. Identify YOUR personal learning needs and target your learning accordingly. Using the e-portfolio PDP section is a good way to document this.
  11. If stats and evidence interpretation is 'not your thing' consider attending specific study events designed to help you answer those questions.
  12. If you are using online or book based practice questions ensure that you are using them to identify which parts of the curriculum in which you have a 'weakness'. That can inform your overall study plan.
  13. Memorise as much of the NICE and SIGN guidances as you can. Favourite topics include asthma, COPD, diabetes, heart failure, (well, all of them really) Check out the Pulse bite size NICE guides in the clinical tools section for quick guides to some of the guidelines.
  14. Memorise the DVLA "At a Glance Guide for Medical Practitioners to the Current Medical Standards of Fitness to Drive and the Fitness to Fly" guidance.
  15. Practise questions are vital. Doing questions from websites, books and RCGP Innovait journal are all thought to be useful in preparing for the exam, the more the merrier it seems!
  16. Read the BNF. Memorise the first 36 pages and then familiarise yourself with the main drug classes and recognised side effects. Which drugs? Analgesics, anaphylaxis, antibiotics, (do keep going past A though!)
  17. Read the RCGP feedback from previous exams. The feedback is feeding you the topics!
  18. Take the AKT seriously. Do not be tempted to think of it as an easy exam. It is only easy if you know the answers!

Which Resources are most useful?

Answers from trainees - research done in Oxford

  • AKT question website
  • AKT question book
  • Guidelines – NICE/ SIGN
  • AKT questions from RCGP Innovait journal
  • Reading – statistics book
  • Reading – Oxford Handbook series
  • Journal – RCGP Innovait
  • Revision course, e.g. Pastest
  • Evidence Based Medicine (EBM) course, e.g. GP Update/NB Medical
  • Reading – revision/study guide
  • Reading – British National Formulary (BNF)
  • Guidelines – Drugs & Therapeutics Bulletin (DTB)
  • Reading – other Guidelines – Clinical Knowledge Summaries (CKS)
  • Journal – British Journal of General Practitioners (BJGP) 
  • Journal – British Medical Journal (BMJ)

Factors contributing to exam failure

When asked specifically about the following, at least two respondents thought these factors might contribute to exam failure:

  • Inappropriate revision/exam technique
  • Lack of curriculum coverage
  • Lack of experience in UK medicine
  • Exam taken too early in training
  • Lack of time to study
  • Doing endless practice questions without using the results of those to inform areas for further study

In addition, some other potential factors are quoted below:

  • 'Many revise by tackling MRCP questions which remove the primary care context'
  • 'Extensive reading of topics/making notes seems less effective than practice questions'
  • 'Reading detailed textbooks rather than targeting learning to sample AKT questions'
  • 'Time out of medicine or a long time in another speciality before joining VTS'
  • 'Being badly prepared and failing to appreciate the depth of knowledge required'
  • 'Nerves'
  • 'Having failed at alternative career, high denial and resistance to change professional behaviours'

AKT preparation guide from Bradford VTS

http://www.bradfordvts.co.uk/MRCGP/akt.htm

This excellent guide from the Bradford VTS gives information on the Applied Knowledge Test, what it is and advice on how to, and how not to prepare for it.

How to revise for the AKT - a guide for AiTs

http://www.bromleygptp.org/Other%20documents/AKT_how%20to%20revise.htm

This useful guide from the Bromley GP training scheme gives advice on

  • when to sit your AKT exam
  • how to prepare for it
  • attitudes to the exam
  • top resources to use
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