20 July 2021 | Postgrad Advice | annie blinkhorn
Luna Williams offers advice tailored to help medical students, graduates and those training to be GPs to prepare for and pass both the MRCGP AKT and RCA exams.
General Practitioners have always been an important part of the UK’s NHS, acting as the first port-of-call for most patients requiring medical care and diagnosis. Because of this, national recruitment drives have long been focussed on helping more UK and overseas medical graduates to pass all the exams required to pass their traineeship and become fully-fledged GPs.
What’s more, the events of the last 18 months have meant the demand for GP roles in the NHS has grown, with more needed to help work through the backlog of routine and non-urgent treatments which has built-up during the peak of the Covid-19 pandemic.
Despite this, the latest data from the Royal College of General Practitioners reveals that pass rates for two essential GP exams - the Applied Knowledge Test (AKT) and Recorded Consultation Assessment (RCA) -- are lower than usual this year. In fact, data shows that an average of 1 in 4 trainee GPs fail at least one of the two.
Both these exams must be passed in order for any trainee GP who graduated from a UK medical school to practice as a GP. In light of this, we’ve put together the following advice, to help medical students, graduates and those training to be GPs to prepare for and pass both the MRCGP AKT and RCA exams.
Passing the MRCGP AKT exam
The AKT (which stands for ‘Applied Knowledge Test’) is the first of the GP training exams and is scored on your performance in a test-based setting. It is designed to assess how you can apply your knowledge of clinical medicine, evidence-based practice, and current medical data and statistics in a timed, written test.
These three areas of knowledge take up different proportions of the exam, with your application of clinical medicine taking up the majority (80%) and the other two areas each taking up 10% of the exam.
Go beyond what you know
Though you need to have a good knowledge of all areas of the clinical curriculum, the AKT goes beyond simply being able to recite this knowledge. The test is scenario based, so you should focus on being able to apply what you know about medicine to a situation. When preparing, try to bear this in mind by discussing clinical situations with a peer or friend, thinking out loud about different medical presentations, conditions and treatments. This can help to take you into a more lateral way of thinking, which can do wonders when it comes to approaching the exam.
Start revising early
According to most data, those who fail the AKT exam tend to slip up because they haven’t spent enough time preparing.We advise starting your revision at least 4 months before your exam, and building up the hours you are revising the closer you get. Those who try to cram for the AKT often fail because they are not able to properly digest and then apply the information they have learnt to the scenarios given to them.
Create resources to help retain key statistics and cases
Part of the AKT will test your ability to remember and apply up-to-date case studies, medical legislation, research and statistics. You can use a variety of methods to help you remember these so that you can easily pull them out when you need them for a scenario in the AKT. Many people choose to use flashcards, which can be a really effective way to retain large amounts of information. When using these, make sure you chunk the information out into small, manageable chunks. It is also advisable to have a friend or peer help you by asking you questions based on the flashcards. This is because the act of explaining information out loud can help to solidify it in your mind.
Passing the MRCGP RCA
The second of the two GP exams is known as the Recorded Consultation Assessment, or RCA. This assessment involves you submitting 13 recorded patient consultations, which the patient must consent to having recorded. The RCA regulations allow candidates to submit audio-only, video, or face-to-face consultations, or a combination of all three formats.
Provide consultations on a wide range of clinical topics
Make sure you use the 13 different consultations to demonstrate your understanding of as wide a range of curriculum areas as possible. Try keeping a table with each of the clinical curriculum areas to hand, so that you can keep track of which areas are covered in each consultation.
Record practice sessions
Practice is always important when it comes to any exam. As it is likely that you’ll be recording at least some of your consultations, it is worth recording practice consultations and roleplay sessions. Not only will this help you get used to the feeling of being recorded, but it will also help you analyse your performance, assess your successes, and work on areas that need improving more effectively.
Stick to a structure
During sessions, create a ‘crib sheet’ that you can see as you’re speaking with patients. This can help you to stick to a specific structure and make sure you aren’t going off on a tangent.
Be aware of your interpersonal skills
As a prospective GP, you also need to demonstrate that you have good interpersonal skills, and that you are able to make patients feel at ease in your company. This is often referred to as a doctor’s ‘bedside manner’. If you feel less comfortable in this area, it may be beneficial to prepare some statements which you can easily incorporate into your patient consultations. For instance, you may say “I appreciate you’ve been worried about this” or thank them for sharing their problems with you.
The best thing to remember when it comes to both the MRCGP AKT and RCA exams is that you are not only being asked to remember and recite information about General Practice, but you are also trying to demonstrate to examiners that you are capable of being a good General Practitioner and you should always bear this in mind when preparing for the exams.
Luna Williams is a commentator for Arora Medical Education, which specialises in providing MRCGP RCA and AKT training for GP trainees, as well as providing a range of other medical education services for national and international medical students and graduates.