A
AKT
Exam Format – The exam lasts for 3 hours, There are 200 question stems. All questions are marked equally and there is no negative marking. Candidates answer questions at a computer terminal at one of the Pearson Vue test centres. Laminated paper and a pen is provided for workings out (nothing may be taken into the exam room).
There are 3 sittings a year and applications can be made from the ST2 year onwards.
Question types include
– single best answer & extended matching questions
– tables and algorithms for completion
– picture format questions
– data interpretation
– seminal trials questions.
The AKT exam content is divided into three areas
• 80% clinical medicine and problem-solving
• 10% critical appraisal and evidence-based clinical practice
• 10% administration, ethical and legal (this covers knowledge of regulatory frameworks (e.g. GMC guidance,the GP contract) and areas such as medical driving rules and health and safety
Exam Tips
Try to identify Your weakest areas. Improvement in these areas is likely to lead to the biggest improvement in your total score, provided the topics carries a significant proportion of the total mark. Identify your weak areas and tackle these early. Read the questions carefully
Fees
AKT fees 2011/2012
Associate in Training £441
Non-AiT £490
CSA fees 2011/2012
Associate in Training £1481
Non-AiT £1646
FREE CSA Cases
Atrial Fibrillation – CHADS VASC Risk Score
B
BNF (adults)
BNF (children)
BASHH guidelines (British Association for Sexual Health and HIV)
C
Cardiovascular Risk Score (QRisk2)
Clinical Knowledge Summaries – CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available.
Cognitive Behavioural Therapy (Mood Gym online CBT)
e-couch – It is the newest online program for preventing and coping with depression, generalised anxiety disorder, and social anxiety disorder (and like MoodGYM it’s free!).
Complementary medicines – National electronic Library for Medicines
CSA
Exam Format – ‘ It is an assessment of a doctors ability to integrate and apply clinical, professional, communication and practical skills appropriate for general practice’ .(RCGP 2007).
13 cases, 2 minutes between cases.
1 or 2 examiners observing the consultation.10 minutes per consultation.
Candidates stay in their consulting room for all cases excepting telephone and home visit consulations.
The total exam lasts approximately 3 hours, There is a break in the middle of the exam for refreshments.
Three domains are assessed
– Data gathering, technical and assessment skills, Clinical management skills and Interpersonal skills
CSA Exam Tips
The best and easy way to pass your CSA exam is to practice as many cases as you can.
Try to develop a structured approach to consulting and practice it in your working day consultations.
Form practice groups with at least 3 people. One acts as the examiner, one the actor and one the candidate. Try to take the acting as seriously as possible and simulate realistic patient responses.
CSA courses are of great value in improving your consultation skills.
CSA course will help you to identify your blind spot.They will be able to better replicate the exam scenario (with realistic actors, better replication of the exam environment, more realistic pressure and experienced feedback).
It will help you to assess your performance and compare it against your colleagues.
It can also recommend tips and solid blue prints to tackle the consultations to optimise your performance and provide useful practical advice for you (where to stay, how to get there, what the venue looks like, what happens on the day etc…).
Take a course just before your exam to check how you are performing OR take a course earlier in your training to assess your performance.
I would recommend the second option as it can otherwise be too late to rectify and improve, leading to an expensive mistake (also bear in mind that the number of attempts at the CSA is limited and IT IS AN EXIT EXAM :-@.
Try my FREE CSA practice cases which are in the style of the exam.
If you would like to book on a CSA course – Email me to csasmartgroup(at)gmail.com.
Feel free to come for one of my FREE CSA Practice sessions on Saturdays for Retakers.
Email me to csasmartgroup(at)gmail.com.
Take a CSA course early to get an idea of how well you are performing in a pressured environment and how you can improve.
If you are an international medical graduate it may help if you practice in groups with UK graduates to help develop your phrasing and to get a clearer picture of your performance.
UK graduates of all ethnic groups perform better on average than non UK graduates.
CSA fees 2011/2012
Associate in Training £1481
Non-AiT £1646
Pass Rate
67.6% First time applicants
69.6% ST3 First time applicants
76% ST2 First time applicants
Fail Rates by Ethnicity
4.6%White,16.3%Asian,29.4%AfroCarr
Fail Rates by Country of Graduation and Sex.
9.1% UK Graduates (Male 12%, Female 6%)
24.8% European Graduates (Male 43%, Female 27%)
43.1% International Medical Graduates (Male 31%, Female 28%)
Summary
First time applicants have the highest pass rates.
Based on RCGP results there is no statistical advantage to delaying your AKT until ST3.
Consider taking the AKT late in your ST2 year to clear this hurdle before the very busy ST3 year.
Female applicants have consistently higher pass rates than their male counterparts.
– White Female UK Graduates as a group have the highest chance of passing.
– Male International Medical Graduates have the lowest chance of passing.
– The AKT is anonymously marked removing marker bias against candidates based on their ethnicity or sex.
FREE CSA Cases
D
DVLA Driving Rules for Medical Conditions
E
Changes to the RCGP Curriculum
F
Frequently Asked Questions about the revised
Family Planning (Faculty of Sexual & Reproductive Healthcare Guidelines)
Fitness to Fly (UK Civil Aviation Guidelines)
G
Guidelines
NICE (National Institute for Clinical Excellence)National Prescribing Centre
SIGN (Scottish Intercollegiate Guidelines Network)
H
Healthtalkonline (A database of patients experiences of different health conditions)
N
NICE (National Institute for Clinical Excellence)
O
Online Cognitive Behavioural Therapy
Osteoporosis Risk Score (Frax)
P
Patient UK (Professional Reference Articles and Patient Leaflets)
Prescribing
BNF (adults)
BNF (children)
MUST Score (malnutrition score for prescribing food supplements)
Q
R
Risk Scores
Atrial Fibrillation Stroke Risk (CHADS VASC)
Cardiovascular Risk Score (QRISK2)
MUST Score (malnutrition score for prescribing food supplements)
Osteoporosis Risk Score (Frax)
TIA Risk of Early Stroke Score (ABCD2)
T
TIA Risk of Early Stroke Score (ABCD2)
Travel Guidelines (NATHNAC)
W
WPBA
ARCP (Annual Review of Competence Progression)
The ARCP report provides evidence that you have met the competences required for your stage of training and are doing so at an appropriate rate. The review is done by your educational supervisor and happens at the end of each ST training year. If there have been concerns with your progress or with a training post, then you may be asked to attend a meeting with a panel to review your progress.
The final ARCP report is made at the end of ST3. A satisfactory report provides the required evidence for the granting of a Certificate of Completion of Training (CCT) and the right to practise as a GP in the UK.
CBD (Case Based Discussion)
Case-based discussion is a structured interview designed to explore professional judgement exercised in clinical cases which have been selected by the GP trainee and presented for evaluation. Evidence collected through CBD interviews will support the judgements made about trainees at the interim and final reviews throughout the entire programme of GP training.
COTS (Consultation Observation Tool)
The COT usually involves your trainer reviewing videos of your consultations and assessing them but can also be done by your trainer sitting in with you during a surgery. After videoing your consultations you should meet with your trainer to discuss and assess them against the COT consultation criteria.
The COT marking sheet looks at 13 areas of the consultation. For each area you will be marked are marked as either competent, excellent, needs further development or insufficient evidence. You are also given a mark for your overall performance. The overall performance mark compares your performance to that expected of a fully qualified GP.
COT Marking Criteria
1. Encourages the patients contribution
2. Responds to cues
3. Places complaints in a an appropriate psychosocial context
4. Explores the patients health understanding
5. Includes or excludes likely relevant significant conditions
6. Appropriately examines (physical or mental state examination)
7. Explains the problem in appropriate language
8. Makes an appropariate working diagnosis
9. Seeks to confirm the pateints understanding
10. Makes an appropriate management plan
11. Gives the patient opportunity to be involved in significant management decisions
12. Makes effective use of resources
13. Specifies the conditions and interval for follow up
Consultations should be selected across a range of patient contexts and over the entire period of training spent in general practice and should include at least one case from each of the following categories:
Children (a child aged 10 or under)
Older adults (an adult aged more than 75 years old)
Mental health
To help you check that you cover the competencies required in a variety of cases you can download the COT grid developed by the Bradford VTS. Cot Grid Tool
Make sure you get your patients signed consent to video. Your practice should be able to provide you with a copy of the consent form.
Multi Source Feedback
Multi Source Feedback is a way of collecting the opinions of your colleagues on how you are performing. Colleagues are asked to provide comments on your clinical performance and professional behaviour. You are required to complete 2 MSFs for each year of training (usually one per post).
OOH – Out of Hours
Your are required to complete 24 hours of OOH training per 6 months GP post. Roughly one per month. So 18 sessions in 18 months of GP post.
Naturally Occuring Evidence
In other words it can be more practical to demonstrate some of the curriculums required competencies by using natrually occuring evidence such as Significant Event Analysis,Audit,Research Projects,CaseStudies, Presentation, Complaints.
These should be documented and filed in your e-portfolio. The Yorkshire and Humber deanery provide some useful guidance on naturally occuring evidence and a link is included here.
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Thats all for mow.
If you know more, add them in the comments section.
To Your Success,
Hema xoxo.