Foundation SJT tips from a resitter, Part 2

Foundation SJT tips from a resitter, Part 2100281534

With FPAS applications open now, the day is getting closer- the SJT, which will rank you with the rest of the UK medical students for jobs. It seems daunting, but remember that to get this far you are a sensible, intelligent person- it’s simply a matter of showing this as best you can, with my help!

As the exam comes up, I can’t stress enough that it is different- not about knowledge but about applying the right principles to make sensible decisions. It’s really not about cramming practice questions- after finding many of the books problematic I did very few. It’s about knowing the key guidance. It’s about showing that you know the GMC Duties of a Doctor and can apply them in scenarios of day-to-day hospital life.

You will need to reduce these massive documents to frameworks that are easily memorable for you. Have an idea of the kind of situations you will need to seek help in- when will you talk to an F1 colleague? When will you escalate a problem, and to who? We found it useful to have a framework “hierarchy” of who you would go to next with an unsolved problem.

It’s also worth reading over things such as DVLA guidance and ethical guidance on issues such as confidentiality and consent, so you are prepared for any of those issues that may come up.

Last year as part of my preparation for the SJT I took a course with Emedica– part of what was so helpful about it was their clear summaries of ethical principles, conscientious objections, confidentiality and other guidance that can almost be applied as “rules” to certain questions.

Remember that the test reflects “real-life” behaviour: Are you remembering to take care of yourself in your decisions, as well as projecting the image of the perfect caring Doctor?

On the flip-side, remember that the exam tests what you should do ideally: so even if you’d be too scared to phone your Registrar in real life, so you can put the ideal option.

FPAS provides a practice paper, which is the only “official” one so you might want to consider when you use it- early on to get an idea of real questions, or closer to the exam as a “mock”.

Consider how you’ll answer the questions. With 70 questions in 140 minutes, you have just 2 minutes in which to read a question, weigh up the scenario, and mark your answer down. Usually with MCQ’s I like to go through the question paper at least twice- you won’t have time here. Also if you’re one of those people who likes to write down your answers and transfer them at the end, consider if you want to risk running out of time for that! Bring several sharp HB pencils (so you don’t waste time sharpening, or worse, waiting for an invigilator to sidle along to you to bring you a new pencil), and please, a decent rubber, so we can avoid the marksheet fiasco of 2012!

I wouldn’t recommend cramming for this exam at all. You can’t learn answers as a slight variation in a question would change it completely. (None of the past paper questions came up last year, either!) Even if it’s not your usual pre-exam style, I’d recommend a good night’s sleep and a good breakfast before the exam, so you’re awake and ready to reason out situations, and apply some well-needed common sense!

This article was written by a final year medical student at Kings College London medical school. She has since passed finals, got a great SJT score again, and is now a foundation doctor at her 1st choice Foundation rotation in London.
The Emedica Foundation SJT preparation course has been running since the first year the SJT was used for Foundation programme entry / FPAS. It has been updated to take account of the new format questions added for 2015 entry onwards.

Foundation SJT tips from a resitter, Part 1

Foundation SJT tips from a resitter, Part 1stockxpertcom_id563921_size2

I did fairly well in the SJT last year; ending up with a total score of 91.6, and landing myself my top-choice job in the hospitals I wanted.

Unfortunately for me I’m retaking the year due to OSCE difficulties, which includes everything that comes with it- including all logbook signups and, of course, the FPAS application system. So whilst digging out my SJT notes from last year, I realised that having gone through the whole experience (including it’s ups and downs!) I had some experience and advice that may prove useful to share.

As you probably know by now, it’s a bit of an odd exam, focusing not on knowledge but on appropriate reactions to scenarios, such as your senior Doctor being drunk (there were at least three questions on that last year, bizarrely) or handling a complaint from a patient. You answer each question by ranking five possible scenarios, from most to least appropriate. The tricky part comes when you realise you can’t justify your answers, or gain extra information, and have to go exactly with what’s in front of you!

So what’s the best way to learn for this new test?

It’s very tempting to try and learn the “correct” answers to a variety of questions, such as from working through the variety of SJT practice question books available. Personally, I didn’t rate any of these, as I found they each had their own biases. The Oxford Handbook version was clearly written by older Consultants with the idea of “don’t bother your seniors”- NOT the SJT ethos! Another book I found had questions on clinical scenarios- the test actually requires very little medical knowledge. We even found such bizarre options in question banks as “try to stab the patient with your pen”- unfortunately nothing in the exam was so clear-cut wrong or right!

I daresay the books/question banks will have improved this year (look out for anything on its second edition, I see on Amazon that the Oxford Handbook one is), but if you use them, use them with an open mind. Be willing to rethink answers that don’t seem right, and discuss with your peers. Remember that a slight change in the options could completely affect your answer in the exam.
(Also: order the books as soon as possible- they sell out fast, and last year one didn’t arrive for me until the week before the exam!)

My main strategy for revision was to try and get into the right “mind-set” of the test. The test isn’t about knowledge- it’s about thinking like a Doctor, and so I did my best to learn what the test was looking for, and familiarise myself with the principles I should be applying/would be tested on. To start with, you can do background reading about how the test was developed and what it is looking for. I went to for this, and specifically read through the SJT monograph which is a really good explanation of what the test is looking to measure, and how.
The UK Foundation Programme Website also provides a person specification for the SJT on their documents page.

Then I spent a lot of time reading the various GMC guidance such as Good Medical Practice (I went so far as to have a summary of this on my bedroom wall!) and Tomorrow’s Doctors. We should of course know these backwards by now, but they are very clear and thorough documents laying out everything expected of us. There are even interactive scenarios you can work through to break up the book-work: and which will help you practice all the guidance to aid recall.

Finally, I would definitely recommend going on a revision course. While my University tried to advise us on this exam, they aren’t familiar with it- but GP trainees are, having been doing SJT’s for years now. Emedica ran an intensive day course where they provided key background information, including the ethical principles, GMC guidance and day-to-day problems you may face as a junior doctor (and so on the test). They provided and confidently went through example questions; explaining the correct answers in a really sensible way that made sense. This was supplemented by a set of practice questions to go through online afterwards; which I found very useful, as I knew I could trust the examples!
The course also included a timed practice test that forced you to answer each question in a set amount of time- this is really important thing as the timing is close and indeed I know of some people whose mark dropped simply due to running out of time.

In summary:

  • Learn the background knowledge;
  • Get advice from the experts;
  • Practise putting the guidance into practice;
  • And use common sense… you’ll be fine!
This article was written by a final year medical student at Kings College London medical school. She has since passed finals, got a great SJT score again, and is now a foundation doctor at her 1st choice Foundation rotation in London.
The Emedica Foundation SJT preparation course has been running since the first year the SJT was used for Foundation programme entry / FPAS. It has been updated to take account of the new format questions added for 2015 entry onwards.

MRCGP AKT exam 2014 – key changes

MRCGP AKT Mock ExamDr Mahibur Rahman

The MRCGP AKT exam was introduced in 2007 as part of the new MRCGP examination. Since then it has been through a few minor changes relating to question formats and the passing standard. From October 2014, some important changes are being implemented. This article looks at the exam format, including the new changes.

Exam basics

The Applied Knowledge Test (AKT) is one part of the MRCGP examination. It can be taken in the ST2 year of training or later. It is a computerised test consisting of 200 questions, and can be attempted a maximum of 4 times. The major change being implemented in 2014 is that the time allowed for the exam is being increased by 10 minutes – candidates will now have 3 hours and 10 minutes to complete the exam. The other change is a minor one – an on screen calculator will be available if needed.

Exam content

The exam is based around UK general practice, with all questions being drawn from areas within the RCGP GP curriculum. The breakdown of the questions are as follows:

  • 80% (160 questions) – clinical medicine relevant to general practice
  • 10% (20 questions) – organisational – this includes administrative issues, medicolegal, practice management, GP contract, certification etc.
  • 10% (20 questions) – evidence based practice – statistics, types of study, graphs and charts etc.

Question formats

The majority of questions (about 90%) are of two formats – extended matching questions (EMQs) and single best answer questions (SBA). Candidates sitting the AKT will be familiar with this type of question from the GP Stage 2 assessments used as part of GP recruitment. The remaining question formats include:

  • Algorithm question – testing knowledge of specific guidelines or protocols – sometimes you will be required to drag the correct answer into the relevant box.
  • Picture question – this will have a scenario with a related image – ranging from an investigation, blood result, audiogram, skin lesion, otoscopy or a photo of a clinical sign.
  • Video question – this will involve a short clip (20 – 30 seconds) with a relevant question. This could show an abnormal gait, a test for a sign, a physical abnormality etc.
  • Seminal trial – this will test knowledge of a specific trial that has had a significant impact on general practice.
  • Rank ordering question – this is a relatively new format, and will ask you to order options from best to worst e.g. most secure password to least secure password
  • Short answer question – this will provide a question and then a blank space into which you have to type the correct answer. Typically the answer will be one or two words.
  • Calculation – this may involve calculating a paediatric drug dosage, converting one opioid to a different formulation, or working out the sensitivity or specificity of a test. The maths is usually limited to basic arithmetic, although an no screen calculator is now available.


The AKT is a challenging exam, and most candidates will need at least 3 months revision to be able to cover the entire curriculum thoroughly. Combining reading with practising exam level questions to time will help make your revision more effective. The Emedica AKT preparation course offers comprehensive coverage of the curriculum, with a focus on the challenging areas highlighted by examiners from previous sittings. This includes statistics and evidence based practise made simple, the organisational domain, and over 100 core clinical topics including high yield topics from previous examinations. You can get a £20 discount by using the code alumnimrcgp

Useful links:

RCGP AKT Content Guide

MRCGP AKT tips for effective preparation – from a registrar with the highest score in the country