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.

Preparation

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

Salaried GP Posts – Advantages and Disadvantages

Dr Mahibur Rahman

Many doctors spend a large part of their careers working in a salaried capacity. For some doctors, it is the first step on the path to a partnership, for others, working as a salaried GP bring the benefits of working in general practice without the extra responsibility, time and uncertainty of partnership. Here is a comprehensive guide to some of the advantages and disadvantages of working as a salaried GP:

Advantages

Stability

As a salaried GP, you will have a stable work environment, being able to develop a working relationship with members of the team. You will be able to plan your finances as you will have a fixed monthly income. You should have a structured working week, making it easier to plan social engagements, childcare etc. Having a regular workplace also makes it easier to access CPD, to take part in audit and significant event analysis – all of which are important as part the appraisal and revalidation process.

Employment rights

As an employee, you have significant rights. First, you have entitlement to sick pay, a minimum amount of paid annual leave, paternity / maternity pay and leave and unpaid time off for compassionate leave. After working for 2 years in the same employment, you also gain full employment rights including the right to redundancy pay. Usually your past NHS service would be recognised towards this as long as you have not had a break in service. Employment rights are one of the biggest advantages of being an employee.

Fixed commitment

As a salaried GP you should have a job plan outlining your duties, and your work time commitment should be fixed. If the practice suddenly needs extra cover, while your employer can request that you do an extra shift, you do not have to accept, and they cannot demand that you provide the extra cover. Your main commitment will be to clinical work, and many doctors prefer this – managing other employees, dealing with the upkeep of the building, keeping an eye on the accounts will not be your responsibility.

Disadvantages

Pay

Salaried GP pay is very variable throughout the UK, and even between practices within the same region. The review body recommended range for salaried GP pay for full time doctors (working 9 sessions) is currently £55,965 and £84,453 (2016 figures). These figures apply to doctors working for GMS practices or for PCOs directly. PMS and APMS practices are free to offer any salary they wish. Average pay for salaried GPs in the UK working in either GMS or PMS practices in 2013-2014 (last available actual figures) was £54,600. This figure includes those GPs working less than full time (i.e. less than 9 sessions), which make up a large proportion of salaried GPs.

In some cases, if there is a shortage of applicants, or if you are taking a salaried role with additional responsibilities, pay can be much higher, or include a “Golden Hello” – an incentive to take a post in a specific area. In the current climate of GP shortages though, you may be able to negotiate a good overall package, especially if you have additional skills that can bring the practice extra income (such as fitting coils and implants, offering joint injections etc.). In many cases, actual take home pay for a full time salaried GP may be similar to a full time partner in a practice with below average profits once you take into account deductions for NHS pensions and indemnity.

Lack of Control

As a salaried GP, you will have less control on the direction of the practice or the services offered. You may also have less flexibility in terms of how much leave you have or when you take it, compared to working as a locum or a partner. Over time, some doctors find that the workload expected of them can creep up, with additional time and responsibilities expected that are not always reflected in additional income.

Summary

shutterstock_98508338Like any job, there are both advantages and disadvantages to working as a salaried GP. Hopefully this article is a good starting point to thinking about how whether working as a salaried GP is for you.  Please feel free to contact us with any queries you may have about your career – we will always do our best to offer advice and support.

Please post a comment and share your tips and advice for newly qualified GPs.

MRCGP AKT Exam Revision – High Yield Topics from the April 2014 AKT Exam

MRCGP AKT Exam – High Yield Topics from the April 2014 AKT Exam

Dr Mahibur RahmanDrug dosage

After each MRCGP AKT examination, the examiners release a report highlighting key information from the last exam. This includes pass marks and rates, and also key topics – both those that were answered well, and those that GP trainees performed poorly on. These topics are frequently examined again in the next few sittings of the AKT exam, so it is worth ensuring that you have a good understanding of them.

As some of you may be starting to think about the October 2014 MRCGP AKT Exam at the moment, we thought it would be helpful to look at the high yield topics from the latest examiners’ report.

Key facts from the April 2014 MRCGP AKT exam:

The top score was 95%
The mean score was 72.2%
The lowest score was 43%
The pass mark was 67% (this is one of the lowest it has ever been so far)
The pass rate was 72.5%

Scores by domain:

Clinical medicine – 72.5%
Evidence interpretation – 73.8%
Organisational – 67.9%

High Yield Topics

The examiners’ report from this diet of the MRCGP AKT exam highlighted the following key topics:

  • Drug dosage calculations
  • Drugs administered by other health professionals
  • Good Medical Practice – 2013 GMC guidance
  • Contraception – including LARC and drug interactions
  • Acute infections – antibiotics and prophylaxis
  • Mental health – diagnosis and management of anxiety
  • Digestive health – irritable bowel and coeliac disease
  • Death and cremation certification
  • Substance misuse – including treatment of withdrawal symptoms
  • Poisoning – symptoms and management
  • Psoriasis – diagnosis and management

The MRCGP AKT is a comprehensive examination, so it is important that you cover the entire curriculum. Remember that 80% of the marks are related to applying knowledge relating to clinical medicine in general practice, 10% to evidence interpretation and 10% to the organisational domain.

Emedica Alumni can get a £20 discount off the Emedica MRCGP AKT course by entering this code when booking: alumnimrcgp

Our AKT course offers comprehensive coverage of all 3 domains, and is updated after every exam to take account of high yield topics from the examiners’ feedback reports.

Further reading:
Complete Examiners’ report – April 2014 MRCGP AKT Exam

Developing a career as a Portfolio GP

Dr Mahibur Rahman

You may have heard the term “portfolio GP” more frequently over the last few years. This is an umbrella term used to describe any GP that has multiple jobs or that does multiple types of work within their working week. Most portfolio GPs have a primary job – this could be a partnership, a part time salaried position or being a locum GP, with one or more additional jobs in their portfolio.

Many GPs develop a portfolio over time almost by accident – what starts as a one off extra session working in a prison for example can become an interesting part of the regular working week.

The range of additional jobs that you might develop an interest in as part of your portfolio is huge – from developing a specialist interest, to taking on a management role as part of the CCG. Some of the more flexible additions to a portfolio can include:

  • Medical Education
  • Forensic Medical Examiner
  • Prison Doctor
  • GP with Specialist Interest (GPSI)

In this article I will discuss some of these options in a bit more detail.

Medical Education

There are various ways to become involved in medical education, from the occasional teaching and supervision of medical students on placement at the practice to becoming a GP trainer or Training Programme Director. Teaching can be very rewarding, as well as acting as a stimulus to refresh your own knowledge and to keep up to date.

Teaching Medical Students and Foundation Trainees

Most medical schools require doctors that will be teaching students on placement to attend a short training course (often over 1 or 2 days), and then to attend annual training days. Beyond this, you will not need to have any formal medical education qualifications. For teaching Foundation trainees, most deaneries require a similar amount of training.

Clinical Tutor

Many medical schools recruit qualified GPs to become clinical tutors to facilitate small group teaching, or teach clinical and communication skills for undergraduates at the medical school. Having experience in teaching will make you a more attractive candidate, and medical schools often offer further in house training as well as support to complete a postgraduate certificate or diploma in medical education. Time requirements are usually 1-2 sessions a week.

GP Trainer

The requirements to become a GP trainer vary by deanery, although there are some requirements that are fairly common throughout:

  • MRCGP – either by examination or via portfolio
  • Training in teaching – either a trainers’ course or a postgraduate certificate or diploma in medical education.
  • Experience – the minimum post CCT experience varies from 2 years to 5 years.

There are also requirements that need to be met in relation to the training practice. A trainer would usually need to put aside the equivalent of 2 sessions a week to allow time for supervision, tutorials and ongoing workshops for trainers.

Training Programme Director

Programme Directors (formerly known as VTS Course Organisers) have responsibility for organising the regular teaching for Speciality Training schemes, as well as supporting trainers. Programme Directors are usually appointed via deaneries, and again requirements vary across the county, although most require experience of teaching and a formal postgraduate qualification in medical education at diploma or Masters level. Many Programme Directors are experienced trainers. The time commitment required is usually equivalent to 2 sessions a week or more. In many areas with larger training schemes, there are multiple Programme Directors for the same area.

Prison GP

Working as a GP in secure environments may seem daunting, however it can have many benefits. There is currently a huge shortage of GPs in the prison service, so the rates paid are usually very good. The work includes GP style clinics and ward rounds for inmates – you will usually be well supported with an experienced nursing team, and guards are nearby (they can be in the room on request in some cases). As well as acute illness and ongoing management of chronic disease, there is a high proportion of patients with mental health issues and drug misuse problems. Undertaking the RCGP Drug Misuse certificate can be useful to give you more confidence in dealing with this aspect of the work. If you are not sure if this is for you, contact your local prison and talk to the lead clinician – in most cases they will be happy to show you around the unit and offer some induction and training. There is also usually some need for on call cover, although this varies at different units.

Portfolio GP

Forensic Medical Examiner

Forensic Medical Examiners (formerly Police Surgeons) work with police forces to provide assessment and treatment to victims of crime and persons in custody. Many FMEs are GPs that work with the police as an additional role. The work can be interesting and varied, and will include assessment and treatment of injuries, minor illness, sudden illness in custody, and assessment of victims of sexual assault. Most FMEs work as part of a group of doctors that provide cover for one or more police stations day and night. A lot of the time you may be able to be on call from home, with extra fees payable for each visit to the station. Another aspect of the work of the FME involves giving evidence in court.

GP with Specialist Interest (GPSI or GPwSI)

A GPSI is a GP that has gained additional skills allowing them to offer services that have tradionally been offerd in secondary care. They can range from ENT or minor surgery to dermatology, sexual health or musculoskeletal medicine. Usually, there is a process of accreditaion that will require relevant additional qualifications and experience and then getting signed off by a consultant to state that the practitioner is capable of independent practice. Once accredited, a practice may be able to bid for work from a CCG that will allow them to accept referrals from other practices within the area. Having a special interest can make you more attractive to a practice, and a practice offering a successful GPSI service can bring in valuable extra income. There are dozens of possible special interests, and so we will look at this in more detail in a separate article.

Variety is the spice of life

These are just a few examples of some of the options you might build into your career as a portfolio GP. I know GPs that work as civilian medical practitioners on military bases, work as team doctors for sporting clubs, are involved with the air ambulance or emergency services One of the great things about being a portfolio GP is that working in different roles can help keep you stimulated and reduce the chances of burnout. I find that for me, it really is true that “a change is as good as a rest”!

Dr Mahibur Rahman is a portfolio GP and the author of “GP Jobs – A Guide to Career Options in General Practice”. 

MRCGP AKT Exam Revision – High Yield Topics from the January 2014 AKT Exam

MRCGP AKT Exam – High Yield Topics from the January 2014 AKT Exam

Dr Mahibur RahmanHuman eye

After each MRCGP AKT examination, the examiners release a report highlighting key information from the last exam. This includes pass marks and rates, and also key topics – both those that were answered well, and those that GP trainees performed poorly on. These topics are frequently examined again in the next few sittings of the AKT exam, so it is worth ensuring that you have a good understanding of them.

As some of you may be revising for the April 2014 MRCGP AKT Exam at the moment, we thought it would be helpful to look at the high yield topics from the latest examiners’ report.

Key facts from the January 2014 MRCGP AKT exam:

The top score was 95%
The mean score was 75.8%
The lowest score was 39.5%
The pass mark was 70.5% (this is the highest it has ever been so far)
The pass rate was 74.7%

Scores by domain:

Clinical medicine – 76.3%
Evidence interpretation – 74.3%
Organisational – 73.3%

High Yield Topics

The examiners’ report from this diet of the MRCGP AKT exam highlighted the following key topics:

  • Hypertension – NICE guidelines on management
  • Good Medical Practice – 2013 GMC guidance
  • Freedom of Information
  • OTC supplements and interactions with drugs
  • Normal childhood development
  • Eye disease – acute eye problems
  • Certification – fitness to work / Med3
  • Osteoporosis – DEXA scan interpretation
  • Diabetes – diagnosis, management (including insulin therapy)

The MRCGP AKT is a comprehensive examination, so it is important that you cover the entire curriculum. Remember that 80% of the marks are related to applying knowledge relating to clinical medicine in general practice, 10% to evidence interpretation and 10% to the organisational domain.

Emedica Alumni can get a £20 discount off the Emedica MRCGP AKT course by entering this code when booking: alumnimrcgp

Our AKT course offers comprehensive coverage of all 3 domains, and is updated after every exam to take account of high yield topics from the examiners’ feedback reports.

Further reading:
Complete Examiners’ report – January 2014 MRCGP AKT Exam

MRCGP AKT Exam Revision – High Yield Topics from the October 2013 AKT Exam

MRCGP AKT Exam – High Yield Topics from the October 2013 AKT Exam

Dr Mahibur Rahman

After each MRCGP AKT examination, the examiners release a report highlighting key information from the last exam. This includes pass marks and rates, and also key topics – both those that were answered well, and those that GP trainees performed poorly on. These topics are frequently examined again in the next few sittings of the AKT exam, so it is worth ensuring that you have a good understanding of them.

As some of you may be revising for the January 2014 MRCGP AKT Exam at the moment, we thought it would be helpful to look at the high yield topics from the latest examiners’ report.156204109

Key facts from the October 2013 MRCGP AKT exam:

The top score was 94%
The mean score was 73.2%
The lowest score was 43.5%
The pass mark was 67%
The pass rate was 76.1% (this is one of the highest pass rates in recent years)

Scores by domain:

Clinical medicine – 72.9%
Evidence interpretation – 69.4%
Organisational – 79.3%

High Yield Topics

The examiners’ report from this diet of the MRCGP AKT exam highlighted the following key topics:

  • Drug interactions for common drugs – statins, macrolides, oral anticoagulants
  • Management of type 2 diabetes
  • Psoriasis – diagnosis and management
  • Oral contraception and LARC
  • Pre-employment vaccinations
  • Incontinence
  • Peripheral vascular disease
  • Dementia – management and diagnosis
  • Diabetes – diagnosis, management, interpreting diabetic blood results

The MRCGP AKT is a comprehensive examination, so it is important that you cover the entire curriculum. Remember that 80% of the marks are related to applying knowledge relating to clinical medicine in general practice, 10% to evidence interpretation and 10% to the organisational domain.

Emedica Alumni can get a £20 discount off the Emedica MRCGP AKT course by entering this code when booking: alumnimrcgp

Our AKT course offers comprehensive coverage of all 3 domains, and is updated after every exam to take account of high yield topics from the examiners’ feedback reports.

Further reading:
Complete Examiners’ report – October 2013 exam

MRCGP AKT Exam Revision – High Yield Topics from the May 2013 AKT Exam

MRCGP AKT Exam – High Yield Topics from the May 2013 AKT Exam

Dr Mahibur Rahman

After each MRCGP AKT examination, the examiners release a report highlighting key information from the last exam. This includes pass marks and rates, and also key topics – both those that were answered well, and those that GP trainees performed poorly on. These topics are frequently 135018281examined again in the next few sittings of the AKT exam, so it is worth ensuring that you have a good understanding of them.

As some of you may be starting your revision for the October 2013 MRCGP AKT Exam, we thought it would be helpful to look at the high yield topics from the latest examiners’ report.

Key facts from the May 2013 MRCGP AKT exam:

The top score was 97%
The mean score was 72.74%
The lowest score was 38%
The pass mark was 68%
The pass rate was 71.4%

Scores by domain:

Clinical medicine – 72.6%
Evidence interpretation – 76.0%
Organisational – 70.4%

High Yield Topics

The AKT summary report after each AKT exam usually highlights topics that were either not answered well by many candidates, or that although were tackled well, were important enough to be mentioned by the examiners. This is usually a clue that these topics will be retested in the next few sittings of the exam.

The examiners’ report from this diet of the MRCGP AKT exam highlighted the following key topics:

  • Management of hypertension
  • Fitness to work certification (sick notes)
  • Drug interactions
  • Skin lesions – recognising common and serious conditions
  • Screening programmes
  • Drug monitoring – blood tests
  • Enteral feeding – including complications
  • Emergency contraception
  • Diabetes – diagnosis, management, interpreting diabetic blood results

The MRCGP AKT is a comprehensive examination, so it is important that you cover the entire curriculum. Remember that 80% of the marks are related to applying knowledge relating to clinical medicine in general practice, 10% to evidence interpretation and 10% to the organisational domain.

Emedica Alumni can get a £20 discount off the Emedica MRCGP AKT course by entering this code when booking: alumnimrcgp

Further reading:
Complete May 2013 AKT Summary report

Improving feedback from the MRCGP CSA examination

Improving feedback from the MRCGP CSA examination

Dr Mahibur Rahman

We are often contacted by GP registrars or GP trainers requesting support with understanding the feedback from the MRCGP CSA. Many doctors have commented that they find the feedback difficult to interpret. This has been recognised as an important issue and recently a motion was passed at the LMCs conference calling for immediate improvement in the feedback from the CSA. In this article Dr Mahibur Rahman looks at the current feedback, the areas that could be improved and suggestions on ways to make the feedback clearer and more helpful for both trainers and registrars.

Understanding the current CSA feedback

Currently there are 2 main sections to the feedback from the CSA. The top part gives the candidate’s total score from all 13 cases (out of 117), with the pass mark for the date they sat the exam. This total score is based on the summative part of the assessment, which is based on 3 domains for every case: data gathering, clinical management, and interpersonal skills.

For each domain, a candidate is graded with a score attached to each grade as follows: Clear pass: 3 marks, Pass: 2 marks, Fail: 1 mark, Clear fail: 0 marks. This gives a total score for each case of between 0 and 9.

To gain a pass, a candidate must get an overall score equal to or above the pass mark for a given day. This is adjusted each day using the borderline group method to ensure the standard of the exam remains the same each day. The actual pass mark is variable with a usual range between 72 and 77 out of 117.

The second part of the feedback is formative – it relates to the 16 feedback statements provided by the RCGP in a grid. This grid can provide information on consulting areas that a candidate could improve on. It is important to understand that this part does NOT determine the score or whether a candidate has passed or failed – it is formative, and aimed at helping doctors identify areas of their consulting that they could improve. The current feedback looks like this:

CSA feedback current

What are the problems with the current feedback?

There is no breakdown of the marks awarded from each case (out of 9), and no way for a candidate or trainer to see clearly if marks were dropped in data gathering, clinical management or interpersonal skills for each case, or as a general trend over the course of the whole exam.

In some cases, the formative feedback can help identify areas to work on, but in some cases it can lead to confusion. A common source of confusion relates to the fact that candidates with the same number of crosses can have very different scores. Finally, where a candidate has no crosses relating to a specific case, many candidates think that it means they must have scored very well, or at least gained 6 or more marks out of 9. However it is impossible to tell how well or poorly they have performed in that case from the lack of crosses– they could have scored anywhere from 0 to 9. This is because:

  • The formative feedback does NOT determine the score for a case – this is determined by the performance in the 3 domains being assessed. Scores for these are not provided in the current feedback as standard – candidates that want to access these scores can request their mark sheets under the Data Protection Act.
  • Only feedback statements that were flagged in 2 different cases show up in the feedback provided to candidates – there are hidden crosses where a statement was only flagged in a single case. A candidate with no crosses could actually have had several crosses relating to feedback statements that did not occur again in other cases. This could have led them to score very poorly in that case, but they would not know it from looking at the feedback.

This candidate failed the CSA by a few marks – look at the formative feedback for their first 3 cases:

CSA formative feedback - current

This candidate scored 7/9 for the first case (joint problems), and 2/9 for the second case (acute illness), but there would be no way to know that they had performed really poorly in the second case from the current feedback. There were actually 3 feedback statements that were flagged in this case, but they don’t show up because those statements did not apply to any other case (and currently these statements are hidden).

How could the feedback be improved?

The GPC motion called for “the feedback from the MRCGP exams to be improved immediately”. Here are 3 simple ways that the feedback could be made clearer and more effective in helping identify areas to work on to improve performance. They can all be introduced using data that is already collected in the exam, and so could be implemented quickly with little additional cost.

1. Provide a breakdown of total marks for each domain as well as the total score. In the AKT, candidates get a breakdown of their scores in the 3 domains (clinical medicine, organisational, and evidence interpretation). This will give a clearer indication of any weaker areas overall:

New CSA feedback - summative

This candidate and their trainer can immediately see that they could make improvements in all parts of the consultation, but that the clinical management domain was their weakest overall. This may allow more targeted work on this part of the consultation. Without this information, this candidate (and their trainer) may focus more on the interpersonal domain, without realising that although this could be improved further, this is actually their strongest domain overall.

2. Provide the domain scores for every case as well as the formative feedback. Taking both the summative and formative feedback together provides more meaningful information and will allow easier identification of both consulting skills and curriculum areas that need improving. This could be provided by adding a separate table for the domain scores:

CSA domain feedback for individual cases

Looking at this, it is clear that this candidate had 2 cases where they performed very poorly – the young adult female with an acute illness, and the middle aged female with a women’s health issue. These may be areas that they struggle with, and indetifying them will allow focused improvement in knowledge.

3. Provide details in the formative feedback section of ALL statements that were flagged, even when this only applied to a single case. This will allow candidates to identify all areas that examiners felt they could work on – even candidates that have done well can benefit from knowing areas that they could improve. Combined with the summative feedback above, this would also make it easier to separate a candidate that is below the pass standard in multiple areas of multiple cases from one that had a couple of really poor cases due to poor knowledge of a specific curriculum area, or because they missed something key in that case. Here is the formative feedback from those first 3 cases that we looked at earlier; the second image shows all crosses (those that were previously hidden are shown in red for clarity):

Current feedback:

CSA formative feedback - current

Proposed feedback:

Proposed feedback showing all crosses

You can see that taking this with the domain scores, it is immediately clear why this candidate got such a low score in the acute illness case, and that had they performed better in this case, they may have passed. This would also help candidates understand their performance better. From the current feedback they may think that this was one of their better cases when actually it is their worst. Providing this extra information does not give any information that will jeopardize case security, but it does provide more meaningful information for someone trying to improve.

How it would look together

All the feedback would fit onto 1 A4 page, allowing quick cross referencing between the different sections. This is how the new feedback could look in the e-portfolio.

New CSA feedback - summative

CSA domain feedback for individual cases

New CSA feedback

Summary

It is clear that further research needs to be carried out to investigate the possible reasons behind the differential pass rates in different groups – however this will take time. By improving feedback immediately, we can ensure that candidates and trainers have clearer, more effective feedback. All these changes can me made using data that is already being collected, so this could be implemented quickly and with little additional cost. Hopefully this will enable more focused work on the key consultation skills that an individual doctor may need to work on to help them improve and pass the exam.

Are you a GP trainer or a GP registrar? What do you think about these ideas for improving the feedback from the CSA? Please share your thoughts!

[polldaddy poll=7143802]

GP ST Payscales including GP Registrar pay / salary 2013 – 2014

These are the current payscales for GP trainees in effect from April 2013 – April 2014. It includes the 2013 pay award of 1%. The GP Registrar supplement is currently 45% – this is for all posts when based in a practice, regardless of the year of training, or the number of on call or out of hours shifts completed.

GP Trainee Payscales
GP ST Pay
GP Specialty Training Salary Scales 2013-2014

You should start on the paypoint with basic pay that is closest to your current basic pay. E.g. if your current basic is £29,500, you will move onto the StR Min scale, with a basic pay of £30,002 and so on. You will move onto the next point on the scale on the anniversary of your increment date (this should be on your last payslip).

When you are on paypoint StR3 or higher (shown in cream above), you are entitled to an extra 5 days of annual leave – so you will get 30 days instead of 25 in addition to bank holidays.

GP Registrar Salary – Net Monthly Pay

All GP rotations now mandate at least 18 months in general practice. As there are a lot of costs during the latter part of your GP training, we thought it would be helpful to look at estimated NET pay (i.e. take home pay after Tax and National insurance). This might help you plan and budget so you can meet the costs of sitting the MRCGP AKT Exam and MRCGP CSA Exam (about £2,100 together) as well as other final year costs such as CCT, indemnity etc.

GP Registrar Pay
GP Registrar Payscales (Practice Based) 2013-2014

*These figures are estimated monthly take home pay net of income tax and national insurance. They have been rounded down to the nearest pound, and are based on a standard tax code.  As your pay may change during the tax year, the actual amount may differ.  You can get an accurate monthly calculation here (external link).  These figures do not include deductions for the NHS pension.

GP Registrar’s medical indemnity will be reimbursed less the amount they would have paid for a hospital job.

MRCGP AKT Exam Revision – High Yield Topics from the January 2013 AKT Exam

MRCGP AKT Exam – High Yield Topics from the January 2013 AKT Exam

Dr Mahibur Rahman

After each MRCGP AKT examination, the examiners release a report highlighting key information from the last exam. This includes pass marks and rates, and also key topics – both those that were answered well, and those that GP trainees performed poorly on. These topics are frequently 867805_inhalerexamined again in the next few sittings of the AKT exam, so it is worth ensuring that you have a good understanding of them.

As some of you may be starting your revision for the May 2013 MRCGP AKT Exam, we thought it would be helpful to look at the high yield topics from the latest examiners’ report.

Key facts from the January 2013 MRCGP AKT exam:

The top score was 93.5%
The mean score was 70.7%
The lowest score was 33.5%
The pass mark was 66%
The pass rate was 68.7%

Scores by domain:

Clinical medicine – 70.6%
Evidence interpretation – 66.9%
Organisational – 75.2%

High Yield Topics

The examiners’ report from this diet of the MRCGP AKT exam highlighted the following key topics:

  • Adverse effects for common drugs
  • Administration of drugs by non-prescribers
  • Drug dosage calculations
  • Oral contraception and LARC
  • Paediatrics – recognising normal findings
  • Asthma management in children
  • Colorectal cancer – screening and diagnosis
  • Breast cancer – screening, diagnosis and referral
  • Diabetes – diagnosis, management, interpreting diabetic blood results

The MRCGP AKT is a comprehensive examination, so it is important that you cover the entire curriculum. Remember that 80% of the marks are related to applying knowledge relating to clinical medicine in general practice, 10% to evidence interpretation and 10% to the organisational domain.

Emedica Alumni can get a £20 discount off the Emedica MRCGP AKT course by entering this code when booking: alumnimrcgp

Further reading:
Complete January 2013 AKT Summary report