Exam Information

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When to take the exam? 

GP trainees in ST2/ST3

Max attempts - 4

Exam Details

• Online computer based exam
• Questions: 200
• Time: 190min, no scheduled breaks
• Time per question: 57 seconds
• Pass % needed: 70-75% (approx), No negative marking

Question categories:

• Clinical Knowledge - 80% (160 Qs)
• Evidence Based Practice - 10% (20 Qs) RCGP tips
• Primary Care Organisation and Management - 10% (20 Qs) RCGP tips

Question Styles:

• Single Best Answer (SBA)
• Extended Matching Questions (EMQs)
• Free-text

1. Popular Resources:

1. GP Self Test (by the RCGP)
2. Passmedicine
3. BMJ OnExamination
4. NICE guidelines & NICE CKS

2. Time to prepare: 3 months at least

4. Study Plan

• Recommended at least 2 hours of focused study daily, increasing to 3 hours as the exam approaches
• Weekly Goals: Set weekly targets for topic coverage and question completion

3. Topic specific approach

• Nightmare List (Weakness): Assess your weaknesses or take a few mock tests to identify your weak areas to focus early on.
• Must-Know List (High-Yield):  

1. Focus on high-yield topics frequently tested in exams, and review the AKT Feedback reports from RCGP (highly recommended). These reports highlight common areas of weakness among test-takers, which are likely to be consistently tested
2. GP curriculum super condensed  The RCGP outlines specific areas within each specialty that are likely to be tested. Each specialty in the AKT has its own set of 3 core topics that trainees should be familiar with. For example:

• Cardiology:  • Interpreting ECG tracings • Adverse drug effects of anti-hypertensives • Genetics of familial hypercholesterolaemia.
• Dermatology:  • Recognition of a malignant skin lesion from photographs • Management of psoriasis • Differential diagnosis of alopecia
• Psychiatry:  • Symptoms of schizophrenia • Increased health risks of atypical antipsychotic drugs • Cognitive behavioural therapy in anxiety management

4.  Timed Mock Exams

• Try a full-length, timed mock exams 'once a week' to simulate exam conditions

5. Group study

• If you would like to join our whatsapp group, focused on AKT preparation. Join the 'AKT Preparation whatsapp group'

7. Exam Techniques from RCGP

• Aim to answer using the cover-test* and your initial  intuition before quickly moving on. 
• Watch the clock throughout and establish in advance how many questions you  should have covered after 60, 120 and 150 minutes. 
• Flag any questions that you feel very unsure about and those that are taking you too long for review at the end, and move on to the next question. The software will automatically ask you to review any flagged or unanswered  questions before finishing the test.
• However uncertain you are, it is good exam technique to choose the answer that feels most right to you at that point in time rather than omitting to answer at all, and flag it.
• Don't spend too much time on one question
• Don't leave a single question unanswered - There's No Negative marking

When to take the exam? 

GP trainees in ST2/ST3

Max attempts - 

Exam Details

Format: OSCE

Time: 

Questions: 

Time per question: 

Question categories:

Popular Resources:

1. BMA & RCGP Guidance – Comprehensive information on SCA requirements, marking criteria, and exemplar cases.
2. MRCGP CSA, AKT, and RCA Preparation Handbook – Contains scenarios, marking schemes, and guidance for each domain.
3. Communication Skills Books – "The Inner Consultation" by Roger Neighbour and "The Skilled Helper" by Gerard Egan can help refine patient-centered communication and empathy.

Preparation Timeline: 

• 3-4 months in advance: Start practicing and recording consultations weekly.
• 1-2 months prior: Increase practice frequency to 2-3 recorded consultations weekly, focusing on refining skills based on feedback.
• Final month: Focus on polishing high-risk areas, such as complex communication and ethical scenarios.

Key Strategies

Master the SCA Domains:

Familiarize yourself with the three assessment domains: Data Gathering, Clinical Management, and Interpersonal Skills. Each case should demonstrate competencies across these areas, so keep them in mind during practice.

Structured Approach to Consultations

Use frameworks like ICE (Ideas, Concerns, Expectations), BATHE (Background, Affect, Trouble, Handling, Empathy), and SPIKES (for breaking bad news) to keep consultations organized and efficient.

Focus on High-Yield Cases

Common SCA case types include acute issues (chest pain, abdominal pain), chronic disease management, mental health, pediatrics, and end-of-life discussions. Practice handling these types to ensure you’re prepared for a range of scenarios.

Record and Review Regularly

Recording consultations, even with friends or colleagues, and watching them back is one of the most effective ways to improve. Look out for non-verbal cues, clarity of explanations, and timing.

Refine Clinical Decision-Making

The SCA often includes complex or unclear cases. Practice reaching clear management plans, even when information is ambiguous, by weighing pros and cons and explaining reasoning clearly to the patient.

Patient-Centered Communication

SCA places high value on rapport and empathy. Show empathy by acknowledging patients' concerns, reflecting emotions, and using open-ended questions to encourage sharing.

Balance Time and Detail

Timing is crucial. Aim for a balance between thoroughness and brevity. Practice using clear, concise language and avoid over-explaining straightforward issues to stay within time limits.

Anticipate Red Flags

Ensure that each consultation covers important "red flags" for presenting symptoms (e.g., chest pain, fever, breathlessness) to show your risk assessment and safety-netting abilities.

Use Clinical Guidelines for Decision-Making

Decisions should align with national guidelines (e.g., NICE). This shows you’re basing management on evidence-based standards, which is critical in scoring well.

Seek Feedback and Reflect

After each practice session, get feedback from peers or supervisors. Reflect on what went well and areas to improve. Reflection is key for continuous improvement and is valued in assessments.

Practice with Varied Patients

The SCA includes diverse patient demographics, so practice consultations with a range of "patients," from different ages and backgrounds, to prepare for the nuances in communication styles.

Stay Calm Under Pressure

Practice grounding techniques or mindfulness exercises to manage anxiety, which is common in assessments. Staying calm allows you to think more clearly and communicate more effectively.

Exam-Day Tips

• First Impressions Count: Start with a polite, welcoming greeting, and set a collaborative tone.
• Clarity and Compassion: Be deliberate in your explanations, checking for understanding, and showing empathy, even if the “patient” is an actor.
• Pace Yourself: Aim for a balanced pace to avoid getting flustered. Allocate time for each part (e.g., 3-4 minutes for data gathering, 4-5 minutes for management).
• Expect the Unexpected: Sometimes the scenarios won’t go as planned. Show flexibility and adapt your approach, remaining professional and patient-focused.