Elumnus blog: 2012 in review

The WordPress.com stats helper monkeys prepared a 2012 annual report for this blog.

Here’s an excerpt:

600 people reached the top of Mt. Everest in 2012. This blog got about 10,000 views in 2012. If every person who reached the top of Mt. Everest viewed this blog, it would have taken 17 years to get that many views.

Click here to see the complete report.

MRCGP AKT Revision – Tips for effective Preparation

MRCGP AKT Revision

MRCGP AKT Revision – Tips for effective preparation

Dr Razwan Ali

The MRCGP AKT exam is a challenging test of applied knowledge in a GP setting, covering clinical medicine, statistics and evidence based practice, and organisational aspects of general practice. Dr Razwan Ali passed the AKT on his first attempt with an overall score of 93.5% – this was the highest score in the April 2012 AKT exam. In this article he shares his tips to help you pass the AKT exam.

The first and most important point that one must appreciate when sitting the AKT is that it is a difficult exam; do not underestimate it. Almost all my colleagues that failed unfortunately decided to “cram” 2 weeks before the exam, a high-risk strategy that ultimately failed. I started my preparation  2 months before the exam, with  my weekends in the last 4 weeks taken up  with high-intensity revision.

It is worth remembering the structure of the AKT exam in relation to the 3 domains; 80% is clinical medicine, with organisational and evidence interpretation each contributing 10% of the marks in the exam.  Although these topics may take up a disproportionately longer time to cover and may at times seem quite dull to read, they can provide a real boost to your score. Moreover, once these topics are adequately covered by trainees, they tend to be fairly straightforward.

I tried to maintain a healthy balance between reading around topics and answering questions.  Simply repeating questions  may provide you with a false sense of reassurance as questions can be answered correctly by pattern recognition the second time round. Similarly, reading alone has its own pitfalls, as it does not allow you to assess whether you have truly absorbed the information you covered.

With regards to the resources for the exam, I tended to favour online AKT examination websites over traditional text books which are often out of date with current best practice.  I used Passmedicine – this is cheaper and is of a similar if not more difficult level than the AKT exam. To supplement your statistical knowledge, you may wish to consider a basic text such as Medical Statistics Made Easy by Michael Harrison whilst the first few chapters of the Oxford Handbook of General practice provide an excellent foundation to the organisational/administrative aspect of primary care. Another important area to cover is the latest NICE/SIGN  guidelines on common topics such as asthma, diabetes, hypertension etc. as this is a common area for AKT questions.

Finally, I thought a good AKT preparation course would allow me to augment my learning and highlight any deficiencies in knowledge. I chose the Emedica AKT course as I had previously had a positive experience from attending courses when applying for entry to GP training and they have an excellent reputation with MRCGP courses amongst GP registrars. Unsurprisingly, it did not disappoint, providing a thorough overview of traditionally weak areas of performance, covering high yield topics, and offering a simplified and easy to follow overview of statistics for those who hate maths (including me!). We also got to do two mini Mock AKT examinations during the course of the day, with teaching on some of the common / challenging areas in the exam. After the course, I had access to a complete 200 question AKT Mock exam, which was a good way of assessing my readiness in the run up to the real exam.

AKT Revision Tips

  • Ensure you allow adequate time for revision – around 2 months.
  • Sign up with an online examination resource.
  • Pay due attention to statistics and organisational medicine.
  • A good AKT course can be invaluable to consolidate your knowledge.
  • Complete the online Pearson Vue tutorial to familiarise yourself with the computer system.

Exam tips for the day

  •  You have 180 minutes to complete 200 questions or 54 seconds per question.  Don’t dwell too much on one question. If you remain unsure, select an answer, mark it for review and come back to it later.
  • Answer every question even if it is complete guesswork. Remember the exam is not negatively marked.
  • Read the question carefully and thoroughly, appreciating discriminators such as most likely, least likely, diagnostic etc.

Useful resources

  • Oxford Handbook of General Practice.
  • Medical  Statistics Made Easy.
  • BNF Learn the first 36 pages, especially controlled drugs. Familarise yourself with common drugs and side-effects.
  • Memorise guidelines on fitness to drive (DVLA) and fitness to fly (CAA).
  • Familiarise yourself with NICE/SIGN guidelines on common topics; asthma, diabetes etc.
  • Be aware of RCGP feedback release from previous exams.

Dr Razwan Ali passed the AKT on his first attempt with an overall score of 93.5% – this was the highest score in the April 2012 – hopefully these tips will help you make the most of your AKT revision.

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

GP Career Options – Advantages and Disadvantages of Working as a Locum GP

GP Career Options – Advantages and Disadvantages of working as Locum GP

Dr Mahibur Rahman

Working as a locum GP is a common starting point for many newly qualified GPs, with some doctors choosing to work as a freelance GP long term. In this article we will look at some of the advantages and disadvantages of working as a GP locum.

Advantages

Flexibility

As a freelance GP, you can have more control over where and when you work.  If you wish to take time off during school holidays, or go for an extended trip, you are free to do so without needing authorization from anyone else.  If you wish to spend 6 months working just a few sessions a week you can.  If you need extra money for a specific purpose, you could increase your working week temporarily.  If you do not like the way a particular practice works, you can choose not to book more shifts there.

Being self employed

As a locum, you are your own boss.  You can set your own rates, and most locums can earn more per day than most salaried GPs and some partners.  As a self employed contractor rather than an employee, you are also able to claim many more expenses against your tax bill, further increasing your take home pay.

A change is as good as a rest

Sometimes working in different environments, and being able to go in, deal with the patients then leave, without getting involved in internal politics or bureaucracy can be very refreshing.  It also allows you a chance to see different ways of working, to take examples of good practice from different places, and also to see what does not work well.  Working several sessions as a locum can give you a really good understanding of whether a practice would be a good place to work long term before committing to a salaried position or a partnership.

Income

As a locum, you can realistically make a £100,000+ a year working full time if you are willing to put in some hours covering evening and weekend shifts.  If you prefer not to work evenings and weekends, you could still earn over £75,000 per year working less than full time. Working 26 hours per week at a realistic average rate of £70 per hour with 6 weeks leave, 2 weeks bank holidays, and 2 weeks study / CPD time (total 10 weeks without any earnings) gives an income of £76,440.

Disadvantages

Uncertainty

One of the big drawbacks with working as a locum is living with uncertainty.  There is no guarantee that you will be able to work as many sessions as you would like, or that practices will be willing to pay the rates that you had hoped to charge.  In some areas there many trained GPs fighting for both salaried posts and locum sessions, while in others there is no shortage of work.  Agency locum rates have gone down in the last year in some regions.  You may not know exactly how much you will earn from month to month, or exactly where you will work from day to day.  For some people this is not really a big issue, but others find it difficult to cope with a variable income when they have large fixed costs to deal with each month (e.g. paying the rent / mortgage, bills, childcare, schooling costs etc.).  Some locums will, over time get most of their work from a few regular practices, so that you might have a fairly fixed amount to your income, with the variation limited to the number of additional sessions that are available each month.

Isolation

Being a locum can be very lonely.  In many practices, you will arrive for your session, be shown to your room by the practice manager or a receptionist, see 18 patients in 3 hours, then leave, without seeing or talking to any other colleagues.  This can be a bit of a shock to newly qualified GPs who have had the regular contact that comes with being in a training practice, as well as the pastoral benefits of being in a VTS group.  If you are doing the odd sessions in many different practices, it can be difficult to build relationships with the team.

No employment rights

As a locum, you are a self employed contractor, so you do not have any of the rights a salaried employee would have.  This means no paid holidays, no paid study leave, no sick pay, no automatic increase in pay and no job guarantee / entitlement to redundancy pay.  Of course you can take this all into account when setting your rates and calculating how much you will have to work in order to make enough to meet all your expenses and still have a decent amount of time for holidays and study leave.  You will also need to make provisions to cover your expenses if you are off sick or unable to find work for some time.

Continuing Professional Development / Revalidation

Working as a locum GP can make it more difficult to engage in CPD – for example, you may not have the opportunity to attend weekly clinical meetings or journal clubs.  Although the proposals for revalidation are not yet finalised, there are suggestions that it will be more difficult for any GP not working in a managed environment (e.g. salaried / partnership) to meet the requirements for revalidation.  Taking part in complete audit cycles for example, can be quite difficult if you are not working regularly in any one practice.

Travelling

In some areas, you may find that you need to be willing to travel quite large distances to ensure that you have enough work.  This can lead to increased expenses, increased tiredness and stress if you have to travel in peak times.

Summary

Like any job, there are both advantages and disadvantages to working as a locum GP. Hopefully this article is a good starting point to thinking about how this style of working might suit you.  If you are thinking of starting out as a locum and have questions, please feel free to ask the Emedica community.

If you have been working as locum for some time, or recently started, please post a comment and share your tips and advice for new locums.

Dr Mahibur Rahman is the medical director of Emedica, and the author of GP Jobs – A Guide to Career Options in General Practice.  He is the course director of the popular Emedica “Life after CCT: GP Careers Course” for GP Registrars in ST3 coming to the end of training and newly qualified GPs.  Alumni members can get a £95 discount off this course by using the code alumnicct

Elumnus – 2010 in review

The stats helper monkeys at WordPress.com mulled over how this blog did in 2010, and here’s a high level summary of its overall blog health:

Healthy blog!

The Blog-Health-o-Meter™ reads Fresher than ever.

Crunchy numbers

Featured image

A Boeing 747-400 passenger jet can hold 416 passengers. This blog was viewed about 2,000 times in 2010. That’s about 5 full 747s.

In 2010, there were 8 new posts, growing the total archive of this blog to 9 posts. There was 1 picture uploaded, taking a total of 70kb.

The busiest day of the year was August 3rd with 200 views. The most popular post that day was GP Specialty Training Payscales 2010-2011.

Attractions in 2010

These are the posts and pages that got the most views in 2010.

1

GP Specialty Training Payscales 2010-2011 August 2010

2

How to pass the MRCGP CSA: Understanding the new MRCGP CSA Mark Scheme October 2010
2 comments and 1 Like on WordPress.com,

3

Pass the MRCGP: Preparing for the AKT exam May 2010

4

New rules for MRCGP AKT and CSA examinations August 2010

5

GP Registrar Payscales 2009-2010 March 2010

We hope to have even more posts in 2011 – why not write an article for us and get published? We are looking for anything of interest for GP trainees – tips on passing the MRCGP AKT, ideas for how to succeed in the MRCGP CSA exam, suggestions for the e-potfolio and WPBA, or an update on working life as a GP registrar, salaried GP, locum or partner. This is YOUR blog, so please do get in touch!

Wishing you all a successful 2011!

The Emedica Team