Dr Maddy Shepherd achieved the highest AKT exam score in the NT in Term 1 2018. Here she talks about how she prepared for the exam and offers her eight top tips to getting a winning pass mark.
1. Recruit study partners to keep you on track
The study partners that I had were friends outside of work. We started meeting about nine months before the exam for about an hour each week and tried to make it reasonably formal by having study plans. I’m not a very motivated person on my own so being accountable to someone else on a weekly basis helped get through the workload.
It’s invaluable to have people in the group with a range of experiences. My study partners were experienced in areas different to me and I learned from their experience during the study sessions which was invaluable. The group was lifesaving.
2. Clinical reasoning skills are vital to pass
Experience is really important for clinical reasoning. Often in general practice, things are not always clear cut. As we see more patients and have more experience some things become more familiar and there is an element of pattern recognition for the more common things that we see.
I think working in the NT gives us an advantage in clinical reasoning skills because we understand how to work remotely with limited resources. We have to act on our clinical judgment without necessarily having the test results that might confirm our clinical suspicions. We are quite used to having to modify our treatment approach according to what is actually achievable.
3. Know second-line management
We tended to focus our study on the more common issues that present in general practice and tried to get familiar with guidelines and treatment frameworks for the common presentations which included knowing the first-line options.
It's relatively common for me to see patients who might have a contraindication or for some reason are not able to tolerate a first-line treatment choice. Experience and being familiar with the most common presentations which included having a thorough understanding of the second-line management options helped me.
4. Read widely and sit the practice exam
I definitely recommend doing the practice exam; it was invaluable. My study partners and I mainly used the resources that we use on a regular basis in practice, such as AFP articles, RACGP check modules, past exam papers from various sources and ETG.
5. Tailor your training to give you varied experiences
The more experience you have, the more likely you are to have seen the presentations that are in the exam. For me, real work-based learning is superior to learning from reading books. If I have seen it in real life, I am more likely to remember what I needed to do or will remember if I had to look something up.
I think for GP training, a wide range of experience is really important and I think being able to recognise when you’re dealing with a presentation you don’t know much about and being prepared to look things up at the time really helps things stick. Practical experience is invaluable – not just for exam preparation but for GP training.
6. Focus on your clinical knowledge gaps
It’s easy to study what you enjoy and what you see a lot of. Be prepared to sit down and study what you don’t know.
Before the exam, I hadn’t done any mainstream general practice; I’d always worked for Aboriginal Medical Services. I was conscious of the type of presentations that I may not see much of such as skin cancers or dermatitis or geriatrics or male health. One of my study partners felt she had similar knowledge gaps and we worked together to address those.
Go through John Murtagh’s book and review the major topics and if it feels like there is something that you’re not seeing a lot of or haven’t worked a lot in then put more study focus into that area.
7. Mentally prepare leading up to the exam
Going into the exam in a good frame of mind is more critical than knowing everything. Self-care is important; don’t go into the exam really burnt out or overtired. Right through medical school, I always made sure the week before the exam I didn’t do very much study and made sure I did something nice like going out for dinner the night before the exam.
8. Read all of the exam questions
Pace yourself. Make sure you get through the entire exam. Flag questions you don’t know and come back to them if you’re not sure. You could probably pick up easy marks somewhere else. Don’t get thrown off by not knowing the answer to everything.