MRCGP exam resit support for GP trainees

After the initial disappointment, and maybe surprise that you have not passed your exam, it can be helpful to reflect systematically on the event. This might prove difficult or even painful, as you are reviewing feelings and behaviour as well as knowledge and skills, but reflection is a tool to help you to move forward with insight and thus to plan re-sit preparation more effectively. It can be difficult to engage with examination feedback; some of the messages may not be what you want to hear. Despite this, feedback is your friend and it’s essential to reflect on it and discuss it with your supervisor.

3 steps to reflect and resit

The following is an example on how to reflect in a structured way on your result in order to inform your future actions. It is not a blueprint and can be adapted to fit your particular learning style.

There are 3 steps that you should undertake:

This step involves reaching out for insights and information. Having access to as much information as possible is crucial for making sure you're in a better place for your next attempt. This step is also about making sure you're getting the wellbeing support you need if you're experiencing difficult feelings over your result.

Use available resources

You might find it helpful to go online and collate materials and resources to give you more insights around your exam.

For example, you can access:

  • Range of MRCGP website materials
  • Other websites, e.g. exam preparation sites, dealing with nerves, techniques for approaching difficult questions
  • Materials from any preparation courses • Copies of the curriculum, for systematic preparation and checking
  • Practice tests • Crib sheets
  • Feedback from trainers and practice colleagues
  • Discussions with peers also siting the exam

AKT feedback reports

The AKT examiners publish feedback reports after every AKT. They're intended to guide the learning of AiTs and to help trainers and training programme directors.

You can find AKT feedback reports on the AKT page.

This step involves looking back over the exam and identifying the things that you think contributed to your exam result. It also includes reviewing your exam preparation so you can see whether it covered the issues you have identified and/or did so in sufficient detail or depth.

Reflection is an absolutely vital process, to safeguard against repeating the same pitfalls as last time, while preserving your strengths and successes.

What strategies did you use for your exam preparation?

Think back on the resources you gathered during step 1. Compare these to the resources, techniques and processes you employed when you prepared for your previous exam attempt. Identify any gaps, or areas you can put more investment into this time.

What might have contributed to your result?

The main purpose of this exercise is to help you identify what went wrong so you can think about why, and then move on. Brooding, over-thinking or dwelling on particular details of the test are not productive reflective strategies.

Some examples of what may have impacted your exam performance:

  • Nerves
  • Running out of time / time management
  • Difficulty with one or more areas, such as lack of understanding or knowledge
  • Problems understanding exam requirements
  • Losing focus after struggling to answer one question
  • Unfamiliarity with testing format
  • External pressures or extenuating circumstances impacting on exam preparation
  • Insufficient time devoted to exam preparation

AKT considerations:

  • Did not have formative discussion with ES about timing of exam entry
  • Problems understanding some of the language
  • Unfamiliarity with some of the UK medical or administrative systems

Resources to help with reflection and reflective practice

When looking at available resources and your own test feedback, it is easy to focus on the areas which were not too standard. It is equally important to note carefully what went well so you can reproduce it again. Reflection should always celebrate the good: it is a solid base on which to build.

When preparing for your resit, you might want to consider the following points.

Use feedback from tests to inform preparation

Discuss with your peers and supervisors the best ways to use your test feedback and built upon it.

Don’t fight test feedback. It can be tempting to spend time working out why you disagree with a particular judgement. Your memories of an individual question or consultation might include a self-assessment of how you think you performed. However, you were managing the interaction whilst the examiner was solely focussed on your performance and assessing it against fixed criteria.

Prepare and practise

  • Arrange local trainee groups
  • Get supervisor feedback during tutorials
  • Attend locally arranged courses if available
  • Balance adequate revision with outside commitments
  • Share any problems with your ES
  • Seek help for any language difficulties by contacting the Deanery for advice

Consider strategies for dealing with exam behaviour and technique

  • To help with nerves, try consulting the web, asking peers and supervisors for suggestions, and seeking medical advice.
  • To help with time management for the AKT, try practising mock assessments so you can get used to the different styles of questions, and understand the time spent on each section of the exam.
  • To help with time management for the RCA, practise consulting within the 10-minute window and try to get to management by 6-7 minutes.

If appropriate, consider a dyslexia assessment

If you think you might have Dyslexia, it’s important to act as soon as possible and discuss your concerns with your ES.

If diagnosed early, support can be put in place and you will be able to develop coping strategies not just for exams but for other day-to-day work as well.

Screening doesn’t necessarily mean diagnosis. It just means if you screen positive you can go on to have a fuller assessment from a qualified EP with costs borne by the Deanery. Deaneries can refer to Access to Work much earlier and get funding support for trainees.

A formal diagnosis from an educational psychologist will take time to get in place. Once you have a formal diagnosis, where deemed necessary a reasonable adjustment can be made for the exam for example, allowing you to have extra time.

Resources you may find useful:

Case study

I didn't pass my AKT

The following case study was compiled following telephone conversations with a practising doctor who initially failed their exam.

"After my first attempt at the AKT I wasn’t sure if I’d passed or not. And in fact, I failed by a very few marks. So, I wasn’t particularly upset. You have to allow yourself to fail. It’s a strange exam in that it’s a broad programme of study, but the test questions are quite specific.

"The feedback showed that a weak area had been administration. So preparing for my re-take I focused more on that. I used the Fourteen Fish video and reviewed the details of regulations for areas such as driving. I started my training in Italy so perhaps I should have allowed more time for preparation in that area given that there are differences between the two administrative systems.

"Timing is important. Halfway through my second attempt, I realised that I needed to speed up a bit or I wouldn’t finish. It’s easy to spend too much time thinking about the early questions.

"It’s important to work out the best time to attempt the AKT. Not everyone’s situations are similar. For me, looking back, I would have taken it the first time in the February of my second year, allowing for a re-sit in May.

"After the second attempt, many of us thought we might have failed. In fact, most of us passed. I did – and I am working as a doctor now."

References