AKT 1

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

combatwombat

Full Member
15+ Year Member
Joined
Jul 19, 2008
Messages
280
Reaction score
1
I am trying to find background on what to expect in the AKT-1, but have not come down on anything definitive so far. I know it's supposed to be a test of anesthesia knowledge, but I keep hearing about how it's becomming increasingly medicine-based. Is this true?

What should I expect to be on the exam? Despite all the searching I've done I still have only a vague idea. What should I be studying if I want to score >90th percentile?

Members don't see this ad.
 
Members don't see this ad :)
Is there any way to view sample questions? I've been doing questions from the 1996 ITE, and was planning to do Hall as well. Am I even remotely on the right track?
To my knowledge sample questions or old exams have never been released.

I can tell you that the AKT 0/1/6 questions tend to be almost exclusively short, direct, 1st order questions of fact/knowledge with less "best course of action" type questions. Generally no patient scenarios. The questions in Hall, the old ITEs, ACE, etc are more difficult management level questions.

The stuff you'll see on the early AKTs are things like "a line isolation monitor protects vs ______" and "which of these drugs is not metabolized by ____" and "inhalation inductions are slowed by [pick from a list of conditions]".

The content outlines they publish are pretty accurate, even if some of the categories are kind of vague.
 
  • Like
Reactions: 1 user
AKT 1 used to be (still is?) the exact same test as AKT 0. I demolished AKT 1 and everybody treated me like I was a genius as a early CA1. It felt good. Took me back to my glory days as a kid after the Iowa Test of Basic Skills results came back every spring.
 
I can tell you that the AKT 0/1/6 questions tend to be almost exclusively short, direct, 1st order questions of fact/knowledge with less "best course of action" type questions. Generally no patient scenarios. The questions in Hall, the old ITEs, ACE, etc are more difficult management level questions.
.

So if I do well with Hall questions and prior ITEs, will I also probably do well on the AKT1?

Typically my best exam prep has come from doing lots of questions. If my only study objectives are to study broad topics like "Airway" and "Recovery Room" I might not do that well. To me aceing an exam is all about getting inside the head of the question writer to see the material the way they do, and the topics listed on http://www.metricsinc.org/akt-testing/how-it-works/akt-1.html are as vague as it gets.
 
Last edited:
I did the chapters in hall that were not subpecialty (no OB or peds) prior to akt 1 and did very well. If you know basic facts about pharm and phys you will be good.
 
So would Hall and the old ITEs be good preparation, or a waste of time? Typically my best exam prep has come from doing lots of questions.
Doing something is better than nothing, though I've got mixed feelings about investing a big piece of your reading time as a brand new resident on review materials, reviewing stuff you haven't seen before. By the time the AKT-6 rolls around you should be completely done with a read of Baby Miller or M&M and at that point I think question-based review is more worthwhile.


Yes, the outline is vague, but even the vague outline allows the people who read it to game the tests a bit. People who don't read the outline generally won't put much time into reading about equipment and monitors. The question asking about what color a CO2 tank is is worth just as much as the question about isoflurane. Ditto for stuff like line isolation monitors, how NIBPs work, which Mapleson circuit is most efficient for a spontaneously breathing patient, what the ETCO2 trace look like if the expiratory valve is incompetent, etc. Would you read about those things before the test if the outline wasn't there to remind you that equipment is part of the test? It's a short test. The difference between a 75th %ile and a 25th %ile isn't very many questions.
 
i can't seem to find the content outline? anyone have a direct link ?
 
AKT = anesthesia knowledge test

Not produced by the ABA or related to the ABA at all. The ABA produces the ITE (in training exam), taken in the spring. Most residency programs have residents take the AKT-0, AKT-1, AKT-6, and AKT-24 at 0, 1, 6, and 24 months into residency. The 0 and 1 are the same test taken a month apart.

This is the content outline for the AKT-1:

http://www.metricsinc.org/akt-testing/how-it-works/akt-1.html

It's intended to give residents some objective feedback on how they are progressing and how they compare to other residents nationwide. Doing well or poorly on these will influence attendings' opinions of you to some degree, but no one gets kicked out of residency just for bombing the AKTs.
 
Thank you for the info.

So there is no anesthesia exam that if you do poorly on would get you dismissed from a program ?
 
Thank you for the info.

So there is no anesthesia exam that if you do poorly on would get you dismissed from a program ?

Well.

The new (2-year-old) ABA Basic exam taken at the end of the CA-1 year is a "must pass" exam to advance. So yes, if you can't pass that after however many tries you get, you're done.

The rest of the exams aren't supposed to be used for promotion/probation purposes. That doesn't mean you should blow them off, though.

For one, you're a lot more likely to pass the actual ABA written and oral board exams if you've been steadily and effectively preparing for them throughout residency. This is what the AKT/ITE feedback is for. Part of that preparation (IMO) should be some intermittent dedicated prep for the AKTs and ITEs. Cramming to catch up at the end of your residency when the real thing is looming is a rough way to go, a setup for failure.

Two, you've got to know that the faculty are generally aware of who scores great on the AKTs and ITEs and who does poorly, and that can cast a soothing light or a shadow on their other impressions of you. Do poorly, have a bad day in the OR, and the subjective evals they write are more likely to have phrases like "poor fund of knowledge" in them. Do well, have the same bad day in the OR, and they're more likely to write it off as just a bad day. Enough bad evals, you can find yourself out.

Resident evaluation is hard. Few attendings have any formal training as teachers. As a group we generally do a lousy job of giving useful negative feedback, and residents everywhere often complain that they didn't know they were behind until the department got formal about remediation. In anesthesia, resident self-assessment is extra hard because we work alone 99% of the time, almost never seeing our peers in action. It's easy to fall behind and not realize it until you're way behind.

Lots and lots of people do poorly on the AKTs and ITEs and still graduate because they're otherwise safe and competent. Some struggle to pass their boards, some don't.

The best answer is to work harder than you think you need to.
 
  • Like
Reactions: 2 users
Thank you for the info.

So there is no anesthesia exam that if you do poorly on would get you dismissed from a program ?

Like pgg said, you can definitely be dismissed if you can't pass the Basic exam. My program gives you 2 shots to pass before giving you the boot.
Programs may also consider the ITE as grounds for dismissal if you consistently bomb them. My program has a threshold score by which, failing to exceed that score, puts you into probation, followed by residency extension (with another sub-threshold score), and POSSIBLY dismissal if along with this, attendings think you can't hold your own clinically. I've seen (and heard) of residencies extended for the ITE results and know of one dismissal within the past 10 years related to combo poor ITE and poor intraop skills/knowledge.
 
Top