Summarising the BNF – yes or no? The WellMedic BNF summary guide!

Have you considered summarising the BNF for your MRCGP AKT revision?

The general advice from most GP supervisors would be to summarise the BNF, either alone or within a small group. If you’ve spent any time around the fourteen fish communities, you will see that GP trainees are often asking each other for their BNF notes.

The BNF summary forms one of my fifteen actionable points to pass the MRCGP AKT. I have summarised over 70 drugs that you can access via our courses!

 

Why is pharmacology so crucial for the MRCGP AKT?

 

Since undertaking the MRCGP, I have personally noted a general push to improve prescribing habits amongst doctors. The Prescribing Safety Assessment (PSA) for new graduates, the Prescribing Audit for GP ST3s and the constant inclusion of pharmacology questions within the MRCGP AKT highlights the importance of prescribing!

 

I need a shortcut to the BNF…

Shortcuts are never the answer, especially when it comes to preparing for the MRCGP AKT. I appreciate that having a completed BNF summary is handy, but the true benefit comes from your understanding of summarising the BNF.

So you may ask, why do I share my BNF summary?

I share the WellMedic summary to demonstrate some of the hidden gems within the BNF and how they can help your application.

 

Let me guide you on how to get the most from your BNF revision.

 

Step One: Be Cautious

Look at both the cautions and contraindications when using the BNF. CIs are relatively straightforward, when not to prescribe a drug. However, cautions make up our regular practice as GPs; when should we be careful during our prescribing? Let’s take Orlistat as an example, where you may offer vitamin supps if there is concern regarding fat-soluble vitamins. 

 

Step Two: Be Curious

Grouping side effects based on their drug class can be beneficial. e.g. ACE inhibitors cause angioedema, which is more common in afro-Caribbean patients. You must consider drug-based side effects also! e.g. Sitagliptin commonly causes headaches, whereas Linagliptin doesn’t.

 

Step Three: Should I use this?

Summarising the BNF should not become a futile exercise. If you’re going to spend the time doing it, use it as a helpful revision tool. If you’re reading about Methotrexate, then consider its use in Crohn’s, Rheumatoid arthritis and Psoriasis.

 

Step Four: Special circumstances

This includes prescribing in pregnancy, breastfeeding, renal disease and hepatic disease. The AKT is an application-based exam; although there will be plenty of first-line medications, consider alternative scenarios. Your newly diagnosed diabetic patient has CKD; how would this affect your management?

 

Step Five: I’m not an obstetrician

Ask yourself, how comfortable am I prescribing in pre and post-natal care? This is a clear example of where you need to explore beyond primary guidance. NICE, Hypertension in pregnancy recommends offering enalapril to treat hypertension during the postnatal period, which is unexplained in the BNF.

 

Step Six: Drug monitoring

Know your monitoring requirements well. The WellMedic admin course summarises the common medications that often appear in the AKT. It’s important to know which parameter needs monitoring (this extends beyond blood tests) and how frequently they may need to be monitored.

 

Step Seven: Interactions

There are far too many interactions for any given drug! Focus on the severe/red drug interactions. In addition to this, focus on commonly prescribed medications that may interact, e.g. SSRIs, Antibiotics, Antihypertensives etc. And finally, look for themes. Check out my Amiodarone summary for a specific example!

 

Step Eight: Working in teams

I would highly advise that pharmacology is a regular feature within your revision plan. Summarising the BNF is a good start, but the key is to practice exam scenarios replicated in the exam. Work in small groups, and create scenarios from within your BNF summary revision.

 

If you’d like to see how this all applies to my BNF summary, fill out our email form below and I will email you a copy of our summary guide!

 

Get your hands on this guide which covers pharmacology examples for the MRCGP AKT.