AKT Preparation Guide

🧠 What is the AKT?

The AKT is one of three components of the MRCGP (Membership of the Royal College of General Practitioners)exam, alongside the SCA (formerly CSA) and WPBA.

It is a computer-based, knowledge-based exam testing clinical knowledge relevant to UK general practice.

📅 AKT Exam Overview

• Eligibility: Open to GP trainees in ST2 or ST3

• Exam Frequency: Held three times annually – in January, April, and October

• Format: Computer-based test comprising 200 multiple-choice questions

• Duration: 3 hours and 10 minutes

• Passing Score: Typically around 70%, though it may vary by sitting

• Attempt Limit: Up to four attempts permittedMaximum of 4

📘 AKT Syllabus Breakdown

• Clinical Medicine (~80%)
  Covers areas such as chronic disease management, acute presentations, prescribing, and day-to-day primary care conditions.

• Evidence Interpretation & Statistics (~10%)
  Includes topics like study types, sensitivity and specificity, number needed to treat (NNT), and p-values.

• Admin / Organisational (~10%)
  Encompasses knowledge of NHS systems, DVLA regulations, death certification, information governance, and related protocols.

📊 AKT Marking & Results

• Results available within ~4 weeks

• Scaled score out of 200

• No pass/fail by section, but weakness in stats/admin can cause failure

🧰 Top AKT Question Banks (2025)

🧠 Comprehensive Comparison of AKT Preparation Courses

Please note that the majority of candidates pass the AKT by solely using an MCQ question bank and revising national guidelines, without the need for additional courses, while applying their knowledge in day-to-day primary care practice through real patient encounters.

🔑 Most Popular Picks

✅ Passmedicine AKT

• 🏆 Most Recommended

  ✅ Regularly updated in line with NICE and BNF
  ✅ Strong coverage of statistics and admin topics
  ✅ Sufficient clinical content to pass the AKT

  🔸 Can feel repetitive at times
  🔸 Some questions are vague or not clearly aligned with the AKT exam

✅ RCGP GP Self Test + Free AKT Sample Questions

• 🆓 Free Practice Sets with Feedback
  ✅ Simulates real exam format closely
  ✅ Offers performance feedback after each block

  🔸 Limited explanations for answers
  🔸 Questions only available in fixed blocks of 20

✅ FourteenFish

• Mock exam simulation

• Great if you need to build up timing and exam strategy

🧠 Preparation Tips

• Start 3–4 months before your exam

• Use 2 question banks: Passmedicine + 1 extra (e.g. Passmedicine and GP Self test)

• Practice stats/admin daily

• Work through RCGP AKT Feedback Reports for high-yield topics

• Revise NICE CKS, BNF, SIGN, and local guidelines

🎯 High-Yield Topics

• Contraception, child health, dermatology

• Emergency medicine, red flags

• Mental health, safeguarding

• Driving regulations (DVLA), Fit notes

• Interpretation of data (e.g. graphs, audit)

My AKT Exam Experience: A Practical Approach to a Practical Exam

I recently sat the Applied Knowledge Test (AKT), and if there’s one thing I’ve taken away from it, it’s this: the AKT is a very practical exam. It tests how you apply knowledge in real-life general practice scenarios — but there’s a twist. Despite its practical nature, there are areas that feel more like academic exercises, especially statistics.

Statistics in the AKT: Know It, Even If You Don’t Use It

In day-to-day GP life, we rarely have to engage directly with statistics like funnel plots or forest plots. The reality is, our practice is guided by national guidelines, and those guidelines are already based on solid evidence and statistical analysis. So, in real life, we’re not calculating NNTs — we’re following NICE recommendations that have already done that work.

However, for the AKT, stats matter. You need to understand key concepts and basic calculations, including:

• NNT (Number Needed to Treat)

• NNH (Number Needed to Harm)

• Mortality rate

• Sensitivity and specificity

• Mean, median, mode

• Confidence intervals

• Statistical plots and graphs

Even though it feels disconnected from clinical practice, brushing up on these concepts is crucial — they could make the difference between a pass and a fail.

Question Style: Short, Practical, and To the Point

One thing that surprised me was how concise the questions were. Compared to revision resources like Passmedicine, which often present long stems, the real AKT questions were much more streamlined. They’re designed to simulate real decisions you’d make in practice, so the key is reading carefully and thinking clinically.

Resources I Used: What Helped Me the Most

• Passmedicine: This was the cornerstone of my preparation. While the question style differs slightly from the actual exam, the explanations are gold. They build your clinical knowledge and help you understand why certain answers are correct — something that goes a long way in a test designed to assess applied knowledge.

• GP Self-Test (RCGP): These questions are very close to the real thing in terms of style and difficulty. They helped me get used to the question format and improved my confidence closer to the exam.

Don’t Skip the Guidelines

It goes without saying, but make sure you're up to date with national guidelines for major conditions — especially the common ones like:

• Cardiovascular disease

• Diabetes and endocrinology

• Respiratory conditions

• Mental health

And don’t forget DVLA guidelines — a commonly overlooked area but one that regularly appears in the AKT.

Where the Real Challenge Lies

Everyone tends to do well in the core clinical areas like cardiology, endocrinology, and respiratory medicine. The real challenge, in my experience, comes from the non-clinical areas — things we don’t deal with every day, like:

• Child development and milestones

• DVLA and fitness to drive rules

• Admin and legal responsibilities

• Dose calculations and drug conversions

• Statistics and epidemiology

These areas often carry a surprising number of marks, and neglecting them can be costly. Focused revision here can give you the edge you need.

Final Thoughts: Be Smart and Strategic

You don’t have to be a genius to pass the AKT, but you do need to be practical and strategic. Use high-yield resources, don’t get bogged down by low-yield topics, and focus on your weaker areas.

Work smart, cover the guidelines, polish your stats, and approach the exam like you would a clinical scenario — calmly and logically. If you do that, you’ll be well on your way to passing.