🎓 The AKT Exam: Your Complete Guide to Success
🚨 IMPORTANT: New Exam Format from October 2025
The AKT has changed! From October 2025 onwards:
- 160 questions (reduced from 200)
- 2 hours 40 minutes (160 minutes total, reduced from 190 minutes)
- Same 60 seconds per question
- Same content domains: 80% clinical, 10% evidence-based practice, 10% administration
All information on this page reflects the NEW format.
Executive Summary
The Applied Knowledge Test (AKT) is a crucial component of the MRCGP examination, assessing your ability to apply medical knowledge in general practice contexts. With proper preparation, strategic study methods, and focused revision, you can pass this challenging exam and progress in your GP training journey.
📋 What is the AKT?
The Applied Knowledge Test is a summative examination that evaluates the knowledge and skills required for independent general practice in the United Kingdom. It forms one of three components of the MRCGP certification, alongside the Clinical Skills Assessment (CSA) and Workplace-Based Assessment (WPBA).
Exam Structure (Current Format from October 2025)
| Component | Details |
|---|---|
| Total Questions | 160 single best answer questions |
| Duration | 2 hours 40 minutes (160 minutes) |
| Time per Question | 60 seconds average |
| Format | Computer-based at Pearson VUE centres |
| Exam Dates | January, April, July, and October |
| Pass Mark | Varies (historically 66-72%, recent exams around 72-73%) |
| Attempts Allowed | Maximum 4 attempts (6 if entered training after Aug 2023) |
Content Breakdown
(~128 questions)
(~16 questions)
(~16 questions)
Clinical Medicine Domain Includes:
- Cardiovascular, respiratory, and metabolic conditions
- Women’s health, children’s health, and mental health
- Dermatology, ENT, ophthalmology, and MSK
- Gastroenterology, neurology, and renal medicine
- Palliative care and older adults
- Infectious diseases and travel health
⏰ When Should You Take the AKT?
Choosing the right time to sit the AKT is crucial for success. You’re eligible to take it from ST2 onwards, but timing matters.
Recommended Timing
❌ Too Early: ST1
Not permitted – you must be at least in ST2.
⚠️ Risky: Early ST2 (First 3 months)
Limited GP experience may make clinical questions harder. Consider only if you have exceptional preparation time.
✅ Optimal: Mid-to-Late ST2 (After 4-6 months GP experience)
Most recommended window. You’ll have sufficient clinical exposure and time to prepare without ST3 pressures.
⚠️ Challenging: ST3
Manageable but pressured – you’ll be juggling CSA preparation, portfolio requirements, and final placement demands.
📚 How to Prepare for the AKT
Timeline: How Long Do You Need?
The evidence consistently shows that dedicated preparation time is the single biggest predictor of success.
Recommended Preparation Timeline
- Minimum: 3 months of structured revision
- Optimal: 4-6 months for most trainees
- Extended: 6+ months if working full-time with significant personal commitments
Important: “Preparation time” means active, focused study – not passive reading while exhausted after a long shift!
The Bradford VTS Study Strategy
Phase 1: Foundation (Months 1-2)
Goals:
- Master statistics and evidence-based medicine (20% of marks – often the “easiest” marks to secure)
- Learn administrative and organizational topics thoroughly
- Complete initial assessment of clinical knowledge gaps
Weekly Time Commitment: 2-4 hours daily, 4-5 days per week
Phase 2: Clinical Knowledge Building (Months 2-4)
Goals:
- Systematically work through all clinical domains using RCGP curriculum
- Focus on high-yield topics (see resource list below)
- Complete 1000+ practice questions
- Integrate learning from daily clinical practice
Weekly Time Commitment: 2-4 hours daily, 5-6 days per week
Phase 3: Intensive Revision (Final 4-6 weeks)
Goals:
- Complete 2000+ total practice questions
- Take full mock exams under timed conditions
- Review all weak areas identified in mocks
- Memorize key facts (DVLA rules, notifiable diseases, drug doses, etc.)
Weekly Time Commitment: 4-6 hours daily, daily study
Consider: Taking 5-10 days of study leave immediately before exam
Essential Study Resources
| Resource Type | Recommended Resources | Cost | Priority |
|---|---|---|---|
| Question Banks |
• RCGP GP Self-Test (FREE with membership) • PassMedicine AKT • Emedica AKT • GP Training Info | Free-£200 | 🔴 ESSENTIAL |
| Statistics |
• Medical Statistics Made Easy (Harris & Taylor) • RCGP Data Interpretation Videos • Emedica Statistics Webinar | £15-£50 | 🔴 ESSENTIAL |
| Clinical Reference |
• NICE Clinical Knowledge Summaries (FREE) • Oxford Handbook of General Practice • BNF (focus on prescribing chapters) | Free-£40 | 🔴 ESSENTIAL |
| Journals |
• InnovAIT (included with RCGP membership) • British Journal of General Practice (FREE) • Drugs & Therapeutics Bulletin | Free | 🟡 IMPORTANT |
| Admin/Organization |
• Oxford Handbook GP (Chapters 1-6) • RCGP AKT Content Guide • DVLA at-a-glance guide | Free-£40 | 🔴 ESSENTIAL |
| Courses |
• GP Update Courses (RedWhale/NB Medical) • Emedica AKT Course • Local deanery AKT prep courses | £200-£500 | 🟢 OPTIONAL |
High-Yield Topics (Most Frequently Tested)
🎯 Focus Your Revision on These Common Topics:
- Asthma & COPD management
- Heart failure & angina
- Hypertension guidelines
- Diabetes (Type 1, 2, and gestational)
- Contraception (all methods)
- Pregnancy care schedules
- Childhood vaccinations
- Developmental milestones
- Prescribing in pregnancy/breastfeeding
- Anticoagulation (AF, DVT, PE)
- Common dermatology (eczema, psoriasis)
- Mental Health Act sections
- Capacity & consent issues
- Safeguarding (children & adults)
- DVLA regulations
- Notifiable diseases
- Sick notes & certificates
- Prescribing regulations
Study Techniques That Actually Work
Common Mistakes to Avoid
📅 Exam Day: What to Expect
Before the Exam
At the Pearson VUE Centre
- All personal belongings (phone, wallet, watch, notes) go in a locker
- You’ll be given a whiteboard and marker for calculations
- Take the computer tutorial (not timed – use this to settle nerves)
- You can leave the room for bathroom breaks, but the clock keeps running
During the Exam
- 30 minutes = 27 questions completed
- 60 minutes = 53 questions completed
- 90 minutes = 80 questions completed
- 120 minutes = 107 questions completed
- 150 minutes = 133 questions completed
- 160 minutes = 160 questions completed
Exam Strategy Tips
- Read carefully: Look for negative phrasing (“NOT”, “LEAST”, “EXCEPT”)
- Cover options first: Try to answer before looking at choices
- After 50 seconds: If you’re stuck, make your best guess and flag for review
- No negative marking: NEVER leave a question blank. Always guess if unsure.
- Trust your gut: First instinct is often correct. Don’t overthink.
- Use the flag function: Mark difficult questions to review if time permits
- Finish all 160: Running out of time is a common reason for failure
After the Exam
- Don’t discuss questions with colleagues (against RCGP policy)
- Results: Published approximately 3 weeks after exam date
- Score breakdown: You’ll receive overall percentage and domain-specific scores
- Try to relax and avoid dwelling on the exam
💪 If You Don’t Pass: Resit Strategy
Approximately 30-35% of candidates don’t pass on their first attempt. This does NOT mean you can’t be a great GP. It simply means you need a different study approach.
What to Do After a Failed Attempt:
- Don’t panic. You have 4-6 total attempts (depending on when you started training).
- Review your score breakdown: Identify which domains were weakest (clinical, stats, or admin).
- Talk to your TPD, trainer, and educational supervisor: They can help you analyze what went wrong.
- Change your study method: If you failed, your current approach isn’t working. Be brutally honest about this.
- Consider dyslexia assessment: If this is attempt 3+, consider getting tested. Dyslexia is common and you may be entitled to extra time (up to 45 minutes).
- Targeted study: Focus heavily on your weak domains. If you scored 60% on clinical but 80% on stats, spend 80% of revision time on clinical.
- More practice questions: Most people who fail haven’t done enough questions. Aim for 3000+ questions for your resit.
Dyslexia and Extra Time
If you suspect you may have dyslexia or other learning difficulties:
- Contact your TPD immediately – they can arrange assessment
- Educational psychologist assessment can diagnose learning difficulties
- Confirmed dyslexia can grant you up to 45 extra minutes in the exam
- This can make a significant difference to your performance
- Resources: Bradford VTS Dyslexia Page | British Dyslexia Association
🧠 Mental Health & Wellbeing During Preparation
The AKT preparation period is stressful. Protect your mental health:
Wellbeing Checklist
- Maintain regular exercise (even 20-30 minutes daily helps)
- Schedule social time with friends/family weekly
- Get 7-8 hours sleep nightly (especially the week before exam)
- Take at least one full day off studying per week
- Eat regular, healthy meals (brain needs fuel!)
- Talk to someone if feeling overwhelmed (trainer, TPD, colleagues, BMA counselling)
- Remember: This is ONE exam. It doesn’t define you as a doctor.
📊 Pass Rates & Statistics
(Recent Exams)
(Varies by exam)
(Most Successful Candidates)
✅ Final Checklist: Are You Ready?
Tick off these items before booking your exam:
- At least 4-6 months of GP clinical experience
- 3+ months of structured AKT revision time available
- Completed 2000+ practice questions
- Scoring 70%+ consistently on mock exams
- Confident with statistics and data interpretation
- Know administrative topics (DVLA, notifiable diseases, certificates, etc.)
- Have taken at least 3 full-length timed mock exams
- Discussed readiness with your trainer/educational supervisor
- Have study leave booked for final 1-2 weeks before exam
- Mentally prepared and in good health
🔗 Essential Links & Resources
Official RCGP Resources (FREE)
RCGP AKT Homepage RCGP eLearning (GP Self-Test) AKT Preparation GuidanceClinical Resources (FREE)
NICE Clinical Knowledge Summaries GP Notebook eGuidelines British National FormularyStatistics Resources
RCGP Data Interpretation VideosQuestion Banks (PAID)
PassMedicine AKT Emedica AKTSupport Resources
Dyslexia Support British Dyslexia Association💬 Words of Encouragement
“You’ve Got This!”
You’ve made it through medical school. You’ve passed countless exams. You’ve survived foundation training. You’re working as a doctor every day, making decisions that help patients.
The AKT is challenging, but it is absolutely passable.
With structured preparation, dedicated study time, good resources, and the right mindset, you WILL pass this exam. Thousands of trainees before you have done it, and thousands after you will too.
Stay focused. Stay consistent. Believe in yourself. And remember – this exam is just one step on your journey to becoming an excellent GP.
Good luck! 🍀
This guide is compiled from Bradford VTS resources, RCGP official guidance, and the experiences of high-scoring AKT candidates. It is regularly updated to reflect current exam formats and requirements.
Last updated: November 2025 | Reflects October 2025 exam format changes