MRCGP AKT: The Complete Guide to Format, Content and How to Pass

The Applied Knowledge Test (AKT) is one of the three components of the MRCGP, the licensing assessment for general practice in the UK, and it is the written, knowledge-based element that every GP trainee must pass. It is a broad test that goes well beyond clinical medicine to include evidence-based practice, statistics and the organisational side of running a practice. This guide sets out exactly what the AKT involves, how it is structured, and how to prepare efficiently for a first-time pass.

What is the MRCGP AKT?

The AKT is a computer-based multiple choice examination that assesses the knowledge base underpinning independent general practice in the UK. It is normally sat during the ST2 or ST3 year of GP training and is delivered at Pearson VUE test centres. Alongside the Simulated Consultation Assessment and Workplace Based Assessment, it is one of the pillars you must complete to be awarded MRCGP and gain your Certificate of Completion of Training.

MRCGP is awarded on completion of three components: the Applied Knowledge Test, the Simulated Consultation Assessment (the clinical/consultation element), and Workplace Based Assessment gathered in your training portfolio. The AKT is the knowledge pillar, confirming that you hold the factual and applied knowledge base, clinical, statistical and organisational, needed for independent UK general practice. Passing all three components leads to your Certificate of Completion of Training and entry to the GP register. Because the AKT can be sat and, if necessary, resat during training, clearing it earlier removes pressure from your final year and lets you focus on the consultation assessment and your portfolio.

MRCGP AKT format and structure

The AKT is a single paper of 160 single best answer questions, sat over two hours and 40 minutes. It is worth knowing that the College reduced the paper from 200 questions and three hours ten minutes in October 2025, so older guides and forum posts you find online may still quote the previous figures, always work from the current format. The questions test higher-order problem-solving rather than simple recall, and there is no negative marking.

The content is divided into three areas with a consistent weighting:

• Clinical knowledge, approximately 80% of the paper. This spans the full breadth of general practice, from cardiovascular and respiratory disease to dermatology, paediatrics, women's health and mental health.
• Evidence-based practice, approximately 10%. This includes critical appraisal, study design and interpreting research data.
• Primary care organisation and management, approximately 10%. This covers the administrative, ethical, regulatory and statutory frameworks of UK general practice.

The pass mark is not a fixed percentage; it is set for each sitting using a criterion-referenced standard-setting method, so it varies slightly between diets but typically sits around the high-60s percentage. Pass rates are generally high for UK-trained candidates sitting at the expected stage of training, but they fall for those who under-prepare the non-clinical domains. The statistics and organisational questions are where many otherwise strong clinicians lose avoidable marks.

Who can sit the MRCGP AKT?

The AKT is sat by GP registrars on a UK GP training programme, and eligibility is tied to being an active trainee in an approved post. Most candidates sit it during their ST2 year or early in ST3, once they have enough clinical grounding to handle the breadth of the paper but with time to resit if needed before the end of training. The RCGP sets the eligibility criteria and the number of sittings per year, and these can be updated, so confirm the current rules and the exam calendar on the RCGP website. Choosing the right sitting matters: too early and the clinical breadth can feel overwhelming; too late and a resit could delay your completion of training.

AKT syllabus: where to focus

Although clinical medicine is the largest slice, it is usually not where candidates fail, most GP trainees are clinically capable. The two smaller domains punch above their weight as sources of lost marks:

• Evidence-based practice and statistics is the classic stumbling block. Concepts such as sensitivity and specificity, positive and negative predictive value, numbers needed to treat, confidence intervals and the main study designs come up reliably, and they are very learnable with focused practice. Because so many candidates neglect this area, mastering it is one of the most efficient ways to lift your score.
• Organisational and informatics questions test the practical framework of UK general practice, certification, safeguarding processes, data governance and the like. These are pure knowledge marks that reward targeted revision rather than clinical experience.

A realistic AKT study plan

Six to ten weeks of consistent preparation is typical for candidates already working in general practice. The structure matters more than the length:

• Weeks 1-3: cover the clinical curriculum through questions, working system by system and reading every explanation. Use your day-to-day clinical work to reinforce what you revise.
• Weeks 4-6: dedicate specific sessions to statistics and evidence-based practice, and to the organisational and informatics content. Treat these as their own topics rather than hoping to absorb them incidentally.
• Weeks 7-10: move to timed, mixed question blocks that mirror the real paper, review your analytics, and focus your last fortnight on your weakest areas. Taper in the final few days.

Common mistakes candidates make

• Treating the AKT as a purely clinical exam and neglecting the 20% of marks in statistics and organisational topics.
• Not practising the question formats. Time pressure is real, and unfamiliar item styles cost seconds that add up.
• Leaving statistics until the final week, when it needs repeated exposure to stick.
• Revising from generic medical resources rather than material mapped to the UK general-practice curriculum.

What to expect on exam day

The AKT is delivered on a computer at a Pearson VUE centre, so on-screen familiarity really helps. With 160 questions in two hours and 40 minutes, you have almost exactly a minute per question, so keep moving and use the flag function for anything you want to revisit. The statistics and data-interpretation questions can be more time-consuming, so do not let one tricky calculation eat into time you need elsewhere. As there is no negative marking, ensure every question is answered before the clock stops.

The best way to revise for the AKT

The AKT is a question-driven exam, and the most efficient preparation is a UK-curriculum-mapped question bank that covers all three content areas, explains the reasoning behind each answer, and tracks your performance so you can see at a glance whether your statistics and organisational scores are keeping pace with your clinical ones. Because those two smaller domains are so decisive, a bank that gives them proper coverage, rather than treating the AKT as clinical medicine alone, is worth prioritising.

Work in tutor mode to learn from explanations as you go, and deliberately ring-fence sessions for statistics and for organisational topics rather than letting clinical questions dominate simply because there are more of them. Use the analytics to watch your three domain scores separately, if your clinical percentage is strong but your evidence-based-practice score lags, that gap is exactly where your next easy marks are. Finish with timed, mixed blocks that reproduce the real paper's variety, so no format or domain catches you out on the day.

Passmed's MRCGP AKT question bank is mapped to the UK general-practice curriculum, covers clinical medicine, statistics and organisational topics, and tracks your performance across all three so nothing is left under-prepared. Explore the question bank →

Frequently asked questions

How many questions are in the MRCGP AKT?

160 single best answer questions, sat in a single paper of two hours and 40 minutes. Note that the College reduced the paper from 200 questions and three hours ten minutes in October 2025, so older sources may quote the previous figures.

What is the AKT pass mark?

It is not fixed. The pass mark is set by criterion-referenced standard setting for each sitting and typically falls around the high-60s percentage.

What are the three parts of the AKT?

Clinical medicine (about 80%), evidence-based practice and statistics (about 10%), and health informatics and organisational issues (about 10%).

Why do people fail the AKT?

Most commonly by neglecting the statistics and organisational domains. These smaller sections are very learnable and are where avoidable marks are lost.

How long should I revise for the AKT?

Six to ten weeks of consistent, question-led preparation is typical for trainees already working in general practice.

How many times can I sit the AKT?

The RCGP limits the number of attempts you can make during training, and the policy is updated from time to time, so check the current rules. The practical implication is to sit when well prepared and to leave enough runway in your training for a resit if you need one.

When in GP training should I sit the AKT?

Most trainees sit it in ST2 or early ST3, late enough to have clinical grounding, early enough to allow a resit before completion of training if required.

Exam format and scoring details were checked against the official examining bodies (accessed July 2026). Specifications, dates and fees change — always confirm the current details on the official website before you sit.