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Tips on passing the AKT exam

  1. As with all exams this will come down to a combination of knowledge and technique. There is no negative marking so answer everything. It is a quick exam – you have 190 minutes to answer 200 questions, so less than a minute each. Go with instinct, don’t agonise for 10 minutes about a question. If you really aren’t sure then ‘flag’ the question but do not progress without putting an answer in case you don’t have time to return later.
  2. Sounds obvious but make sure you have been to the loo before you start the exam – wasting time going on an escorted trip to the toilet wastes time you could be better using elsewhere.
  3. Keeping the pace up for over three hours can be gruelling – especially as you are not likely to be the well-honed exam machine that you were in medical school. A significant part of your revision should be practice questions. These build technique, stamina and knowledge and you must ensure that you have allocated sufficient time in your revision programme to really hit these hard.
  4. There are 50 sample questions, with answers, on the RCGP website.1 This gives good examples of sample questions from all sections of the content, and is written by the same people who write the exam so makes an excellent place to start. InnovAiT, the lime green trainee-focused magazine that comes free with your RCGP subscription, contains sample AKT questions each month. These are invaluable and can be accessed online. If you are particularly keen you may want to contribute some. Simon Glew of InnovAiT presents a useful podcast on the exam that can be accessed from the RCGP AKT webpage.
  5. The RCGP Essential Knowledge Updates (EKU) are also a valuable resource to explore.
  6. A number of commercial sites offer access to their question databases, typically for four to six months for a subscription fee. These are quite competitively priced and worth investing in to give you access to the number of questions you need to be doing to give you your best chance of success. Ask recent cohorts which they favour, but most offer a free trial for you to explore the content before you buy.
  7. The RCGP provide AKT feedback reports for each sitting of the exam.2 These are priceless as they outline things that your peers found challenging. Make sure that you have covered these common areas of weakness in your preparation to give you the edge.
  8. There’s no escaping it, you need to know your NICE guidance. Remember that as far as the exam is concerned, NICE guidance trumps local guidance. Make sure you are going from the national standard and don’t get caught out. For example, at present some localities are not adhering to the NICE guidance on varicose veins.
  9. On the big day make sure you are actually allowed in to sit the exam. Bring two forms of ID with you – a passport or photocard driver’s licence as photo ID and a credit/debit with name and signature. If you do not have these documents already in your possession get them as soon as possible. If you do already have these then check expiry dates – the documents have to be valid and current to be accepted.
  10. The name on your documents must be exactly the same as the name you used to register to sit the exam. If this is not the case you will not be allowed to proceed. If your name has changed recently then you will be required to bring documentary confirmation of this. Either way, in this situation best check with the RCGP well in advance of the exam day.
  11. Be on time. If you are late, you won’t be allowed to sit the exam. It’s that simple and there is no flexibility in this so check, double check and triple check travel arrangements minutely.
  12. Personal items must be left in a locker and you are not allowed to take any personal items in with you, including pens, watches, phones, wallets, food, drink or lucky gonks. As mentioned above, you can leave the room to get water/use the toilet but you will not be allowed extra time for this.
  13. Pearson (and the RCGP) take security and probity seriously – they administer the written component of the driving test and have heard and seen every excuse, sob story and attempt to cheat in the book. Expect to be monitored by CCTV and the environment to be very formal. Don’t be rattled by this.
  14. Having completed the exam, don’t be tempted to rush straight onto social media to tell the world all about it – entry to the exam requires a non-disclosure agreement that is rigorously enforced by the RCGP, who treat breaches of this exam as a probity matter that could question your fitness to practice.
  15. The scope of the AKT can be daunting and should finally dispel any lingering thoughts that general practice is easy. However, on a positive note, ploughing through all this knowledge is very good for you and your evolution into an independent medical practitioner, not to mention your patients. This is the time to really get your GP database filled up and up-to-date. Pick a time to sit the exam that works with your training/life commitments. Plan your revision, giving yourself enough time to work through as many practice questions as you possibly can, and work quickly on the day. Remember, failing the AKT is not the end of the world, but if this happens, try to identify where you fell down and plan to address the issue rather than repeat the mistake. The cumulative pass rate is high, so take heart – it is possible, you can do it.

Dr Matt Burkes is a GP partner and trainer in Chichester, West Sussex. He has written on many aspects of GP training and co-edited ‘The Good GP Training Guide’ (RCGP Press, 2014) and was a contributor to the Oxford Handbook of General Practice (OUP, 2014).


1 RCGP. MRCGP Applied Knowledge Test: 50 sample questions with answers. 2014

2 RCGP. Exams overview. MRCGP Applied Knowledge Test (AKT)