AI, MCQs & OSCEs: a 2025 playbook for UK medical exams (AKT, MRCP & SCA/PACES)

Executive summary

Success in UK postgraduate medical exams like the MRCGP AKT, SCA, and MRCP(UK) PACES requires a study strategy that is both rigorous and efficient. In 2025, the most effective preparation blends high-quality traditional resources with a new generation of AI-powered tools. The core of any successful plan remains anchored in proven learning science: retrieval practice (active testing) and spaced repetition. AI now supercharges these methods with innovations like adaptive MCQ practice that targets your specific weaknesses, and AI-simulated patients for practising OSCE-style communication stations.

This guide provides a practical playbook on how to combine these elements. We will cover the specific formats of the AKT, SCA, and PACES23, map out the best traditional question banks, and demonstrate how to layer on AI-driven tools to create a smarter, more effective revision plan.

Exam landscape: what you’re actually preparing for

MRCGP AKT: A computer-based exam focused on higher-order problem solving, with domains covering clinical medicine, evidence-based practice, and organisational aspects of UK general practice (Royal College of General Practitioners).
MRCGP SCA: The Simulated Consultation Assessment involves 12 remote simulated consultations, each lasting 12 minutes, designed to assess a candidate's clinical, communication, and professional skills in a realistic setting (Royal College of General Practitioners).
MRCP PACES (PACES23): The current format consists of five clinical stations in a timed carousel, with a strong emphasis on examination technique, communication, and clinical reasoning (thefederation.uk).

The “classic stack”: high-value traditional resources to keep

While AI offers new capabilities, the foundation of your revision should be built on these high-quality, trusted resources:

Question banks: Passmedicine, Pastest, and Quesmed remain the go-to platforms for their vast question volumes, detailed explanations, and interfaces that closely mimic the real exams.
Official exam pages & guidance: Your first stop for any query about format or content should be the official hubs from the RCGP for the AKT/SCA and MRCP(UK) for PACES.
Courses & clinics: For communication-heavy exams like PACES, structured communication skills training courses remain invaluable for refining your technique.

What AI adds in 2025: three concrete use-cases

Adaptive MCQ practice: AI can personalise your revision by using knowledge tracing and spaced repetition to automatically target your weak concepts and sequence questions in the most optimal way for learning (Stanford University).
Faster understanding: When a question bank explanation isn't clear, retrieval-augmented Q&A tools can help you quickly understand why an answer is right or wrong by pulling in context from UK guidelines.
OSCE/communication practice: AI-simulated patients are a game-changer for practising the conversational stations of the SCA and PACES. Platforms like BMJ OnExamination’s PACES AI, SimConverse, and Geeky Medics’ virtual patients offer a safe space to rehearse and receive iterative feedback (BMJ).

Primer: knowledge tracing for clinicians

Knowledge Tracing (KT) is a sophisticated machine learning technique that models a learner's evolving mastery of a topic to decide which question to show them next. Modern Deep Knowledge Tracing models can identify hidden relationships between concepts, making them far more powerful than a simple "get it right, move on" approach (Act-R).

For AKT and MRCP candidates, this matters because KT reduces wasted repetitions on topics you already know and intelligently escalates the difficulty of topics you're struggling with. The evidence suggests this can significantly accelerate your "time-to-mastery" (Frontiers).

MCQ strategy: an AI-enhanced study loop (AKT & MRCP Parts 1/2)

Baseline: Start with a full mock exam from a classic bank like Pastest or Passmedicine to map your knowledge gaps against the official blueprint.
Switch on adaptivity: Use a tool with a knowledge tracing or spaced repetition mode for your daily practice. Interleave topics to simulate the randomness of the real exam.
Explain-verify: When you get a question wrong, don't just memorise the answer. Read the explanation in your Q-bank, and if you're still unsure, use a citation-first Q&A tool to get more context from the underlying guidelines.
Calibrate to blueprint: Regularly check your progress against the official exam domains to ensure you are not neglecting any key areas.

OSCE/communication strategy: SCA & PACES23

Simulate the station: Use AI-powered virtual patients to practise your history-taking and counselling skills. Focus on structure, red-flagging, and clear signposting.
Get feedback that sticks: Use AI tutors and platforms that provide feedback linked directly to the official examiner criteria for the PACES communication encounters or SCA domains.
Deliberate practice reps: Short, frequent practice runs are more effective than marathon sessions. Rotate through a variety of common and challenging scenarios, such as breaking bad news, discussing risk, and counselling on medication changes.

Evidence signals to watch

This is not just hype. Early studies are showing the feasibility of using AI to provide feedback on communication skills, with growing concordance between AI and human assessors (PMC). Similarly, pilots of virtual patient practice are reporting measurable improvements in medical students' interview scores and demonstrating the potential for highly scalable training (JMIR Medical Education).

Toolscape (editorial picks, mix & match)

Traditional MCQ engines:
- Passmedicine: Large MRCP banks, offline app, and the excellent "Knowledge Tutor" for spaced repetition.
- Pastest: The largest MRCP Part 1 bank, with tiered plans and themes based on past papers.
- Quesmed: Strong for UKMLA/AKT, with excellent OSCE mark-schemes and integrated flashcards.
AI for OSCE/communications:
- BMJ OnExamination PACES AI: The official, purpose-built tool for PACES practice.
- SimConverse: An enterprise-grade platform for creating and running simulated patient encounters.
- Geeky Medics virtual patients: An accessible and growing library of scenarios for practice.
UK-focused AI Q&A/adaptive add-ons:
- Use a retrieval-with-citations tool like iatroX to get rapid, UK-guideline-informed answers to supplement your primary Q-bank's explanations.

Governance & exam-safe use

Never paste live station content or any patient-identifiable data into public-facing AI tools. Only use practice vignettes.
Use AI for learning and preparation, not for live assistance during an exam. Always follow the specific rules of your Royal College.
If you use AI as part of a formal Quality Improvement Project for your portfolio, keep a good audit trail of your prompts and the outputs.

AI in Action: A 4-Week Study Plan

Week Action
Week 1 Blueprint & Baseline: Sit one timed mock exam. Tag your weak domains. Set up your adaptive Q-bank and spaced repetition schedule.
Week 2 Retrieval Ramp: Commit to 40–60 MCQs daily. For every question you miss, read the authoritative explanation and ensure it's scheduled for a spaced review.
Week 3 Mix & Simulate: Complete two full mock exams. For clinical exams, run through several AI-simulated OSCE/SCA stations and debrief your performance against the official rubric.
Week 4 Consolidate & Taper: Shift to short, daily mixed-subject blocks. Focus on reviewing "marked" or difficult topics. Use a Q&A tool for quick, cited clarifications on last-minute queries.

Week	Action
Week 1	Blueprint & Baseline: Sit one timed mock exam. Tag your weak domains. Set up your adaptive Q-bank and spaced repetition schedule.
Week 2	Retrieval Ramp: Commit to 40–60 MCQs daily. For every question you miss, read the authoritative explanation and ensure it's scheduled for a spaced review.
Week 3	Mix & Simulate: Complete two full mock exams. For clinical exams, run through several AI-simulated OSCE/SCA stations and debrief your performance against the official rubric.
Week 4	Consolidate & Taper: Shift to short, daily mixed-subject blocks. Focus on reviewing "marked" or difficult topics. Use a Q&A tool for quick, cited clarifications on last-minute queries.

Calls to action

Trainees: Run a two-week sprint combining your main Q-bank with an adaptive or spaced repetition layer. Track the improvement in your accuracy in your weakest blueprint domains.
PACES/SCA candidates: Schedule three AI-simulated communication sessions per week. Actively map the feedback you receive to the official marking criteria to guide your practice.
Educators: Pilot the use of AI-simulated interviews in your communication skills teaching. Compare the rubric scores generated by the AI with those from human examiners to calibrate and validate the tool for your programme.