The MRCGP Applied Knowledge Test underwent its most significant structural change in years in October 2025. The exam moved from 200 questions in 190 minutes to 160 questions in 160 minutes. The RCGP framed this as an inclusivity adjustment — the time per question increased slightly from 57 seconds to 60 seconds, and the shorter overall duration reduces fatigue. The item types remain the same: single best answer, extended matching questions, free text, and multiple best answer items. There is no negative marking. The content blueprint is unchanged.
What did change is the strategic implication for revision. With fewer questions, each item carries marginally more weight. There is slightly less room for recovery from a weak section. And the three-domain split — 80% clinical medicine, 10% evidence-based practice, and 10% organisational and administrative — remains the architecture that every study plan must reflect.
This article provides two things: a critical assessment of the best AI and traditional tools for AKT preparation in 2026, and a practical 8-week study plan that integrates them.
The AKT in 2026: What You Need to Know
The AKT is a computer-based exam taken at Pearson VUE test centres, usually during ST2 or ST3. There are typically four sittings per year: January, April, July, and October. From April 2026, a staged payment system is being introduced, allowing candidates to spread the exam fee across two instalments.
The exam tests the knowledge base required for independent general practice in the UK. The clinical medicine component (80%) spans all primary care specialties, from cardiovascular and respiratory to dermatology, mental health, paediatrics, women's health, and musculoskeletal medicine. The evidence-based practice component (10%) tests statistics, critical appraisal, and research methodology. The organisational component (10%) covers NHS structures, practice management, ethics, law, and health informatics.
A maximum of four attempts is allowed for trainees who were in training before August 2023, and six attempts for those entering training from August 2023 onwards. The pass rate for first-time sitters is typically around 75-80%, but this varies by diet.
The Science of Effective AKT Revision
Before choosing tools, understand the learning science that should drive your strategy.
Retrieval practice — testing yourself — is consistently shown to be more effective for durable learning than passive reading or re-reading. Every question you answer is a learning event, whether you get it right or wrong. The act of retrieving information from memory strengthens the neural pathways that hold that information.
Spaced repetition — reviewing material at increasing intervals over time — combats the forgetting curve. Information you encounter once and do not revisit decays rapidly. Information you revisit at optimal intervals becomes durable long-term knowledge. This is the single most important technique for an exam where you need to retain a vast curriculum.
Interleaving — mixing topics within study sessions rather than blocking by subject — builds the discrimination skills the AKT tests. Real exam questions do not come labelled by specialty. Your revision should not either.
The best study tools are the ones that implement these principles systematically, not the ones with the most questions.
The Essential Tool Stack for AKT 2026
Primary Question Banks
Pastest remains the market leader for AKT question volume. It offers over 3,000 AKT-aligned questions, mock exams, a textbook, podcasts, and flashcards. Its strength is sheer scale and exam-theme tracking — Pastest has been producing AKT content long enough to understand what the RCGP emphasises. Pricing typically runs from around £95 for three months to £180 for twelve months.
Passmedicine is the other heavyweight, particularly valued for its "Knowledge Tutor" spaced-repetition feature and its strong data-heavy question style that matches the AKT's critical appraisal section well. Many trainees who have passed the AKT cite Passmedicine's statistics and evidence-based practice questions as particularly close to the real exam.
Quesmed offers a modern platform with MRCGP AKT content, mock exams, and integrated revision notes. It has gained traction among trainees who want a cleaner interface and a more structured learning experience than the legacy platforms provide.
The Adaptive and Spaced Repetition Layer
This is where AI tools add genuine value — not by replacing your primary Q-bank, but by making your revision more efficient.
iatroX's Q-Bank is a free, adaptive question engine mapped to the AKT curriculum. It uses spaced repetition and active recall algorithms to target your weak areas automatically. The workflow is straightforward: complete your primary Q-bank blocks in Pastest or Passmedicine, identify your weak domains, then use iatroX's adaptive mode to drill those specific areas. The spaced repetition mode resurfaces questions you previously got wrong at optimal intervals, ensuring they do not slip through the cracks before exam day.
The critical advantage is that iatroX is completely free. For trainees already spending £100-180 on a primary Q-bank, having a free adaptive layer for targeted weakness work is a significant practical benefit.
Anki remains the gold standard for custom flashcard-based spaced repetition. Many AKT candidates create Anki decks from their Q-bank errors or from guideline summaries. The downside is the setup time — building and maintaining an Anki deck requires significant effort. iatroX's built-in spaced repetition removes this overhead by automating the process within a pre-built question bank.
The Guideline Reference Layer
The AKT tests your ability to apply UK guidelines to clinical scenarios. You need fast, reliable access to current guidance.
NICE CKS is the definitive point-of-care reference for UK general practice. It is free, comprehensive, and directly relevant to the AKT. Every trainee should be using it regularly.
The BNF is essential for prescribing questions, drug interactions, and pharmacology — an area where many candidates lose marks unnecessarily.
iatroX's Ask feature provides a fast, conversational interface to UK guideline content. When you get a question wrong and need to quickly understand the NICE-recommended management pathway, Ask iatroX gives you a citation-first answer with a link to the primary source. This is faster than navigating CKS directly and more reliable than searching Google. The Knowledge Centre serves as a structured front door to NICE, CKS, SIGN, and BNF content, organised by topic.
The Clinical Reasoning Layer
Some AKT questions — particularly the more complex clinical medicine items — test reasoning rather than recall. They present a clinical scenario and ask you to apply knowledge to reach a management decision.
iatroX's Brainstorm tool helps you work through clinical scenarios step by step, exploring differentials, investigations, and management options. This is particularly useful for the complex multi-step questions that the AKT occasionally features, and for building the clinical reasoning patterns that transfer to both the exam and real practice.
Mock Exams and Benchmarking
Pastest mock exams are widely used for benchmarking. They simulate the exam format and provide a score that many trainees find broadly predictive of their actual performance.
BMJ OnExamination offers over 2,000 MLA-aligned questions. Access is often free for BMA members, making it a useful additional source for practice questions without extra cost.
An 8-Week AKT Study Plan
This plan assumes you are in ST2 or ST3, working clinically during the week, and can dedicate 10-15 hours per week to revision.
Weeks 1-2: Foundation and Baseline
Complete a full-length mock exam (Pastest or BMJ OnExamination) to establish your baseline. Score it by domain — clinical medicine, evidence-based practice, and organisational — and by specialty topic. Identify your three weakest clinical areas and your weaker non-clinical domain.
Begin daily Q-bank blocks: 40 questions per day from your primary Q-bank (Pastest or Passmedicine), in timed mode, mixing topics. After each block, review every question — including the ones you got right — and note the topics where your knowledge was uncertain.
Start iatroX adaptive sessions: 20 minutes per day focused on your identified weak areas. Let the adaptive algorithm select questions for you.
Weeks 3-4: Targeted Weakness Work
Continue daily Q-bank blocks (40 questions). Your primary Q-bank should now be generating enough performance data to show clear patterns in your weak areas.
Increase iatroX spaced repetition sessions to 30 minutes per day. The algorithm is now working with your error data and will be surfacing your weakest topics at optimal intervals.
Dedicate two sessions per week to evidence-based practice: critical appraisal, number needed to treat, sensitivity and specificity, study design, and bias types. Use Passmedicine's statistics-focused questions alongside guideline review.
Dedicate one session per week to the organisational domain: NHS structure, GP contract, QOF, consent, capacity, fitness to drive, DVLA rules, certification, and safeguarding. This domain is high-yield because many candidates neglect it.
Weeks 5-6: Consolidation and Integration
Continue daily Q-bank blocks, now doing full 160-question timed sessions twice per week to build exam stamina.
Use Ask iatroX for rapid guideline clarification whenever you encounter an uncertain topic. The goal is to resolve knowledge gaps the same day rather than letting them accumulate.
Begin reviewing your error log systematically. For each error, ask: was this a knowledge gap, a misread, or a reasoning error? Focus your remaining revision on knowledge gaps.
Weeks 7-8: Simulation and Polish
Do two full 160-question timed mocks under exam conditions. Score them by domain and compare with your baseline.
In the final week, do only targeted micro-blocks on iatroX: 15-20 minute adaptive sessions focused on your three to four weakest remaining domains. Do not start new topics. Consolidate what you know.
Review the BNF entries for the most commonly tested drug classes. Review your evidence-based practice notes. Review DVLA guidance, fitness-to-work rules, and common administrative topics.
Rest the day before the exam. You have done the work. Trust the process.
Domain-Specific Tips
Clinical medicine (80%). The breadth is enormous, but the AKT consistently emphasises common presentations: cardiovascular risk management, diabetes, respiratory infections, dermatology, musculoskeletal pain, women's health, and mental health. Focus your revision on the conditions you will see most often in a GP surgery, not rare diagnoses.
Evidence-based practice (10%). This is the domain where targeted revision has the highest return. Learn the key statistical concepts cold: sensitivity, specificity, positive and negative predictive value, number needed to treat, absolute and relative risk reduction, odds ratios, confidence intervals, p-values, and the hierarchy of evidence. These appear in every sitting.
Organisational (10%). DVLA rules, fitness to drive, medical certification, consent and capacity, safeguarding, controlled drugs, notifiable diseases, death certification, and GP contract basics. These are factual, memorisable, and high-yield. Do not neglect them.
Where iatroX Fits in Your Revision
iatroX is designed to complement — not replace — your primary Q-bank. It fills three specific gaps in a traditional AKT revision stack.
First, it provides adaptive, weakness-targeted practice that automatically identifies and drills your weakest areas. This is the revision you should be doing every day but that most static Q-banks do not automate well.
Second, it provides spaced repetition built into the question bank itself, so you do not need to maintain a separate Anki deck for your AKT errors. Questions you got wrong come back at optimal intervals.
Third, it provides instant guideline retrieval via Ask iatroX and the Knowledge Centre, so you can resolve knowledge gaps in seconds during your revision sessions rather than breaking your flow to navigate multiple websites.
It is free, it is UKCA-marked, and it is mapped to the AKT curriculum. For a trainee already investing in Pastest or Passmedicine, adding iatroX as the adaptive and retrieval layer costs nothing and adds measurable efficiency.
Conclusion
The AKT rewards preparation that is structured, evidence-based, and targeted. The format change in October 2025 made each question slightly higher-stakes, but the content and the skills tested remain the same.
Build your stack deliberately: a strong primary Q-bank for volume and exam-style practice, an adaptive layer like iatroX for targeted weakness work and spaced repetition, a reliable guideline reference for rapid clarification, and mock exams for benchmarking and stamina.
Start eight weeks out. Follow the plan. Trust the science. And remember that the best revision is the revision that targets what you do not yet know — not the revision that re-confirms what you already do.