The MRCGP Applied Knowledge Test (AKT) is the written component of MRCGP membership — testing the breadth of clinical, organisational, and evidence-based knowledge that GPs need in daily practice. The exam covers clinical medicine (approximately 80% of questions), evidence interpretation and statistics (approximately 10%), and organisational/professional topics (approximately 10%).
AKT preparation is uniquely demanding because of the breadth: GP trainees must cover chronic disease management across all major specialties, prescribing safety, paediatrics, women's health, mental health, dermatology, musculoskeletal medicine, ENT, ophthalmology, evidence-based medicine, critical appraisal, statistics, practice management, ethics, and medico-legal topics — all at a primary care depth that differs from hospital-focused exams.
What Makes a Good MRCGP AKT Revision App?
Primary care orientation. AKT questions test GP-relevant management — not tertiary-level subspecialty knowledge. Questions should reflect what a GP would manage, refer, safety-net, or prescribe — including NICE guideline-concordant management, UK prescribing practice, and primary care investigation and referral thresholds.
Breadth of coverage. The AKT covers an exceptionally wide clinical range. A Q-bank focused only on medicine or only on therapeutics is insufficient. Coverage must span the full AKT curriculum including statistics, evidence interpretation, and organisational topics.
Statistics and critical appraisal. The 10% evidence-interpretation component catches candidates who neglect it. Questions on NNT, sensitivity, specificity, likelihood ratios, study design, and guideline appraisal require specific preparation.
SBA format. The AKT uses SBA questions with clinical vignettes. Revision questions should match this style — applied reasoning, not isolated factual recall.
Mock exams. The AKT was historically 200 questions in 3 hours 10 minutes; from October 2025 it is 160 questions in 160 minutes — a demanding pace that requires timed practice to prepare for.
Comparison
| App | AKT coverage | GP focus | Mocks | Stats/EBM | Spaced repetition | Adaptive |
|---|---|---|---|---|---|---|
| PassMedicine | Yes | Yes | Yes | Yes | No | No |
| Pastest | Yes | Yes | Yes | Yes | No | No |
| BMJ OnExam | Yes | Yes | Yes | Partial | No | No |
| iatroX | Yes | Yes — primary care weighted | Yes | Yes | Yes | Semantic adaptive |
Where iatroX Fits
iatroX has built its MRCGP AKT collection around the AKT curriculum — covering clinical medicine, evidence interpretation, and organisational topics in proportions that reflect the exam's published weighting. Questions are written in SBA format with primary care clinical vignettes, reflecting the management decisions a GP would face in daily practice.
The Q-bank includes mock exam mode (full-length, timed to AKT specifications), study plan mode (structured revision across the AKT curriculum), spaced repetition (missed concepts resurface), and semantic adaptive learning (recognising that repeated errors across diabetes, hypertension, cardiovascular risk, and prescribing may represent a common chronic-disease-management weakness).
For GP trainees, the MRCGP AKT Q-bank is part of iatroX's UK core exam offering. Ask iatroX sits alongside for clinical clarification during revision — when a Q-bank question reveals a knowledge gap, the clinician can check the guideline or medicines question immediately.
How to Use iatroX for MRCGP AKT Revision
- Start with a diagnostic mixed block to identify baseline performance across clinical, stats, and organisational domains.
- Focus early revision on clinical medicine (80% of the exam) by curriculum area.
- Schedule dedicated statistics and evidence-interpretation sessions — do not leave the 10% to the final week.
- Use spaced repetition throughout — primary care breadth is too wide to cover once and hope it sticks.
- Sit timed mocks every 1-2 weeks from 8 weeks before the exam.
- In the final month, increase mock frequency and review high-yield topics based on exam-pattern analysis.
Final Verdict
The MRCGP AKT demands broad primary care coverage, exam-style SBA practice, statistics preparation, and timed mocks. For GP trainees who want all of these with spaced repetition and adaptive learning, iatroX is a strong addition to the AKT revision stack.
Start MRCGP AKT revision with iatroX →
MRCGP AKT Exam Format and Key Facts
The MRCGP AKT now consists of 160 questions in 160 minutes (changed from 200/3h10m from October 2025). 80% clinical, 10% EBP, 10% organisational. The pass mark is ~70-72%, varies by sitting. The exam fee is £470. Maximum attempts: 4 attempts (pre-Aug 2023) or 6 (post-Aug 2023). Overall pass rate: 70-80% overall.
The 2025 format change maintains one-minute-per-question pacing but with a shorter overall exam. The balance remains: 80% clinical medicine, 10% evidence-based practice (statistics, critical appraisal), and 10% organisational topics (practice management, NHS structures, ethics, medico-legal).
AKT Clinical Domain Deep Dive
The clinical 80% covers every area of primary care: cardiovascular (hypertension, lipids, AF, heart failure), respiratory (asthma, COPD), diabetes and endocrinology (T2DM stepwise management, thyroid, HRT), mental health (depression, anxiety, psychosis — first-line management and referral), MSK (back pain red flags, OA, inflammatory arthritis recognition), dermatology (eczema, psoriasis, skin lesion assessment), paediatrics (childhood infections, safeguarding, developmental assessment), women's health (contraception including UKMEC categories, cervical screening, menopause), and ENT/ophthalmology.
The EBP 10% tests statistical literacy: NNT, NNH, sensitivity, specificity, PPV, NPV, absolute vs relative risk reduction, confidence intervals, p-values, and critical appraisal. Candidates who have not studied statistics systematically find this disproportionately difficult.
The organisational 10% tests NHS structures (PCNs, ICBs), contractual frameworks (GMS, PMS, QOF), medico-legal topics (capacity, consent, confidentiality, fitness to drive, notifiable diseases), and professional issues (GMC guidance, appraisal, revalidation).
AKT Competitor Landscape
PassMedicine (4,500+ AKT questions) and Pastest (3,300+) have been the dominant AKT revision platforms for years. Both offer comprehensive question banks with detailed explanations aligned to UK primary care practice. BMJ OnExam positions around blueprint mapping. GPNotebook provides a clinical knowledge reference. iatroX adds adaptive learning, spaced repetition, mock exams, and study planning alongside its clinical AI features — a more integrated approach to AKT preparation than traditional Q-banks offer.
Building an Effective MRCGP AKT Study Strategy
Effective MRCGP AKT preparation follows a structured progression from broad coverage to targeted consolidation.
Phase 1 — Foundation building (weeks 1-4 of a 12-16-week plan). Work through questions by topic area in untimed mode. The goal is broad coverage, not speed. Read every explanation thoroughly, including why incorrect options are wrong. Flag topics where understanding feels superficial rather than confident. Use iatroX's topic filters to ensure systematic coverage rather than gravitating toward comfortable subjects.
Phase 2 — Gap identification and targeted revision (weeks 5-8). Review analytics to identify persistent weak areas. Shift from broad coverage to targeted work on the topics where performance lags. iatroX's adaptive algorithm prioritises questions from areas where the candidate has demonstrated uncertainty, ensuring revision time is spent where it will have the greatest impact. Spaced repetition scheduling resurfaces previously answered questions at intervals optimised for long-term retention.
Phase 3 — Exam simulation and consolidation (final 4+ weeks). Transition to timed practice and full mock exams. Mock exams should replicate exam conditions as closely as possible — full-length, timed, with no interruptions. Review mock performance not just for content gaps but for pacing, question interpretation, and decision-making under time pressure. iatroX's mock exam mode generates exam-length papers that mirror the real assessment format.
Active recall vs passive reading. The evidence for active recall in medical education is robust. Answering questions, retrieving information from memory, and testing oneself are consistently more effective than re-reading notes or textbooks. A well-structured Q-bank provides the scaffolding for active recall — each question is a retrieval opportunity, each explanation is a learning event. Combined with spaced repetition, this produces durable knowledge that persists to exam day and beyond.
Analytics-driven adjustment. Static study plans assume every candidate starts from the same baseline and progresses at the same rate. Analytics-driven preparation — where study allocation adjusts based on actual performance data — is significantly more efficient. iatroX's dashboard shows per-topic accuracy, trend data, and comparison between areas, enabling candidates to make evidence-based decisions about where to spend their limited revision time.
Common MRCGP AKT Preparation Mistakes
Over-relying on a single resource. No single Q-bank, textbook, or course covers everything. Candidates who use only one resource risk developing blind spots in areas that resource under-represents. The strongest preparation combines a primary Q-bank with supplementary reading and, where possible, a second source of practice questions for cross-referencing.
Studying topics rather than weaknesses. Candidates naturally gravitate toward topics they find interesting or already know well. Effective preparation requires the opposite — disproportionate time on the areas where performance is weakest. Analytics tools that track per-topic accuracy and flag persistent weak areas are essential for overcoming this tendency. Without data, candidates spend revision time reinforcing strengths rather than closing gaps.
Neglecting exam technique. Knowledge alone is insufficient. Candidates who never practise under timed conditions often find that exam-day time pressure degrades their performance by 10-15% compared to untimed practice. Regular timed practice and full-length mock exams build the pacing, endurance, and decision-making stamina that the real exam demands. This is a trainable skill, not an innate one.
Starting too late. Cramming produces short-term recall but poor long-term retention. Spaced repetition — revisiting material at increasing intervals — builds durable knowledge. Starting preparation early enough to allow multiple revision cycles produces significantly better outcomes than last-minute intensive cramming. A 16-week plan with moderate daily study consistently outperforms a 4-week plan with intensive daily study.
Ignoring incorrect answers. Many candidates check whether they got a question right and move on. The learning value is primarily in the explanation — understanding why the correct answer is correct, why each distractor is wrong, and what clinical reasoning links them. Candidates who spend time on explanations learn more per question than those who rush through high volumes without reflection.
How iatroX Supports MRCGP AKT Preparation
iatroX provides several features specifically relevant to MRCGP AKT candidates:
Adaptive question selection. Rather than presenting questions randomly, iatroX's adaptive algorithm analyses performance patterns and selects questions that target demonstrated weak areas. Revision time is spent where it will have the greatest impact on exam readiness, not reinforcing already-strong topics.
Spaced repetition scheduling. Previously answered questions are re-presented at intervals calibrated to the spacing effect. Incorrectly answered questions return sooner; correctly answered questions are spaced further apart. This produces durable long-term retention rather than fragile short-term recall.
Mock exam mode. Full-length, timed mock exams replicate the structure and time constraints of the real assessment. Mock analytics show per-topic performance, pacing data, and score trends across multiple attempts — enabling candidates to track improvement and identify persistent gaps.
Study planning. Personalised study plans based on exam date, available study time, and current performance level. Plans adapt as the candidate progresses, shifting emphasis toward areas where improvement is most needed.
Multi-platform access. Available on web, iOS, and Android — enabling revision during commutes, placements, and breaks without losing progress or analytics data. Progress syncs across all devices automatically.
Clinical AI integration. Ask iatroX provides guideline-grounded clinical queries powered by RAG over NICE, CKS, BNF, EMC, and NHS content — enabling candidates to verify management approaches against current UK guidelines during revision. Over 80 clinical calculators cover scoring systems and decision tools used in daily practice. CPD tracking with FourteenFish integration means the platform serves beyond exam preparation into ongoing professional development.
MHRA-registered platform. iatroX holds UKCA marking and MHRA Class I registration — a regulatory standard that most revision platforms do not hold, reflecting the platform's clinical decision support capabilities alongside exam preparation.
2026 Revision Strategy and Resource Checklist
Candidates should treat every revision resource as an exam-performance tool, not simply as a content library. The strongest platforms make the candidate practise the same cognitive task the real exam demands: reading a vignette, identifying the discriminating clinical clue, choosing the safest answer, and learning from the distractors. For this reason, the most useful comparison is not "which app has the most questions?" but "which app produces the most improvement per hour of revision?"
The key capability is primary care judgement, guideline-concordant management, evidence interpretation and organisational knowledge. That means a revision app should provide more than topic filters. It should let candidates build a representative exam mix, practise in timed mode, revisit missed concepts, and see whether performance is improving across the domains that actually matter. The RCGP AKT information confirms the current 160-question, 160-minute AKT structure and the 80/10/10 split across clinical knowledge, evidence-based practice and organisational topics.
A practical way to evaluate a question bank is to inspect ten explanations before committing. Strong explanations usually do four things: they identify the diagnosis or principle being tested, explain why the correct answer is safer or more appropriate than the alternatives, show why the distractors are tempting but wrong, and link the point back to a repeatable exam rule. Weak explanations simply restate the answer. In high-stakes medical exams, that difference matters because candidates lose marks at the margin: two options may look plausible, but only one is most appropriate in that clinical context.
A Practical 16-20 weeks Study Workflow
A sensible MRCGP AKT plan should begin with a mixed diagnostic block rather than a favourite topic. The purpose is not to score highly on day one; it is to expose the initial pattern of weakness. Once the baseline is clear, the first phase should focus on broad curriculum coverage. Candidates should work in untimed mode, read explanations carefully, and convert recurrent errors into a small number of revision rules: "what did I miss?", "what clue should have changed my answer?", and "what will I do next time I see this pattern?"
The second phase should become more selective. This is where iatroX's adaptive learning and semantic similarity approach become useful. Instead of merely showing that a candidate is weak in a large topic such as cardiology, respiratory medicine, paediatrics or prescribing, the platform can identify clusters of related errors across apparently separate labels. A candidate who repeatedly misses questions involving breathlessness, anticoagulation, heart failure and renal dosing may not have four unrelated weaknesses; they may have one underlying weakness in integrated cardiorenal decision-making. Targeting that root gap is more efficient than simply serving another random block from the same broad category.
The final phase should be dominated by timed work and mocks. Untimed practice builds knowledge, but timed practice builds the exam behaviour: reading stems efficiently, resisting overthinking, managing uncertainty and recovering after difficult questions. Candidates should deliberately practise NICE- or local guideline-aligned chronic disease review, safeguarding, prescribing safety, multimorbidity and prevention. These are the areas where a good app should force active recall rather than passive recognition.
What iatroX Adds Beyond a Traditional Q-Bank
iatroX is positioned as a revision layer and a clinical reasoning layer. The question bank provides curriculum-mapped practice, mocks, spaced repetition and adaptive recommendations. Ask iatroX, calculators and CPD logging then connect that revision to clinical practice. This matters because most candidates are not revising in isolation; they are revising while working, on placement, preparing for another exam, or moving between health systems.
The practical advantage is continuity. A candidate can use iatroX for focused practice, switch to a mock, clarify a guideline-linked point, return to missed concepts through spaced repetition, and then use the same broader platform in clinical work. For candidates preparing for more than one assessment, multi-exam access also reduces duplication. Knowledge built for one exam often supports another, but only if the platform is organised around reusable clinical concepts rather than isolated exam silos.
Candidate Checklist Before Subscribing
Before choosing a revision resource, candidates should check:
Does it match the exam format? SBA, MCQ, EMQ, calculation, written response and case-simulation exams require different practice behaviours.
Does it map to the curriculum or blueprint? Large question volume is less useful if the distribution does not reflect the real assessment.
Does it support timed mocks? Exam performance depends on pacing and endurance, not knowledge alone.
Does it resurface missed concepts? Without spaced repetition, early revision decays while later topics are being covered.
Does it show actionable analytics? Topic percentages are useful, but the best systems identify the clinical reasoning pattern behind repeated errors.
Does it fit real working life? Mobile access, short practice blocks and continuity across devices are not luxuries for clinicians; they are what make consistent revision possible.