Failing the MRCGP AKT is rarely a verdict on your ability as a GP trainee. It is more often a mismatch between everyday primary-care reasoning and the exam's specific decision thresholds, its statistics and administrative content, and the one-minute-per-question pacing that came in with the shorter format. Start from your score report, not from a blank revision plan.
Since October 2025 the AKT has been 160 single-best-answer questions in 160 minutes — almost exactly a minute each — with no negative marking and four sittings a year in January, April, July and October. The content split is unchanged: 80% clinical medicine, 10% evidence-based practice and critical appraisal, and 10% primary-care organisation, management, ethics and statutory frameworks. The shorter paper gives slightly more time per item, but it also means each question now carries more weight, so there is less room to absorb careless losses.
The AKT is not just clinical knowledge
The most useful reframe after a failure is that the AKT tests primary-care decision thresholds, not textbook facts. A GP who manages a presentation safely in clinic can still pick the wrong option when the exam asks for the threshold at which you would refer, investigate or escalate. The clinical domain is where most banks prepare you well; the two 10% domains are where candidates quietly lose a pass.
Rebuild from the three domains
Your score report breaks performance down by the three domains above. Read it before you revise anything, because the remediation for each is different.
| Domain | Common failure | What to do |
|---|---|---|
| Clinical medicine (80%) | Treating it like finals or MRCP, out-of-date thresholds | Blueprint-led blocks; check current NICE/CKS thresholds on misses |
| Evidence-based practice (10%) | Under-revising statistics and critical appraisal | Short, frequent stats blocks until the concepts are automatic |
| Organisation and management (10%) | Ignoring NHS structure, regulatory and ethical frameworks | A dedicated admin and governance block, not incidental reading |
Beyond the domains, watch for pacing collapse, weak image and rash recognition, and — counter-intuitively — overthinking the obvious GP presentations until a safe answer starts to look like a trap.
Your recovery plan
The first 48 hours are for dissecting the score report and being honest about which domain dragged you down. Over the following five days, run one focused block per weak domain rather than revising everything at once. Each week, sit a timed 160-question mock to rebuild pacing for the new format. Daily, do around 20 questions from your weakest clinical area plus 10 statistics or admin questions, so the two small domains never go cold.
The resources worth using honestly
PassMedicine and Pastest are both strong, widely used traditional banks with large AKT-aligned content, and the RCGP's own self-test material is worth using for official question style. The candid point is that breadth is rarely the missing piece after an AKT failure — targeted repair of weak domains and better pacing usually are.
Where iatroX fits
iatroX is built by UK GPs and grounds its AKT content in current UK guidance — NICE, CKS, SIGN and NHS content — which is exactly where the threshold and "hot topic" questions live. The adaptive engine surfaces your weakest domains first, so you spend the limited days before a resit on cardiology or statistics rather than re-covering ground you already hold, and incorrect items return at spaced intervals to keep the volatile admin and stats facts warm. When a miss reflects a misconception rather than a gap, the Socratic Tutor asks you to reason it out before it resolves the point, which is more durable for borderline GP decisions than reading a model answer. Used this way, it is the free daily layer that makes your primary bank more efficient, not a replacement for it.
A short FAQ
How many attempts do I have? The number depends on when you entered GP training, so check the current RCGP rules for your cohort — and prioritise a first-time-ready resit rather than burning an attempt.
Should I do 200-question mocks to build stamina? No. Train for the 160-question format you will actually sit, so your pacing matches the exam rather than the old one.
Which domain should I prioritise? The one your score report flags, not the one that feels hardest. The two 10% domains — evidence-based practice and organisation — are where many candidates quietly lose a pass.