The AKT changed format in October 2025 — now 160 questions in 2 hours 40 minutes. The domain split remains 80% clinical, 10% evidence-based practice, 10% organisational management. Each question now carries more weight than before — you can afford fewer mistakes.
The AKT exam fee is £470. A maximum of 4 attempts is allowed if you entered training before August 2023; 6 attempts if you entered after. First-time pass is the goal.
The Three Domains
Clinical (80% — 128 questions). Broad primary care medicine across all specialties. This is what most Q-banks prepare you for. Passmedicine, Pastest, and iatroX all cover this domain well.
Evidence-Based Practice (10% — 16 questions). NNT, NNH, sensitivity, specificity, positive/negative predictive value, study design interpretation, audit cycle, meta-analysis. Trainees who neglect this domain lose 16 questions — enough to fail.
Organisational (10% — 16 questions). NHS contract structures (GMS/PMS/APMS), QOF, CQC, clinical governance, screening programmes, medico-legal frameworks (GMC duties, capacity, consent, Gillick competence). Same story — 16 questions that many trainees do not specifically revise for.
12-Week Study Plan
Weeks 1-2: Take a baseline diagnostic mock (FourteenFish or your primary Q-bank). Identify your weak domains and topic areas. Set up your daily routine.
Weeks 3-6: Systematic Q-bank work. 50 questions per day minimum from your primary bank (Passmedicine or Pastest). Verify every wrong answer against CKS/BNF. iatroX adaptive quiz for 15 minutes daily — it automatically targets your weakest topics.
Weeks 7-8: Focused EBP and organisational blocks. Most trainees have neglected these — dedicate specific sessions to statistics, audit, contracts, and governance.
Weeks 9-10: Full mock exams under timed conditions (160 questions, 2h40m). Analyse performance patterns — are you consistently weak in specific specialties or question types?
Weeks 11-12: Targeted revision of persistent weak areas. Review NICE guideline updates from the past 6 months (hot topics). Final mock exam. Light revision in the final 2-3 days.
Daily Routine Template
45-60 minutes primary Q-bank → 15 minutes iatroX adaptive quiz → 15 minutes CKS/BNF verification of wrong answers. Total: 75-90 minutes/day.
Where iatroX Fits
iatroX's adaptive engine automatically surfaces your weakest topics — no manual triage needed. It is the free daily revision layer that makes your primary Q-bank more efficient. Ask iatroX provides instant guideline verification for every wrong answer.