PassMedicine is a capable engine for the clinical bulk of the MRCGP AKT — and a dashboard that is structurally blind to the two non-clinical thirds that decide many candidates' results. This audit is for GP trainees deciding how far to trust its numbers. The principal limitation: the AKT deliberately splits into clinical medicine, evidence-based practice and organisational content, and a clinical Q-bank's analytics tell you least about the two areas that most often separate a pass from a fail.
What PassMedicine offers for MRCGP AKT right now
As of 19 July 2026, PassMedicine sells low-cost fixed-term AKT access on its standard model — a large single-best-answer bank, timed and revision modes, textbook notes, and peer-comparison analytics. No AI tutor is advertised; you configure the practice loop. Verify current counts and price on the product page; the offering follows the same low-cost pattern as its MRCP product (5,100+ questions, £35 for four months). PassMedicine's clinical coverage is strong and its value obvious. The audit below is about what its dashboard cannot see.
The exam the numbers must answer to
The MRCGP Applied Knowledge Test is a computer-based single-best-answer exam at Pearson VUE centres, sat four times a year, with a content split the RCGP publishes explicitly: roughly 80% clinical medicine, 10% evidence-based and critical-appraisal practice, and 10% organisational, administrative and regulatory content covering UK general practice. The format changed from October 2025: the paper moved from 200 questions in 3 hours 10 minutes to 160 questions in 2 hours 40 minutes, keeping the same content weightings. Confirm the current format and your attempt limits on the RCGP pages before you plan.
Two consequences. The evidence-based-practice component is statistics and critical appraisal — a distinct skill that clinical drilling does not build. And the organisational component (regulation, certification, practice management, UK-specific administrative frameworks) is pure knowledge that specialty-flavoured clinical practice systematically under-samples. Together they are a fifth of the exam and a disproportionate share of its failures.
What each metric actually measures
First-attempt accuracy on unseen items is the dashboard's only exam-shaped number. Repeat accuracy measures recognition and rises with exposure regardless of learning. The peer percentile compares you with a self-selected population of PassMedicine users at unknown stages — motivation, not prediction. Coverage counts attempts, not competence, and is the raw material for the audit below. Difficulty and time-per-item are diagnostic per topic. And critically: none of these metrics distinguishes your performance on the clinical 80% from the evidence and organisational 20% unless you deliberately filter — so an overall percentage silently blends three different exams into one flattering number.
Selection bias and the three-way blend
Every dashboard number reflects conditions you chose, so the general warning about Q-bank percentages applies. The AKT-specific twist is the blend: if you practise mostly clinical questions (the comfortable majority of any bank), your overall percentage is essentially a clinical score wearing an AKT label, and it tells you almost nothing about the statistics and organisational content that will decide your margin. The fix is to stop reading the overall number and start reading three numbers.
The three-strand audit
Fortnightly, separate your analytics into the exam's three strands and read each on its own. Clinical: is coverage broad across the RCGP curriculum's clinical areas, and is unseen accuracy stable? Evidence-based practice: have you done enough critical-appraisal and statistics questions to have a real accuracy figure — and is it good? This is the strand candidates most often discover, too late, they never practised. Organisational: have you deliberately covered fitness-to-practise, certification, regulatory and practice-management content, or has it never appeared because you never filtered for it? An overall 72% that is 76% clinical, 55% evidence and 12 organisational questions attempted is not a 72% — it is a pass-shaped clinical score with two unexamined liabilities underneath.
What a credible readiness signal requires
Per strand, not in aggregate: unseen questions, exam-pace timing (the new format allows one minute per item), mixed composition within the strand, no assistance, and a sample large enough to trust. For evidence-based practice and organisational content specifically, "enough" often means "more than you have done", because these strands generate few questions in a self-directed clinical feed. A defensible readiness statement names all three strands; a percentage names none of them.
When to override the selector
Force evidence-based-practice blocks weekly — statistics, study design, likelihood ratios, number-needed-to-treat — because this strand is a distinct skill and the highest-yield fix for most trainees. Force organisational content on a rota, because it never surfaces unprompted. Force timed mixed blocks at the new one-minute pace. And treat the clinical majority as the part that can look after itself once covered, rather than the part that absorbs all your attention because it is the most comfortable.
A worked dashboard example
Six weeks out, suppose: overall 70%; cardiovascular 78% over 300 attempts; respiratory 74% over 250; mental health 61% over 90; evidence-based practice 52% over 40; organisational 15 questions attempted; timed pace 72 seconds per item.
Translated: clinical strong areas are maintained, not grown. Mental health takes a clinical quota. But the two real jobs are the non-clinical strands — evidence-based practice at 52% over a thin sample is a live liability that gets three dedicated blocks this fortnight, and organisational content at 15 attempts is essentially unexamined and gets its first proper coverage. Pace at 72 seconds needs bringing under the 60-second budget the new format demands. No overall pass prediction appears, because the overall number was hiding the two things most likely to fail you.
A seven-day pattern for busy trainees
Monday: 40 PassMedicine clinical questions in a weak area, explanations read. Tuesday: a dedicated evidence-based-practice block — statistics and appraisal — reviewed slowly. Wednesday: a timed, unseen 40-question mixed block in iatroX's free MRCGP AKT bank, whose adaptive selection spans the curriculum rather than repeating your history. Thursday: an organisational-content session plus error review. Friday: 40 clinical questions, timed at one minute each. Saturday: a full timed mixed simulation across all three strands, same-day review. Sunday: rest. PassMedicine drills clinical volume; iatroX measures on unseen items; the non-clinical strands get protected time they never get by default.
Why the two non-clinical strands decide borderline results
It is worth dwelling on why a fifth of the exam accounts for so many failures. The clinical 80% is where candidates are comfortable, well-resourced and heavily practised — which means most people arrive with broadly similar clinical scores, and the clinical strand does not discriminate much at the margin. The evidence-based-practice and organisational strands are the opposite: under-practised, under-resourced, and treated as an afterthought, so performance on them varies enormously between candidates. At the borderline, the marginal mark is far more likely to come from a critical-appraisal question you can actually work or a certification rule you actually know than from your five-hundredth clinical item. That is the statistical reason this workflow refuses to let the overall percentage stand in for three separate readings — the average is dominated by the strand that discriminates least.
The practical implication is uncomfortable but liberating: once your clinical coverage is broad and stable, additional clinical volume has low marginal value, and an hour moved from clinical drilling to critical appraisal or organisational content is almost always the higher-yield choice. Most candidates feel the opposite pull — clinical practice is where they feel competent — which is exactly why the strand floors have to be set deliberately and defended against the comfort of the clinical feed.
A note on the format change
The move from 200 questions in 3 hours 10 minutes to 160 questions in 2 hours 40 minutes (from October 2025) did not change the content weightings, but it did tighten the clock slightly and reduce the number of items across which a weak strand can be diluted. With fewer questions, each strand carries proportionally similar weight but less room to absorb a bad run, which raises rather than lowers the value of covering the non-clinical strands properly. Confirm the current format for your sitting on the RCGP pages, and set your timed-block pace to the current per-item budget rather than an older one.
Continue, supplement, switch or stop
Continue while all three strands are improving on unseen timed material. Supplement the moment your evidence or organisational strands lag — that is the highest-value intervention available. Switch only for a measurable gap (our AKT resources are here). Stop accumulating clinical volume in the final fortnight once all three strands meet their floors; simulate the whole paper at the new pace.
Frequently asked questions
Is PassMedicine enough for MRCGP AKT on its own? It can carry the clinical majority well, but its analytics are blind to the evidence-based-practice and organisational thirds unless you deliberately filter, so pair it with dedicated practice in those strands and unseen timed mixed blocks.
Which MRCGP AKT component does PassMedicine not reproduce well? The evidence-based-practice (statistics and critical appraisal) and organisational strands — around a fifth of the exam and a disproportionate share of failures — which specialty-clinical drilling systematically under-samples.
How many PassMedicine questions should I complete per day for MRCGP AKT? 40–60 on study days, but composition is the point: protect weekly evidence-based-practice and organisational blocks regardless of the clinical count, and time your practice at the new one-minute-per-item pace.
When should I stop using PassMedicine and move to mixed mocks? When all three strands meet their coverage floors, unseen accuracy is stable and pace is under a minute per item — the final two to three weeks, given to full timed simulation.
How should I combine PassMedicine with iatroX without duplicating practice? PassMedicine for clinical drilling; iatroX (free for MRCGP AKT) for unseen adaptive measurement across all three strands and Socratic repair on misses — no repeated questions, and an honest readiness signal. The strand discipline is the point: whatever you drill in PassMedicine, make sure your iatroX measurement blocks deliberately sample the evidence-based-practice and organisational content too, so your readiness figure reflects the whole paper rather than the clinical majority you find easiest to practise.
Editorial notes and references
Written by Dr Kolawole Tytler, NHS GP and founder of iatroX. Last checked 19 July 2026; the AKT format change (from October 2025: 160 questions in 2 hours 40 minutes) and content weightings are per the RCGP; PassMedicine details are vendor-published — verify current format, counts, price and your attempt limits before relying on them. Disclosure: iatroX offers a free competing MRCGP AKT bank. Corrections via the feedback route on iatrox.com. References: RCGP Applied Knowledge Test pages (rcgp.org.uk); PassMedicine product pages; related reading: the iatroX MRCGP AKT hub, how to pass the AKT first time and why your Q-bank percentage is not your exam score.