Dr Kola Tytler (MBBS CertHE MBA MRCGP)|21 April 2026|8 min read
The MRCGP Applied Knowledge Test changed format in October 2025. It now consists of 160 questions in 160 minutes — one question per minute, replacing the previous format of 200 questions in 3 hours 10 minutes. The content blueprint remains the same: approximately 80% clinical medicine, 10% statistics and evidence-based medicine, and 10% administration and organisational knowledge. The pass mark is set using modified Angoff methodology.
This guide covers how to approach each section, the dedicated strategies required for the statistics and admin components, and the best resources available in 2026.
The 80% Clinical Medicine Section
The clinical section tests primary care medicine. It is mapped to the RCGP curriculum and covers the breadth of conditions seen in general practice, including diagnosis, investigation, management, prescribing, referral thresholds, and safety-netting.
If you have previously prepared for the MSRA, approximately 60–70% of the clinical knowledge you built for the MSRA CPS paper also applies to the AKT clinical section. The AKT adds GP-specific elements: primary care management of chronic disease, referral criteria for the two-week wait pathway, contraception and sexual health, child safeguarding, palliative care in the community, and conditions that present predominantly in primary care.
For clinical revision, the approach is the same as for any medical Q-bank exam: high-volume question practice with careful review of explanations, supplemented by guideline reading for areas where you are weak.
The dominant resource is PassMedicine, which offers 4,500+ AKT questions aligned to the updated 2025 RCGP curriculum. This is the largest AKT bank available and remains the default choice for most GP trainees. iatroX offers a free AKT Q-bank with AI-adaptive learning — useful as a complement to PassMedicine, especially for targeted weak-area drilling. Pastest and Quesmed also offer strong AKT modules.
The 10% Statistics and Evidence-Based Medicine Section
This is the section that fails GP trainees. It is only 10% of the exam, but it tests material that most clinicians find uncomfortable: sensitivity, specificity, positive predictive value, negative predictive value, number needed to treat, number needed to harm, absolute risk reduction, relative risk reduction, odds ratios, confidence intervals, p-values, study design hierarchy, critical appraisal of papers, and screening programme criteria.
The statistics section requires a different revision approach from the clinical section. Passive question practice is not enough — you need to understand the underlying concepts so that you can apply them to novel scenarios.
Statistics Revision Strategy
Start by learning the core concepts from a structured resource. The Rouleau or RCGP AKT statistics guides provide a solid foundation. The Zero to GP podcast covers AKT statistics in an accessible audio format.
Then practise calculation-based questions. Know how to calculate sensitivity, specificity, PPV, and NPV from a 2x2 table. Know the relationship between prevalence and PPV (high prevalence increases PPV; low prevalence decreases it). Know how to interpret a forest plot and a funnel plot.
Finally, practise critical appraisal questions. These present a study abstract and ask you to identify the study design, the main source of bias, or the appropriate statistical test. The RCGP curriculum specifies which study designs you need to recognise: randomised controlled trials, cohort studies, case-control studies, cross-sectional studies, systematic reviews, and meta-analyses.
Dedicate at least 10% of your total revision time to statistics. Many trainees allocate far less and then lose marks on questions that are, with preparation, highly predictable.
The 10% Administration and Organisational Knowledge Section
This section tests knowledge that is unique to the AKT — you will not encounter it in the MSRA, MRCP, or any other postgraduate exam. It covers the administrative and organisational framework of UK general practice.
Key topics include: DVLA fitness to drive rules (the most frequently tested admin topic), sick note and fit note regulations, GMC duties and procedures, CQC registration and inspection, NHS complaints procedures, mental health legislation (Mental Health Act and Mental Capacity Act), safeguarding processes for children and vulnerable adults, consent and capacity, death certification, and controlled drug regulations.
Admin Revision Strategy
Create or obtain a concise reference sheet covering the key facts for each admin topic. Many GP trainees use PassMedicine's admin section or the BMJ Learning modules. The iatroX clinical AI is particularly useful here — you can query specific DVLA rules or GMC guidance instantly (for example, "What are the DVLA rules for Group 2 licence holders with diabetes?" or "When must a doctor report a patient to the DVLA without consent?").
The admin section is high-yield for its weight: the topics are finite, the facts are concrete, and the questions are relatively predictable. A trainee who memorises the core admin facts can realistically score close to 100% on this section, which compensates for weaker performance elsewhere.
Study Plan
Most GP trainees sit the AKT during ST2 or ST3, while working in GP placements. Time is limited. An efficient plan allocates 10–12 weeks.
Weeks 1–6: clinical question practice (50–80 questions per day) using PassMedicine as the primary bank and iatroX as a free adaptive supplement. Identify weak clinical areas and target them.
Weeks 4–8 (overlapping): statistics revision. Work through a structured statistics resource, then practise calculation and critical appraisal questions.
Weeks 6–10: admin revision. Memorise the core admin facts. Use spaced repetition (Anki or iatroX's spaced repetition mode) to retain them.
Weeks 9–12: mock exams and consolidation. Do at least two full-length mock exams under timed conditions (160 questions, 160 minutes). Review errors and target remaining gaps.
The MSRA to AKT Pipeline
If you prepared well for the MSRA, you have a significant head start on the AKT clinical section. The unique AKT work is statistics (10%), admin (10%), and GP-specific clinical topics. A well-prepared MSRA candidate can potentially reduce their AKT revision timeline to 8 weeks by focusing on these three areas.
Using a platform that covers both exams — such as PassMedicine (separate MSRA and AKT modules in one account) or iatroX (free MSRA and AKT banks with shared adaptive progress) — means your performance data carries forward, and weak areas identified during MSRA revision can be addressed during AKT preparation.
Resources Summary
PassMedicine: 4,500+ AKT questions. Volume leader. Knowledge Tutor textbook. Very affordable.
iatroX: free AKT Q-bank with AI-adaptive learning and spaced repetition. Integrated clinical AI for instant guideline and admin fact lookup. Covers MSRA + AKT + specialist diplomas on one platform.
Pastest: premium AKT module with past papers, multimedia, and AI tutor.
Quesmed: AKT alongside UKMLA and MRCP. Knowledge library and flashcards.
Zero to GP podcast: free audio covering AKT topics including statistics.
BMJ OnExamination: check if your Trust provides free access.
Information based on public sources and the 2025 RCGP curriculum as of 21 April 2026. Trademarks belong to their owners.