Executive summary
Scoring highly in UK postgraduate medical exams like the MRCGP AKT and MRCP(UK) requires more than just knowledge; it demands a clear strategy. The key to success is to know the exam format and its blueprint cold, and to align your revision to what is actually examined. For the AKT, this means a focus on clinical medicine, evidence-based practice, and organisational aspects, with standards set by the modified-Angoff method. For the MRCP, it means mastering the "best-of-five" format for the written papers and the slick five-station carousel of the PACES23 clinical exam (Royal College of General Practitioners, Royal Colleges of Physicians UK).
Official examiner feedback consistently highlights recurring weak domains, such as data interpretation in the AKT. A practice-first study schedule, anchored to the definitive UK sources—NICE guidance, CKS, and the BNF for the AKT, and core medical texts for the MRCP—is non-negotiable. Modern, UK-centric AI tools like iatroX can accelerate the verification of guideline-based answers, but the final word always rests with these primary sources.
Understand the exams you’re sitting (formats, timings, standard setting)
MRCGP AKT
The Applied Knowledge Test (AKT) is a computer-based exam comprising 200 questions over 3 hours and 10 minutes. The questions are predominantly single-best-answer and extended-matching formats. Its domain weighting is approximately 80% clinical medicine, 10% evidence-based practice (including statistics), and 10% organisational/administrative issues. The pass mark is determined using a modified-Angoff standard-setting approach, where a panel of experienced GPs assesses each question to determine the standard expected of a competent trainee. Learn more on the RCGP website.
MRCP(UK) Part 1 / Part 2 Written
Both the Part 1 and Part 2 written exams consist of two, three-hour papers, each containing 100 "best-of-five" questions. The questions are designed to test clinical reasoning and application of knowledge rather than simple recall. Learn more on the MRCP(UK) website.
MRCP(UK) PACES (PACES23)
The Practical Assessment of Clinical Examination Skills (PACES) now runs in the PACES23 format. This is a five-station clinical carousel, with each cycle lasting 20 minutes and involving two independent examiners. It is designed to assess a candidate's ability to perform key clinical skills, from physical examination to communication and patient assessment.
Use the official blueprint to drive your plan
Your revision must be guided by the official exam syllabus, not just by what you think is important.
- AKT: The RCGP provides a detailed content guide and topic distribution. Use the official RCGP Curriculum "Clinical Topic Guides" to understand the breadth of knowledge required.
- MRCP: The MRCP(UK) website publishes the syllabus for its written exams and the curriculum for PACES, outlining the core specialties and clinical sciences that will be tested.
What recent examiner feedback says (and how to exploit it)
The official feedback reports published after each exam sitting are a goldmine of information. For example, the AKT January 2025 feedback report consistently highlights that candidates struggle with evidence and data interpretation items. This is a clear signal to convert this weakness into a strength by doing targeted drills on statistics and critical appraisal. Similarly, the reports often detail the overall pass mark (typically around 70%) and mean scores, giving you a clear target to aim for.
High-yield revision strategy (evidence-based habits)
- Deliberate practice: Use spaced repetition and mixed-set question banks to simulate exam conditions. Progressively increase the difficulty and timing pressure as you improve.
- Error log to primary sources: For every question you get wrong, create an error log. More importantly, go back to the primary source to understand why. For the AKT, your ground truths are NICE, CKS, and the BNF. For the MRCP, it's your core medical textbooks and major clinical guidelines.
- Master the "best-of-five" technique: For the MRCP written exams, learn to triage the question stem, identify the core clinical problem, and then systematically prune the five options to find the single best answer.
- Weekly mock cadence: Complete at least one timed mock exam per week in the run-up to your test. Spend as much time analysing your performance and weak domains as you did sitting the mock.
The AKT blueprint in practice (UK-GP specifics)
The RCGP is explicit about the core resources you must use for your AKT preparation. The RCGP’s own resource hub, NICE CKS, the BNF/BNFC, and GMC Good Medical Practice are repeatedly emphasised. Dedicate protected time to the non-clinical domains where candidates often lose marks: prescribing safety, statistics/EBM, and organisational/management topics. The RCGP has an excellent guide on data interpretation that is essential reading. During your revision, you can use a UK-centric AI search tool like iatroX to quickly ask questions about NICE guidelines, but you must always open the cited source to verify the answer against the full context.
The MRCP blueprint in practice (internal medicine breadth)
- Part 1: Focus on breadth across the clinical sciences and common medical disorders. Align your study blocks to the official syllabus.
- Part 2 Written: This requires more clinical application. Practise longer, data-heavy vignettes and questions that require you to interpret results in context.
- PACES23: Success in PACES is about performance. Practise your examination choreography until it is slick. Refine your communication for clarity and empathy. Structure your thinking: differentials → diagnosis → management.
6-week and 12-week templates
| Focus | 12-Week Plan (Example) | 6-Week Plan (Example) |
|---|---|---|
| Weeks 1-4 | Baseline mock. Deep dive into 2-3 core topics per week. 50 Qs/day. | Baseline mock. Rapid review of all major topics. 75 Qs/day. |
| Weeks 5-8 | Mid-point mock. Focus on weak domains identified. 75 Qs/day. | Mid-point mock. Intense focus on weak domains. 100 Qs/day. |
| Weeks 9-12 | Two final mocks. Timed practice & exam technique. 100+ Qs/day. | Two final mocks. Timed practice & consolidation. 100+ Qs/day. |
Quick comparison tables
| Exam | Format | Time | Question Style | Core Sources | Common Pitfalls |
|---|---|---|---|---|---|
| MRCGP AKT | 200 items | 3h 10m | SBA/EMQ | NICE CKS, BNF | EBM, Organisation |
| MRCP Part 1/2 | 2 x 100 items | 2 x 3h | Best-of-five | Core medical texts | Distractor management |
| MRCP PACES23 | 5 stations | 20m/station | Clinical | Clinical examination | Choreography, timing |
Frequently asked questions
- What is the AKT pass mark and domain split?
- The pass mark varies but is typically around 70%. The domain split is roughly 160 clinical, 20 EBM/stats, and 20 organisational questions.
- How is the AKT pass standard set?
- It is set using the modified-Angoff method, where a panel of experienced GPs determines the expected standard for each question.
- What is the MRCP written format?
- Two papers, each lasting three hours and containing 100 "best-of-five" questions.
- What changed with PACES?
- The new PACES23 five-station format is now the standard for all candidates.
- Which resources matter most for AKT?
- The RCGP’s own preparation materials, alongside the definitive UK references: NICE CKS and the BNF/BNFC.
Calls to action
- Map your weak domains today: Pull the latest official AKT feedback report or run an MRCP mock. Set three weekly topic targets and one technique goal.
- Verify with primary sources: For any question you struggle with, make it a habit to open the relevant NICE/CKS/BNF page (for AKT) or the authoritative guideline/textbook chapter (for MRCP).
- Use UK-centric search to speed up verification: During your revision, try using iatroX to ask questions about NICE guidelines and then click through to the provided sources to read them in full.