Almost every AKT candidate builds their revision around clinical medicine, promises themselves they will get to the statistics and the admin later, and then runs out of time. It is an understandable plan and a demonstrably poor one. Since October 2025 the AKT has been 160 questions in 160 minutes, and the blueprint has not changed: 80 per cent clinical, 10 per cent evidence-based practice, 10 per cent primary care organisation and management. Do the arithmetic on what that last fifth is actually worth, and the case for postponing it collapses.
Key takeaways
- The AKT is 160 questions in 160 minutes since October 2025, with the 80/10/10 blueprint unchanged.
- That makes roughly 128 clinical questions, 16 on evidence-based practice and 16 on organisation.
- Those 32 non-clinical marks are enough to move most borderline candidates across the pass mark.
- The non-clinical fifth is finite and teachable, unlike the clinical curriculum, which is effectively unbounded.
- Track the three domains separately, because a single overall percentage hides which one is sinking you.
The arithmetic that should change your plan
Convert the blueprint into marks and the picture becomes uncomfortable. Of 160 questions, about 128 are clinical, about 16 test evidence-based practice and statistics, and about 16 test primary care organisation, regulation and administration. The pass mark is not fixed, since it is set after each sitting by Angoff standard-setting, but it has historically fallen somewhere in the low-to-mid sixties as a percentage of available marks.
Now model two candidates. Both score 70 per cent on the clinical component, which is a respectable performance. The first scores 30 per cent on the 32 non-clinical questions, because they left them to the last fortnight. The second scores 70 per cent on them, because they did not. The first finishes around 62 per cent overall; the second finishes at 70. In a paper where the pass mark sits in that same territory, those 32 questions are the difference between a comfortable pass and a nervous wait for the result.
Why the non-clinical fifth is the best return on your time
Here is the part that makes this actionable rather than merely alarming. The clinical curriculum of general practice is effectively unbounded: you can always know more paediatrics, more dermatology, more prescribing. The marginal return on the hundredth hour of clinical revision is small.
The other two domains are not like that. Evidence-based practice is a finite set of concepts, and the same ones recur: study design, bias and confounding, sensitivity and specificity, predictive values, likelihood ratios, number needed to treat, and the interpretation of confidence intervals. Primary care organisation is a bounded body of rules about certification, regulation, confidentiality, complaints and NHS structures. Both are learnable in a way that "all of clinical medicine" is not, and both are repeatedly identified in RCGP feedback as areas where candidates underperform.
That combination, high mark value and finite content, makes them the single best return on revision time in the whole paper. And most candidates give them the least.
How to structure the plan
Work the three domains as three separate projects rather than as one undifferentiated revision effort.
Establish coverage before you optimise. Begin in Standard mode across the whole curriculum, sampling broadly rather than following interest, and record two things per topic: accuracy and exposure. A domain you have barely attempted is not a strength, it is an unknown, and unknowns are where exam-day surprises come from.
Then target within each domain, not across them. Once you have a genuine baseline, adaptive practice earns its place, but run it inside each section of the blueprint rather than letting it collapse everything into one weighted stream. Otherwise the sheer volume of clinical questions will dominate the engine's attention, and your 16-mark blind spots stay exactly where they are.
Protect the small domains with short, frequent sessions. Statistics and organisational rules decay fast and are easily crowded out. Fifteen minutes twice a week from the start beats a panicked weekend in the final fortnight, and spaced repetition is the natural home for the thresholds, criteria and statutory details that will otherwise evaporate.
Track the three domains separately
The most common measurement error is watching a single overall percentage climb and concluding you are on track. That number is dominated by the clinical component, because the clinical component is 80 per cent of the questions, so it can rise steadily while your statistics performance stays flat at 35 per cent and your admin knowledge remains untested.
Keep three lines on the graph. Look at them weekly. If the clinical line is healthy and the other two are not, you know exactly where the next fortnight goes, and you know it in time to do something about it.
Do not confuse practice habit with exam answer
One trap deserves naming, because it catches strong clinicians. The AKT tests appropriate, evidence-based, cost-effective management within the UK NHS, and the correct answer is sometimes not to investigate, prescribe or refer. Candidates default to action. Similarly, on organisational questions, the way your practice happens to do something is not necessarily the national rule the exam is testing. Answer from the guidance and the regulation, not from local habit.
Where iatroX fits
iatroX's MRCGP AKT bank is mapped to the RCGP curriculum with explanations grounded in NICE, CKS, SIGN and the SmPC, and it supports the structure above directly: Standard mode for the coverage audit, an adaptive engine you can run within each blueprint section rather than across the whole paper, spaced repetition for the statistics and organisational content that decays, and timed mocks at the current 160-question, 160-minute format so your pacing is calibrated to the paper you will actually sit rather than the old one. Missed questions can be opened in the Socratic Tutor, which asks you to reason before it explains. Try it with free sample questions at iatroX. For the domain most candidates neglect, see the AKT organisational questions.
Frequently asked questions
What is the MRCGP AKT blueprint? Eighty per cent clinical medicine, 10 per cent evidence-based practice including statistics and critical appraisal, and 10 per cent primary care organisation and management. Since October 2025 the paper has been 160 questions in 160 minutes, and the blueprint is unchanged.
How many marks are the non-clinical sections worth? Roughly 32 of 160 questions, about 16 for evidence-based practice and 16 for organisational topics. With the pass mark typically in the low-to-mid sixties as a percentage, those 32 marks routinely decide borderline results.
Why do candidates underperform on the statistics and admin sections? Because they are postponed. Both are finite and learnable, unlike the clinical curriculum, but they decay quickly and are easily crowded out. Short, frequent sessions from the start of preparation are far more effective than a late block.
Should I use adaptive practice for the whole AKT? Establish representative coverage first, then run adaptive practice within each blueprint section rather than across the whole paper. Otherwise the clinical questions, being 80 per cent of the paper, dominate and your small-domain blind spots persist.