MSRA vs MRCGP AKT (2026): How They Differ, How They Overlap, and How to Prepare for Both
At a Glance
Who is it for?
MSRA (Multi-Specialty Recruitment Assessment):GP / Psychiatry / 15+ Specialty Applicants
MRCGP AKT (Applied Knowledge Test):GP Trainees (ST1–ST3)
Why choose MSRA (Multi-Specialty Recruitment Assessment)?
- 50% Clinical Problem Solving + 50% Professional Dilemmas (SJT)
- Score determines training place allocation — no interview
- Broad clinical knowledge (not GP-specific)
- Sat early in career (typically F2/F3)
Why choose MRCGP AKT (Applied Knowledge Test)?
- 80% Clinical Medicine + 10% Statistics/EBM + 10% Admin/Organisation
- GP-specific content (primary care focus)
- Changed to 160 questions in 160 minutes (from October 2025)
- Required for MRCGP and CCT in general practice
Feature Comparison
| Capability | MSRA (Multi-Specialty Recruitment Assessment) | MRCGP AKT (Applied Knowledge Test) |
|---|---|---|
| Purpose | Determines which training programme you get | Required for MRCGP membership and CCT |
| Timing | Typically F2/F3 (before training starts) | ST2 or ST3 (during training) |
| Format | 97 items: ~65 CPS + ~32 Professional Dilemmas | 160 SBAs in 160 minutes |
| Content Focus | Broad clinical + SJT (50/50 split) | GP-specific clinical + statistics + admin (80/10/10) |
| S J T Component | **50% of total score** — ranking and rating items | No dedicated SJT component |
| Statistics Component | Minimal statistics content | **10% dedicated to statistics/EBM** — known failure point |
| Admin Component | Minimal admin content | **10% dedicated to admin/organisation** — DVLA, GMC, CQC, sick notes |
| Scoring | Normalised score (mean ~250). Bands 1–4. | Modified Angoff pass mark. Pass/fail. |
In-Depth Analysis
Overview
Every GP trainee in the UK must pass both the MSRA (to get a training place) and the MRCGP AKT (to complete training). They are different exams with different purposes, but the clinical knowledge overlap is substantial.
Key Differences
Purpose
The MSRA is a ranking exam — your score determines which deanery and training programme you are allocated to. There is no pass/fail; only relative ranking. The AKT is a membership exam — you need to pass it for MRCGP and CCT.
Content
The biggest differences are:
- SJT: The MSRA is 50% Professional Dilemmas (SJT). The AKT has no SJT component.
- Statistics: The AKT has a dedicated 10% statistics/evidence-based medicine section. The MSRA has minimal stats content.
- Admin: The AKT has a dedicated 10% organisational/admin section (DVLA, GMC, sick notes, CQC). The MSRA does not test this.
- GP Specificity: The AKT is GP-specific (primary care management, referral thresholds, safety-netting). The MSRA tests broader hospital and primary care knowledge.
The Overlap
Approximately 60–70% of the clinical knowledge required for the MSRA CPS paper also applies to the AKT clinical section. If you have prepared well for the MSRA, you have a strong foundation for the AKT. The AKT-specific elements (statistics, admin, and GP-focused clinical topics) require targeted additional preparation.
Combined Study Strategy
- MSRA first: Build broad clinical knowledge + master SJT.
- AKT later: Top up with GP-specific clinical content, statistics/EBM, and admin/organisation.
- Use resources that cover both: PassMedicine and Emedica offer both MSRA and AKT modules. iatroX covers both for free.
For free MSRA and MRCGP AKT Q-banks with AI-powered guideline interrogation, iatroX covers both at no cost.
Public information as of 2 April 2026. Trademarks belong to their owners.
Looking for a faster way?
While MSRA (Multi-Specialty Recruitment Assessment) and MRCGP AKT (Applied Knowledge Test) are powerful tools, iatroX offers a free, AI-driven alternative focused specifically on rapid UK guideline retrieval and exam prep.
Use-Cases
GP Trainee Preparing for Both Sequentially
When to choose MSRA (Multi-Specialty Recruitment Assessment)
- Sit first (F2/F3). Focus on broad clinical knowledge and SJT.
When to choose MRCGP AKT (Applied Knowledge Test)
- Sit later (ST2/ST3). Build on MSRA clinical base but add GP-specific content, statistics, and admin.
Maximising Content Overlap
When to choose MSRA (Multi-Specialty Recruitment Assessment)
- Clinical Problem Solving content overlaps ~60–70% with AKT clinical questions. MSRA prep builds a strong foundation for AKT.
When to choose MRCGP AKT (Applied Knowledge Test)
- 80% clinical content overlaps substantially with MSRA CPS. The unique AKT elements are statistics (10%) and admin (10%).
Choosing Resources That Cover Both
When to choose MSRA (Multi-Specialty Recruitment Assessment)
- PassMedicine, Emedica, and iatroX (free) all cover both MSRA and AKT.
When to choose MRCGP AKT (Applied Knowledge Test)
- Same resources work for both. Add a statistics/EBM resource and admin cheat sheet for AKT-specific content.
FAQs
- How much does the MSRA overlap with the AKT?
- Approximately 60–70% of MSRA Clinical Problem Solving content also applies to the AKT clinical section. The AKT adds GP-specific topics, statistics (10%), and admin/organisation (10%).
- Should I use the same Q-bank for both?
- Mostly, yes. PassMedicine, Emedica, Pastest, and iatroX (free) all cover both exams. For the AKT, you will additionally need statistics/EBM resources and an admin cheat sheet.
- Is the MSRA harder than the AKT?
- They test different things. The MSRA's difficulty comes from the SJT paper and the competitive ranking. The AKT's difficulty comes from the statistics section and GP-specific clinical knowledge. Most trainees find the AKT has a steeper knowledge requirement but the MSRA has higher stakes.