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From October 2025 the AKT is 160 SBAs in 160 minutes — exactly one minute per question. Published RCGP curriculum mapping, candidate-reported pitfalls and an adaptive question bank by UK GPs aligned to the AKT assessment framework.
160 single-best-answer questions · 2 hours 40 minutes · computer-based at Pearson VUE test centres.
80% clinical medicine · 10% evidence-based practice and critical appraisal · 10% primary care organisation, management, ethics and statutory frameworks.
Usually during ST2 or ST3 of UK GP specialty training; candidates book through MyRCGP within published RCGP windows.
From October 2025 the AKT moved from 200 questions in 190 minutes to 160 questions in 160 minutes.
Four annual sittings: January, April, July and October. From October 2025 onwards the AKT fee is £481; confirm the exact 2026 booking window in MyRCGP before applying.
Approximate question distribution across the RCGP AKT curriculum — 160 questions (the new October 2025 format). Domain split is published by RCGP: 80% clinical, 10% EBP, 10% organisation/admin.
Source: official Royal College of General Practitioners (RCGP) blueprint
Mapped to the published RCGP curriculum and prioritised using item-density signals across the iatroX bank.
Cardiovascular risk and prevention — QRISK3 thresholds (≥10% for primary prevention statin offer per NICE NG238), absolute CVD risk modifiers (CKD, FH, severe mental illness), HFrEF four-pillar therapy per NICE NG106
Mental health — stepped care for depression and anxiety per NICE NG222 and CG113, antidepressant choice and switching, suicide risk frameworks, sectioning under the Mental Health Act
Women's health — contraceptive choice (UKMEC categories), HRT in menopause per NICE NG23, cervical screening intervals (5-yearly HPV primary), urgent suspected cancer referrals (postmenopausal bleeding, breast)
Diabetes — Type 2 diabetes algorithm per NICE NG28 (metformin → SGLT2 inhibitor in those with CV/renal disease → GLP-1 agonist), QoF targets, ketoacidosis recognition, GAD/MODY differential
Prescribing safety — pregnancy and breastfeeding categories, polypharmacy interactions, controlled drug regulations, MHRA Drug Safety Updates (sodium valproate, JAK inhibitors)
Evidence-based practice — sensitivity, specificity, PPV/NPV at different prevalences, NNT, hazard ratios, study design (RCT vs cohort vs case-control vs cross-sectional)
NHS structure, regulation and admin — fitness to practise, duty of candour, never events, social prescribing, primary care networks, Quality Outcomes Framework (QOF) indicators
Recent NICE pathway shifts — gestational diabetes (NG3), atrial fibrillation (NG196 CHA₂DS₂-VA), eating disorders (NG69), suspected cancer (NG12 updates)
Observations from UK GP trainees and recent AKT candidates under the new 160-question format. Verify against current NICE, CKS and BNF guidance.
Candidate-reported observations — not official guidance.
A pragmatic phased approach used by recent UK GP trainees who passed the new-format AKT first time.
A live item from the iatroX bank. Try it before launching a full session.
A haemodynamically stable patient has symptomatic atrial fibrillation of uncertain duration. Elective cardioversion is chosen, and no TOE-guided expedited pathway is planned. What preparation is required?
Why iatroX is built differently for MRCGP AKT.
Every iatroX item is tagged to a blueprint topic, so your performance dashboard mirrors the structure of the exam itself.
The engine surfaces your weakest topics first, in real time, instead of marching you through a static syllabus.
Incorrect items return at increasing intervals to interrupt the forgetting curve and lock knowledge into long-term memory.
Timed full-length simulations that mirror the official exam structure under realistic conditions.
One iatroX subscription includes the MRCGP AKT bank, the Socratic Tutor inside supported sessions, and every other premium iatroX exam bank.
Cancel anytime · 7-day money-back guarantee on annual
Free MRCGP AKT sample questions are available without a subscription. Full adaptive access to the 1,500+ AKT bank, including the dashboard, mocks and supported Tutor workflow, is included with an iatroX subscription.
The AKT moved from 200 questions in 190 minutes to 160 questions in 160 minutes. The RCGP framed this as an inclusivity adjustment — slightly more time per item (60 vs 57 seconds) to reduce the speed-reading burden. The content blueprint is unchanged: 80% clinical, 10% EBP, 10% organisation. Each question now carries proportionally more weight.
The AKT uses criterion referencing — the pass mark is set by panel review of item difficulty rather than a fixed percentage. Recent diets have settled around 70%, but the cut score varies per sitting based on item difficulty. The aim is to identify the standard expected of a doctor entering independent UK general practice.
Most candidates sit during ST2, with a smaller number sitting in ST3. ST1 attempts are not permitted. RCGP training records must show ST2 or ST3 status at the time of booking. Most candidates take it in ST2 to reduce pressure in the final training year when SCA is also due.
£481. From 1 April 2026 the RCGP introduces compulsory staged payments — 25% six months before the exam, 25% twelve weeks before, and balance at booking. Both intermediate payments are refundable if you change plans before the final booking deadline.
A maximum of 4 attempts for trainees who entered GP training before August 2023, and 6 attempts for trainees who entered after. Most candidates pass within 1-2 attempts. After exhausting attempts, candidates would need to apply for ARCP-related processes.
MRCGP has three mandatory components: AKT (knowledge), SCA (clinical — Simulated Consultation Assessment), and WPBA (Workplace-Based Assessment, ongoing throughout training). All three must be passed to gain CCT in general practice.
Other iatroX hubs you may find useful.
see how iatroX compares to PassMedicine, Quesmed.
Reviewed by Dr Kola Tytler MBBS CertHE MBA MSt MRCGP · Last reviewed 12 May 2026
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