MRCGP Applied Knowledge Test (AKT)

The MRCGP Applied Knowledge Test (AKT) is a computer-based examination that forms part of the Membership of the Royal College of General Practitioners (MRCGP). It assesses the knowledge base that underpins independent general practice in the UK within the context of the NHS, testing problem-solving skills and application of medical knowledge in primary care settings.

Available to GP registrars in ST2 and ST3 training years, the AKT focuses on clinical medicine, evidence-based practice, and primary care management. Success in the AKT, alongside other MRCGP components, is essential for becoming a qualified General Practitioner in the UK.

Frequently Asked Questions

What is the MRCGP AKT?

The MRCGP Applied Knowledge Test is a computer-based examination assessing the knowledge required for independent general practice in the UK. It forms part of the MRCGP certification process and tests clinical medicine, evidence-based practice, and primary care management within the NHS context.

How many questions are in the MRCGP AKT?

From October 2025 onwards, the AKT contains 160 questions (reduced from 200). Prior to October 2025, the exam has 200 questions. All questions are in single best answer format, covering clinical medicine, critical appraisal, and primary care organization.

How long is the MRCGP AKT exam?

From October 2025, the exam duration is 160 minutes (2 hours 40 minutes). Before October 2025, candidates have 190 minutes (3 hours 10 minutes). This gives approximately 60 seconds per question with the new format.

When can I take the MRCGP AKT?

The AKT can be taken anytime during ST2 or ST3 training years. There are typically three sittings per year: January, April, and July. Applications open 7-8 weeks before each exam date during a 5-6 day booking window via the RCGP website.

What topics are covered in the AKT?

The AKT covers 80% clinical medicine, 10% evidence-based practice (including critical appraisal and research interpretation), and 10% primary care organization and management issues (administrative, ethical, regulatory frameworks).

How much does the MRCGP AKT cost?

The AKT exam fee varies but is typically around £400-500. Exact fees are confirmed during the booking process. Additional costs may include travel to test centers and preparation materials.

Should I take the AKT in ST2 or ST3?

Both have advantages: ST2 allows focus solely on the AKT without other MRCGP components, while ST3 provides more clinical experience. Most candidates take it in ST2 to reduce pressure in the final training year when other assessments are due.

What is the pass rate for the MRCGP AKT?

Pass rates vary by sitting but typically range from 70-85%. The exam uses statistical analysis to maintain consistent standards across different sittings. There is no negative marking, so candidates should attempt all questions.

MRCGP AKT Key Information

Exam Format: Computer-based single best answer questions
Questions: 160 (from Oct 2025) / 200 (before Oct 2025)
Duration: 160 minutes (from Oct 2025) / 190 minutes (before)
Eligibility: ST2 and ST3 GP registrars
Frequency: 3 times per year (Jan, Apr, Jul)
Marking: Pass/fail, no negative marking

MRCGP AKT Exam Structure

Clinical Medicine (80%)

  • Content: Core clinical knowledge for general practice
  • Focus: Common presentations in primary care settings
  • Areas: All body systems and age groups
  • Context: UK NHS general practice environment
  • Application: Diagnosis, management, and referral decisions

Evidence-Based Practice (10%)

  • Critical Appraisal: Interpretation of research studies
  • Statistics: Understanding of basic statistical concepts
  • Data Interpretation: Graphs, charts, and research data
  • Guidelines: Application of clinical guidelines and evidence
  • Research Methods: Study design and methodology understanding

Primary Care Organization & Management (10%)

  • NHS Structure: Organization and funding of primary care
  • Regulatory Frameworks: GMC, CQC, and other regulatory bodies
  • Ethics: Medical ethics and professional responsibilities
  • Quality Improvement: Audit, QOF, and practice management
  • Legal Issues: Consent, confidentiality, and medico-legal aspects

Application Process

Eligibility Requirements

  • Must be registered with RCGP with active membership
  • Currently in ST2 or ST3 GP training year
  • Training records must be up to date on RCGP systems
  • No resigned, lapsed, or suspended RCGP membership

Booking Process

  • Booking Window: 5-6 days, opening 7-8 weeks before exam
  • Application: Online via RCGP website only
  • Payment: Required at time of booking
  • Test Centers: Pearson VUE centers across UK and internationally
  • Reasonable Adjustments: Applications must be made in advance

MRCGP AKT Preparation Strategy

Clinical Medicine Preparation

  • Focus on common presentations in general practice
  • Study NICE guidelines and clinical pathways
  • Review red flag symptoms and emergency presentations
  • Practice differential diagnosis and management decisions
  • Use clinical experience from GP placements effectively

Evidence-Based Practice

  • Understand basic statistical concepts (NNT, NNH, sensitivity, specificity)
  • Practice interpreting research abstracts and data
  • Learn to read forest plots and funnel plots
  • Study different research methodologies
  • Review critical appraisal frameworks

Management and Organization

  • Study NHS structure and primary care organization
  • Learn about QOF (Quality and Outcomes Framework)
  • Understand GMC ethical guidance
  • Review medico-legal principles and consent
  • Study practice management and quality improvement

Exam Technique

  • Practice time management (60 seconds per question)
  • Use question banks with similar format to AKT
  • Take timed mock exams under exam conditions
  • Read questions carefully and identify key information
  • Don't leave questions blank - no negative marking

MRCGP AKT Resources

Start Your MRCGP AKT Preparation

Ready to begin your journey toward MRCGP certification? Access our comprehensive AKT question bank with over 1,500 practice questions, detailed explanations, and mock exams designed specifically for the updated exam format.