Common AKT questions

The Applied Knowledge Test (AKT) is one of the three components of the MRCGP, the qualifying examination for general practice in the UK, administered by the Royal College of General Practitioners (RCGP). It is a computer-based exam of 160 multiple-choice questions taken over 2 hours 40 minutes at Pearson VUE test centres. Questions cover clinical medicine (80%), evidence-based practice and statistics (10%), and organisational and professional topics (10%). GP trainees usually sit the AKT in ST2 or ST3. AKT Navigator is an independent revision resource built specifically for this exam, with free syllabus-mapped questions and 90+ hours of audio covering all 32 curriculum topics.

The RCGP runs AKT sittings at fixed points in the year, booked through the RCGP and sat at Pearson VUE test centres. The next 2026 sitting is on 26 October; the July 2026 sitting took place on 7 July. You are eligible to sit the AKT from ST2 onwards, and most trainees take it during ST2 or ST3. Booking windows open in advance and places at popular test centres fill quickly, so book early once your sitting is confirmed.

Check your Pearson VUE confirmation, arrive on time and bring the two forms of ID required by RCGP. The names on your ID must match your RCGP application. Personal belongings are not allowed in the test room and must be left in a locker. If you need reasonable adjustments, request them through the RCGP process before the deadline with supporting evidence.

The RCGP currently lists the Applied Knowledge Test examination fee as £481. From April 2026, staged payments apply through the RCGP booking process. The AKT is for ST2 and ST3 GP trainees, and attempt limits are four or six depending on when you entered GP specialty training. Always check the official RCGP fee and application pages before booking.

Most trainees start 3 to 6 months before the exam, with around 12 weeks as a practical focused plan. Eight weeks can work if you take a baseline mock early, practise questions consistently and review weak areas. If you're short on time, AKT Navigator is built around that. A typical session is 15 to 20 minutes where you work through 10 questions picked specifically for your weak areas. And if you don't even have 15 minutes, put the audiobooks on. Over 90 hours of exam focused content you can listen to on your commute, at the gym, or between patients.

The most effective approach is targeted practice, not just doing thousands of random questions. AKT Navigator's algorithm starts by testing you across every major AKT topic and subtopic to understand where you stand. From there it shifts to targeting your weaknesses, focusing on what matters most for the exam. As you improve it keeps drilling the areas you're struggling with while gradually introducing new ground. Every session is built around you. No two trainees get the same questions. You just hit start and the algorithm handles the rest.

Every question follows the AKT's single-best-answer format: a clinical vignette stem set in UK primary care with plausible distractors, just like the real exam. Content and explanations are aligned to NICE, CKS and the BNF, and questions are regularly reviewed and updated as guidance changes. Each answer comes with a structured, examiner-style explanation in three parts: understanding the question, the key points to take away for your AKT, and why the other options are wrong — so every question teaches you something whether you got it right or not. You can judge the quality yourself in the free demo at medexia-akt.com/demo, which includes a full worked example and five real questions to sit. As with any revision resource, always check NICE, CKS and the BNF for clinical decisions.

The RCGP AKT syllabus spans 32 topic guides across three areas: Professional, Life Stages and Clinical. Clinical topics make up 80% of the exam and include things like cardiovascular, dermatology, mental health, respiratory, and musculoskeletal. Evidence in practice covers critical appraisal and statistics (10%), and organisation and management covers ethics, prescribing, and professional topics (10%). AKT Navigator covers every single one of these 32 topics with questions, over 90 hours of audio, and detailed explanations for each.

Since October 2025 the AKT has 160 single-best-answer questions in 2 hours and 40 minutes. That works out to one minute per question with no negative marking. The exam is 80% clinical knowledge, 10% evidence-based practice and 10% primary care organisation and management. AKT Navigator lets you generate mock exams at 40, 80, or 160 questions so you can practise under real exam conditions or do shorter sessions when time is tight. The debrief afterwards shows where you're losing time, whether accuracy drops towards the end, and topics you got confidently wrong.

Know sensitivity, specificity, PPV, NPV, absolute risk, relative risk, absolute risk reduction, absolute risk increase, NNT and NNH. The AKT also tests interpretation, so practise explaining results, reading confidence intervals, and using charts or prescribing dashboards rather than only memorising formulas.

Prioritise shared decision making, consent, decision-specific capacity, risk communication, safety-netting, managing uncertainty, remote-consultation limits and communication barriers that affect safe GP care.

Prioritise reasonable adjustments, accessible information, professional interpreter use, disability and neurodiversity access, health inequalities, cultural context, screening uptake, inclusive consulting and practical systems that remove barriers to safe GP care.

Prioritise teamwork, delegation, supervision, raising patient-safety concerns, complaints, duty of candour, resource use, audit, PDSA, significant-event learning and safe practice systems such as repeat prescribing, recalls and test-result follow-up.

Prioritise family-history taking, first- and second-degree relatives, inheritance patterns, familial cancer clues, rare disease red flags, genetic testing consent, NHS referral routes and safe handling of direct-to-consumer DNA results.

Prioritise study design, bias, confounding, diagnostic-test interpretation, confidence intervals, absolute and relative risk, NNT, NNH, shared decision making and applying guidelines to individual GP patients.

Prioritise common medication monitoring, prescribing errors, side effects and interactions, repeat prescribing safety, higher-risk groups such as pregnancy, breastfeeding, older adults and renal impairment, and high-risk medicines. Use the BNF and NICE CKS as reference sources during question review rather than trying to memorise the whole BNF.

Prioritise continuity of care, clinical governance, audit, PDSA, significant-event learning, patient-safety systems, test-result follow-up, handover, medicines reconciliation, repeat prescribing, monitoring and medicines optimisation.

Prioritise continuity of care, audit cycles, PDSA, significant-event learning, patient-safety reporting, safety-netting, test-result follow-up, handover, medicines reconciliation and repeat-prescribing systems.

Revise GMC confidentiality principles, information sharing without consent, child and adult safeguarding, Gillick competence, Fraser guidance, recorded consultations, access to records and secure handling of health information. Recent AKT feedback has highlighted data protection around recorded consultations and safeguarding children with confidentiality.

Prioritise gait disturbance, headache red flags, first seizures, epilepsy medication principles, stroke and TIA recognition, Parkinson's disease, tremor, multiple sclerosis, neuropathy and urgent referral thresholds. Recent RCGP feedback says neurology has been a frequent feedback area, including each of the last four AKTs.

Prioritise acute illness in children, paediatric cancer red flags, safeguarding, developmental milestones, immunisation, common childhood infections, adolescent health, confidentiality and Fraser guidance. Recent AKT feedback has highlighted paediatric cancer, acute illness, safeguarding and confidentiality.

Prioritise rashes and eruptions, eczema, psoriasis, acne, fungal infections, cellulitis, shingles, urticaria, leg ulcers, benign skin lesions, skin cancer recognition and urgent referral thresholds. Dermatology is visual, so pair written explanations with image-led practice where possible.

Prioritise hypertension diagnosis and treatment, atrial fibrillation anticoagulation, heart failure and NT-proBNP, acute coronary syndrome red flags, lipid modification, QRISK3, TIA and stroke prevention, AAA screening and peripheral vascular disease.

Prioritise asthma diagnosis and treatment, COPD diagnosis and exacerbations, inhaler technique, spirometry, FeNO and peak-flow variability, pneumonia severity, lung cancer red flags, sleep apnoea and acute asthma or COPD escalation.

Prioritise type 2 diabetes medicines, HbA1c targets, SGLT2 inhibitor cautions, GLP-1 receptor agonists, insulin safety, hypoglycaemia, DKA, urine ACR, eGFR, thyroid function tests, sick-day rules, obesity and adrenal red flags.

Prioritise CKD staging with eGFR and ACR, AKI recognition, medication safety, UTI and pyelonephritis, haematuria, LUTS, PSA counselling, renal stones, acute urinary retention and urological cancer red flags.

Prioritise low back pain and sciatica, cauda equina and fracture red flags, osteoarthritis, rheumatoid arthritis referral, osteoporosis risk assessment, gout, septic arthritis, analgesic safety and when imaging is not needed.

Prioritise IBS diagnostic criteria, faecal calprotectin, IBD flares, coeliac serology, dyspepsia and H. pylori testing, GORD alarm features, abnormal LFTs, NAFLD fibrosis assessment and colorectal cancer red flags.

Prioritise acute otitis media, otitis externa, sore throat, sinusitis, antimicrobial stewardship, sudden hearing loss, tinnitus, vertigo, epistaxis, hoarseness, mouth ulcers, neck lumps and head and neck cancer red flags.

Prioritise red eye red flags, reduced visual acuity, photophobia, contact lens keratitis, acute glaucoma, retinal detachment, sudden visual loss, diplopia, cataracts, glaucoma, AMD and diabetic retinopathy screening.

Prioritise anaemia patterns, ferritin interpretation, iron replacement, B12 and folate deficiency, VTE probability and D-dimer use, DOAC safety, thrombocytopenia, neutropenia, abnormal FBCs and haematological cancer red flags.

Prioritise anaphylaxis recognition, IM adrenaline, tryptase timing, allergy referral, adrenaline auto-injector counselling, IgE versus non-IgE food allergy, drug allergy documentation, urticaria, angioedema and immunodeficiency red flags.

Prioritise HIV testing and indicator conditions, hepatitis B and C risk groups, immunisation schedules, travel vaccines, malaria prevention, fever in the returning traveller, notifiable infections, antimicrobial stewardship and sepsis recognition.

Prioritise sepsis recognition, acute deterioration, NEWS2 as an adjunct to clinical judgement, same-day triage, delayed antibiotics, acute otitis media, tonsillitis, sinusitis, respiratory infections, UTI red flags, safety-netting and antimicrobial stewardship.

Prioritise sepsis recognition, acute deterioration, NEWS2 as an adjunct, anaphylaxis, acute asthma, chest pain, acute abdomen, same-day or out-of-hours triage, emergency escalation and explicit safety-netting.

Prioritise smoking cessation, AUDIT scoring, alcohol withdrawal risk, detox thresholds, relapse prevention, opioid substitution, naloxone, blood-borne virus testing, harm reduction and safeguarding.

Prioritise NHS screening programmes, routine immunisation, prevention, health inequalities, wider determinants of health, antimicrobial stewardship, inhaler carbon footprint and safe resource stewardship.

Prioritise depression severity, anxiety and panic, suicide risk, self-harm, SSRI prescribing, psychosis, antipsychotic monitoring, eating disorders, safeguarding, the Mental Health Act and the Mental Capacity Act.

Prioritise contraception and UKMEC, emergency contraception, menopause and HRT, abnormal uterine bleeding, postmenopausal bleeding, breast lumps, cervical screening, PCOS, endometriosis and ovarian or endometrial cancer red flags.

Prioritise antenatal care, early pregnancy pain or bleeding, ectopic pregnancy, miscarriage, pre-eclampsia symptoms, gestational diabetes risk factors, postnatal bleeding, mastitis, postnatal mental health and contraception after pregnancy.

Prioritise sexual history-taking, STI screening, chlamydia, gonorrhoea, genital herpes, HIV testing, PEP timing, PrEP awareness, partner notification, contraception safety, Fraser guidance, consent and safeguarding thresholds.

Prioritise frailty recognition, falls assessment, dementia work-up, delirium, polypharmacy, medication review, multimorbidity, anticholinergic burden, care-home medicine, advance care planning and decision-specific capacity.

Prioritise multimorbidity, treatment burden, shared decisions, chronic disease reviews, medicines optimisation, cancer red flags, NICE suspected-cancer referral, safety-netting, survivorship and palliative transitions.

Prioritise identifying patients approaching end of life, advance care planning, DNACPR, capacity and best interests, anticipatory medicines, symptom control, syringe-driver principles, carer support and care after death.

Prioritise annual health checks, health action plans, reasonable adjustments, diagnostic overshadowing, supported communication, decision-specific capacity, safeguarding, epilepsy, constipation, mental health and medication review.

Prioritise ADHD and autism recognition, referral pathways, reasonable adjustments, shared-care medication monitoring, diagnostic overshadowing, safeguarding and mental health comorbidity.

The pass rate changes each sitting. In official RCGP feedback reports, 80.22% of all candidates passed in April 2026, 76.52% passed in January 2026, and 70.63% passed in October 2025. The pass marks were 107, 108 and 109 out of 160 respectively. UKG first-time pass rates were higher, at 88.68%, 88.39% and 88.84%. The areas where people struggle most include data interpretation, prescribing, organisation topics and time pressure. AKT Navigator targets these weak spots with syllabus-mapped practice, timed mocks, debriefs and 90+ hours of audio revision.

Start with the official score report and compare your score with the pass mark for that sitting. Work out whether the main issue was knowledge, statistics, pacing, fatigue or specific weak domains. Then build a retake plan around those gaps using timed mocks, targeted question practice and the latest RCGP feedback report themes. Check the RCGP rules on attempt limits, booking and appeals before making decisions.

Yes. AKT Navigator keeps syllabus-mapped AKT questions free, with deep structured explanations, mock exams and basic practice. Free Practice also includes 2 hours of audiobook listening across any audiobook. Full access to the 90+ hour audiobook library is separate: Full Audio Access is £79 for 4 months.

The best way is to take a full length mock under timed conditions. AKT Navigator's 160 question mocks simulate the real exam and the debrief finds things you can't see yourself. It picks out where you're losing time, whether your accuracy drops towards the end from fatigue, and flags topics where you're confidently getting answers wrong. That last one matters because confident mistakes mean gaps in your understanding, not just gaps in recall. The debrief tells you exactly what to focus on next.

That's exactly why this was built. The founder is a GP trainee who knows what it's like juggling work, family, and AKT revision. Nothing out there made it easier so we built something that did. Sessions are 15 to 20 minutes of targeted questions designed around your weak spots. The audiobooks give you over 90 hours of exam content you can absorb while doing something else. You can study on the bus, between patients, or before bed. The algorithm remembers where you left off and what you need next. No planning, no wasted time, just open it and go.