About the exam
MRCGP AKT Exam structure
An independent study guide aligned to the current 160-question MRCGP Applied Knowledge Test, its 80/10/10 blueprint and the RCGP curriculum effective from 1 August 2025.
Issuer and path
MRCGP Applied Knowledge Test Study Guide is administered through Royal College of General Practitioners. Check official resources before booking, retesting, or relying on a stale requirement.
MRCGP Applied Knowledge Test
160 scored + 0 pretest
One 160-minute computer-based assessment containing 160 questions across clinical knowledge, evidence-based practice, and UK primary care organisation and management.
Before booking and sitting
Confirm current eligibility, attempt count, application window, Pearson booking, matching photographic ID and reasonable adjustments through RCGP. The 160 minutes exclude tutorial and quarantine time, and any unscheduled break uses examination time.
Official Outline Coverage Map
Coverage is mapped to official outline item counts so content depth can be checked without hard-coding a single exam.
| Topic | Official outline items | Your questions | Your flashcards | Confidence |
|---|---|---|---|---|
| Clinical Knowledge | 128 | 481 | 130 | Strong |
| Evidence-Based Practice | 16 | 60 | 20 | Strong |
| Primary Care Organisation and Management | 16 | 60 | 20 | Strong |
How to use this guide
How to prepare for the MRCGP AKT
Build broad current clinical knowledge, then rehearse evidence interpretation and the ethical, administrative, statutory and regulatory decisions unique to UK primary care.
1. Identify the tested domain and task
Decide whether the stem asks for a clinical judgement, evidence interpretation or a UK primary-care governance action, then name the precise decision.
2. Extract the decisive evidence
Find the symptom, trend, risk factor, denominator, graph feature, legal duty or time point that changes the answer.
3. Set the safety and authority boundary
Check urgency, safeguarding, capacity, confidentiality, statutory duties, medicine harm and whether the GP or another body makes the final decision.
4. Apply current UK general practice
Choose the proportionate action supported by current national guidance, primary-care scope, patient context and continuity.
5. Select, flag and move
Choose the most appropriate available answer, remembering that no action may be correct; flag genuine uncertainty and protect time for the remaining questions.
Official current blueprint
Keep all three domains active throughout revision
The official split is 128 Clinical Knowledge, 16 Evidence-Based Practice and 16 Primary Care Organisation and Management questions.
Clinical Knowledge
Clinical knowledge and its application to the broad, uncertain and longitudinal work of UK general practice.
Choose a topic to open below
Evidence-Based Practice
Evidence interpretation, critical appraisal, research methods, risk, diagnostic-test statistics and primary-care data.
Choose a topic to open below
Primary Care Organisation and Management
Administrative, ethical, regulatory and statutory frameworks governing safe UK general practice.
Choose a topic to open below
Children and Young People
Primary-care assessment, prevention and management from infancy through adolescence.
Key rules
Rule 1
Growth, development, common acute and chronic illness, immunisation, safeguarding and age-appropriate communication.
Exam cue: Name the exact decision and time point before reviewing the options.
Rule 2
Integrate parental concern, developmental stage, examination and safety-netting when deciding whether to manage, review or refer.
Exam cue: Separate the decisive clinical, numerical or governance fact from plausible background detail.
Rule 3
Recognise the seriously unwell child, safeguarding concern and time-critical presentation before routine differential refinement.
Exam cue: Choose the safest proportionate action for UK general practice and include follow-up or escalation where relevant.
Rule 4
Apply current UK guidance and patient context while accepting that the most appropriate answer may be no investigation, prescription or referral.
Exam cue: Name the exact UK general-practice decision, extract the decisive evidence and choose the safest proportionate action at this point in care.
Common traps
Applying adult thresholds or reassurance without accounting for age, development and carer observations.
Prevention: Do not choose a familiar fact or technically possible action when the stem asks for the most appropriate current UK primary-care decision.
Recalling a guideline fragment without checking whether it applies to this patient, population or administrative context.
Prevention: Do not choose a familiar fact or technically possible action when the stem asks for the most appropriate current UK primary-care decision.
Choosing an action that is possible but not the most appropriate option at the stated point in care.
Prevention: Do not choose a familiar fact or technically possible action when the stem asks for the most appropriate current UK primary-care decision.
Memory anchors
Children and Young People: scope
Growth, development, common acute and chronic illness, immunisation, safeguarding and age-appropriate communication.
Children and Young People: primary-care lens
Integrate parental concern, developmental stage, examination and safety-netting when deciding whether to manage, review or refer.
Children and Young People: safety boundary
Recognise the seriously unwell child, safeguarding concern and time-critical presentation before routine differential refinement.
Children and Young People: common trap
Applying adult thresholds or reassurance without accounting for age, development and carer observations.
Children and Young People: AKT decision sequence
Define the exact UK general-practice problem, identify the decisive evidence and safety issue, then choose the most appropriate action for this point in care.
Next best moves
Quick check-up
Use a short quiz to confirm the rule pattern is actually sticking.
Check-up Questions
A 5-week-old baby has a temperature of 38.1°C measured at home. He is feeding less but is alert in the consultation. What is the most appropriate action?
A 7-month-old with bronchiolitis has oxygen saturation 91% in air, respiratory rate 62/min and takes half of usual feeds. What is the best next step?
Answer all questions to submit.
Next step personalized recommendations
Open another topic next
Official resources
Verify the details with the official sources
Use these links for eligibility, scheduling, handbook rules, and issuer updates. Our guide helps you study; official sources tell you what the testing partner currently requires.
Introducing the Applied Knowledge Test
Current official overview of delivery, 160 questions, 160 minutes, 80/10/10 blueprint, UK general-practice focus, eligibility and cohort-based attempt limits.
Changes to the AKT timetable from October 2025
Official confirmation that item count and duration changed from 200/190 to 160/160 in October 2025 while curriculum coverage, percentages, format and standard were unchanged.
Preparing for the Applied Knowledge Test
Current official preparation hub listing SBA, MBA, Free Text and EMQ formats plus evidence, administration, examples and Pearson tutorial resources.
RCGP curriculum: Being a General Practitioner
The current GMC-approved core curriculum implemented from 1 August 2025.
The RCGP Curriculum: The Curriculum Topic Guides
The current Professional, Life Stages and Clinical topic guides used for structured coverage without treating the clinical list as exhaustive.
RCGP assessment blueprint
The current capability-to-assessment matrix showing where the AKT contributes evidence across the GP curriculum; it is not a clinical specialty percentage table.
Data interpretation in the AKT
Official worked guide to interpreting graphs, risk, diagnostic statistics, confidence intervals, NNT, NNH and evidence in primary care.
Data interpretation topics in recent AKTs
Current-linked evidence topic list covering common areas through September 2024; its 20-question example predates the current 160-item format.
Primary care organisation and management topics in recent AKTs
Current-linked organisation topic list covering common areas through September 2024; its 20-question example predates the current 160-item format.
AKT 57 October 2025 feedback report
Official report for the first 160-question diet, confirming 128 Clinical, 16 Evidence-Based Practice and 16 Organisation and Management questions.
AKT marking, results, retakes and appeals
Current official marking and result guidance, including computer marking, one mark per correct answer and no negative marking.
FAQ
Common MRCGP AKT questions
Is this an official RCGP resource?
No. This is an independent study guide. The current RCGP website, curriculum, candidate guidance and direct examination communications remain authoritative.
What is the current AKT structure?
From October 2025 the AKT contains 160 questions answered in 160 minutes. It is a single computer-based assessment delivered at Pearson test centres across the UK.
How many questions are in each official domain?
The current 80%/10%/10% blueprint gives 128 Clinical Knowledge questions, 16 Evidence-Based Practice questions and 16 Primary Care Organisation and Management questions. The first current-format feedback report confirms that exact 128/16/16 split.
Why do some RCGP topic PDFs still say 20 questions?
The current preparation page links two recent-topic PDFs whose examples run through September 2024 and still describe each 10% domain as 20 questions. They predate the October 2025 reduction from 200 to 160 items. RCGP states that the percentages and curriculum coverage did not change, so each 10% domain now contains 16 questions.
Does RCGP publish clinical specialty weights?
No. RCGP publishes 80% for Clinical Knowledge but no numeric subweight for individual Clinical or Life Stages topic guides. This module therefore covers all 26 current Clinical and Life Stages guides with a near-even internal 481-item plan rather than claiming unsupported official specialty weights.
Are the RCGP curriculum topic guides a complete clinical syllabus?
No. RCGP says the Clinical topic guides illustrate areas encountered in general practice and should not be treated as a complete list. They are used here as a structured coverage map alongside the whole curriculum and current UK guidance.
What does the clinical domain test?
It tests broad clinical knowledge applied to UK general practice, including prevention, diagnosis, investigation, prescribing, management, referral, continuity, multimorbidity, urgent care and patient safety. Questions emphasise higher-order decisions rather than isolated recall.
What evidence and data skills are in scope?
Current RCGP resources cover study design, bias and appraisal; sensitivity, specificity and predictive values; absolute and relative risk, NNT and NNH; confidence intervals; and interpretation of graphs, audit, prescribing and practice data. RCGP describes the expected level as basic principles, graph or chart interpretation and simple calculations.
What organisation and management topics are in scope?
The domain includes administrative, ethical, regulatory and statutory frameworks. Current-linked topic guidance includes certification and benefits, DVLA and fitness, confidentiality, consent, capacity, safeguarding, health and safety, health inequalities, immunisation, information governance, notifiable disease, prescribing principles and quality improvement.
Are all questions standard five-option SBAs?
No. Single Best Answer is the main format and commonly uses five options, but the current RCGP preparation page also lists Multiple Best Answers, Free Text and Extended Matching Questions. Candidates should use the official tutorial and examples to learn the live interface.
How is the AKT marked?
The examination is computer marked. Each correct answer receives one mark and there is no negative marking. Standard setting and post-examination quality assurance mean a pass mark from one diet, such as 109 in October 2025, must not be treated as a permanent fixed threshold.
When can a GP registrar take the AKT?
RCGP states that candidates can take the AKT during or after ST2. Readiness should be discussed with the educational team and current eligibility and booking rules should be checked before applying.
How many attempts are allowed?
RCGP states a maximum of four attempts for doctors already in training on 1 August 2023 and six attempts for doctors who first entered GP specialty training on or after 2 August 2023.
Are the 601 practice questions an official RCGP allocation?
No. The official live examination contains 160 questions. This independent bank contains 601 original five-option SBA questions, allocated 481/60/60 by the official domain proportions with a transparent near-even spread inside the unweighted Clinical curriculum map. It is a practice bank, not a complete official-format mock: RCGP also uses Multiple Best Answers, Free Text and Extended Matching Questions.