Printed on: December 27th, 2024

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Preparing for the Applied Knowledge Test (AKT)

Preparing for the Applied Knowledge Test (AKT)

As part of the Membership of the Royal College of General Practitioners (MRCGP) exam in the UK, GP trainees need to complete the Applied Knowledge Test (AKT) to achieve their Certificate of Completion of Training (CCT).

To achieve success in the AKT requires a comprehensive understanding of both clinical and non-clinical knowledge relevant to general practice, and the ability to apply it to the types of scenarios we might see in clinical practice.

So, in true Red Whale style, we’ve put together our top tips, backed by our Red Whale GP trainers and programme directors. This will help all GP trainees prepare effectively for this exam.

The AKT tests issues relating to UK general practice as defined by the RCGP. The RCGP, based on its curriculum, divides the questions into three main areas:

• Clinical knowledge (80%).
• Evidence-based practice, including evidence interpretation and the critical appraisal skills needed to interpret research data (10%).
• Primary care organisation and management issues, including administrative, ethical, regulatory and statutory frameworks (10%).

Knowing the exam structure will help you to allocate time and focus revision.

The exam length is 3 hours and 10 minutes; this is to answer 200 questions.

There are usually 4 sittings a year for the AKT, published on the RCGP website.

Generally, trainees sit the AKT towards the end of their ST2 year or early in ST3. This ensures that you have had enough exposure to the organisation and management issues around primary care organisations.

The RCGP adheres to the Equality Act 2010, which means that anyone disabled within the meaning of this act (which includes physical and mental disabilities) would be eligible to apply for a reasonable adjustment. These requests need to be agreed before booking the AKT examination. If you feel that you require reasonable adjustments, e.g. additional time with a diagnosis of ADHD or wheelchair access for a physical disability, the RCGP has more information on how to apply.

Start early! This can’t be overstated.

We’ve found that GP trainees who make a detailed, realistic study plan over several months have a much better chance of passing their AKT, as well as less stress in the run up to the exam!

Ask your educational supervisor, fellow trainees and programme directors for tips on what they have seen as good preparation in advance of the AKT exam.

Study habits for medical exams often suggest that spaced repetition and consistent practice improve long-term retention. By setting specific goals, trainees can avoid last-minute cramming and retain information more effectively.

Anything else?

Some useful spaced repetition techniques we’ve seen have effective results include trainees creating their own flashcards in order to review material periodically and solidify knowledge. These can also be shared with others within your peer group. Some of our trainees have created questions to ask others in their peer study groups, helping to support each other.

Choosing resources that are relevant, comprehensive and updated will ensure that you are using material that will support and help your exam preparation. One of the best ways to learn is through seeing patients. When in a clinical setting, or attempting questions where you feel your knowledge is lacking, having some resources to hand is essential.

We’ve done the hard work and collated the AKT top topics for you here, within Red Whale Knowledge (that GP trainees can access). The AKT often includes guideline-based questions, and this resource will help you stay updated with key clinical guidelines from NICE, SIGN and the British National Formulary (BNF).

Tips from our trainers and programme directors suggest that we should continue to focus on conditions common in primary care, such as hypertension, diabetes, asthma and mental health disorders, all of which can be found in this AKT Top Topics digital handbook.

Anything else?

The RCGP also produces regular feedback reports on past sittings that identify common areas that trip candidate up. You can find these on the RCGP website, and these were used in determining what featured in the Red Whale AKT Top Topics handbook.

The AKT can feel time pressured so it’s good to familiarise yourself with this.

There are 200 questions to be completed in 190 minutes so aiming to answer questions, on average, within 55 seconds will help in your preparation. Practising in timed settings has been shown to improve pacing and accuracy under pressure.

Anything else?

Set aside time with your peers to practise answering questions within set times.

Identifying your weak areas early will allow you to focus additional study time on these topics. Self-assessment of weak areas can highlight where you can improve, and also where you may need to arrange a tutorial or discussion within your peers to improve your knowledge gap. The RCGP has example AKT question and answers that you may find useful.

Anything else?

Keeping a record of your weak areas and going back to them regularly will help you maintain oversight. Another idea is to create a list of the curriculum areas and then rate your confidence in each area; start by focusing on the more tricky areas first. When practising questions, look at incorrect answers, review these topics in detail and don’t hesitate to ask others!

Spend time on looking at statistics because evidence-based practice questions make up a significant 10% of the AKT.

Many AKT questions require interpreting data, understanding study designs or calculating statistical measures. Trainees often find this challenging, but, with dedicated revision, it can become one of the easiest areas to achieve maximum marks.

Anything else?

Want a head start on revising statistics? Look at our comprehensive article on Statistics for the GP trainee.

Studying in trainee peer groups can enhance understanding through discussion and reinforce learning by teaching others. Group study has been shown to improve recall and understanding, especially in complex areas. Explaining concepts to peers also deepens personal understanding, and this approach can be especially beneficial for tricky topics for the AKT.

Anything else?

Form a study group with other GP trainees as soon as you are considering sitting the AKT. Schedule regular sessions and assign topics to each member to reflect back and teach to the rest of the group.

It’s important when you plan your revision to ensure regular breaks, physical activity and adequate sleep, especially in the days leading up to the exam. A strong correlation exists between wellbeing and cognitive performance; fatigue and stress can impair recall and decision-making under pressure. Practising good self-care during study preparation and on the exam day itself will lead to higher knowledge retention.

Anything else?

Incorporate regular exercise and maintain social connections. You could also consider mindfulness exercises to manage your stress levels during times of revision and leading up to the exam.

Prepare in advance so that you don’t have additional stress on the day.

Ensure that you know where the venue is, and plan your journey in advance to arrive early at the location.

Take ID that matches your RCGP application. If you have, for example, a maiden name and married name, you need to produce evidence such as a marriage certificate.

Anything else?

You can take water into the exam, but it must be in a clear bottle with a sports cap. Remove the label and ensure the bottle is less than 750ml.

By planning well, you will make the journey to (and through) the AKT easier. Discuss with your educational supervisor in your ST2 year about planning for the AKT, and decide when to sit it.

Each of these tips should complement your training, and help you focus on completing the AKT confidently, while maintaining balance and avoiding burnout.

Like any exam, preparing for the AKT requires a combination of disciplined study habits, familiarity with clinical guidelines and efficient time management. By structuring revision using high-quality resources, trainees can boost their chances of passing the AKT – a significant milestone on the path to becoming a qualified GP in the UK.

	Preparing for the Applied Knowledge Test (AKT) Plan your approach to revising early. Reduce your stress by ensuring you know what the exam is about. Review the additional resources in Red Whale Knowledge to complement your revision. Your peers and educational supervisors are excellent supporters in your preparation.
	Useful resources: Websites (all resources are hyperlinked for ease of use in Red Whale Knowledge) For the most up-to-date information on the AKT, always refer to the official sites: Applied Knowledge Test