The Applied Knowledge Test (AKT) is an assessment of your knowledge. the test comprises a three hour multiple-choice test of 200 items.

Most of the work for the AKT is individual work that you need to do yourself.

Approximately 80% of the questions will be on clinical medicine, 10% on critical appraisal and evidence based clinical practice and 10% on health infomatics and administrative issues. Questions focus on problem solving rather than just the simple recall of facts.

The test takes place three times a year (January/February, April/May, October/November) at any Pearson VUE test centre within the UK. Candidates must register for the nMRCGP through the RCGP website, then apply to take the AKT, before booking a test centre with Pearson Vue at www.pearsonvue.com/rcgp. Read the 'AKT overview' download on the right for more detailed information.

Registrar feedback has lighted that the statistics MCQs were hard and covered funnel plots, forest plots, and blobograms. NNT calculations were difficult, you need to know your mean, mode and median and there was al ot of data interpretation of graphs. there were questions on lifestyle advice from national guidelines, and fundoscopy pictures to look at. Extended clinical scenario questions relied on getting the diagnosis correct so that the consequent investigations and management were also correct. there are also some new types of question that involve some written- single word- answers.

What should you do?


  • Start checking your knowledge base against the RCGP curriculum early in ST1 and build on this. Use your e-Portfolio.
  • AKT type questions are published each month on the RCGP's InnovAIT website. These are based on the articles featured in that month's jurnal. Several hundred questions are now available. Visit www.rcgp-innovAIT.oxfordjournals.org.
  • Use the RCGP e-GP, a free learning resource, with interactive modules which have knowledge tests built in. Completed e-learning sessions are automatically recorded in your ePortfolio. Go to www.e-GP.org.
  • Take the RCGP Essential knowledge challenge. Each challenge contains 50 AKT type questions based on the accompanying Essential Knowledge Update, a six monthly update of new or changing knowledge. www.elearning.rcgp.org
  • Demonstrate your learning in your ePortfolio from reading, e-module entries and learning opportunities within the Practice.
  • Read NICE and SIGN guidelines and the first five chapters of the BNF.


  • Start revising three months before the exam.
  • At first concentrate on reviewing NICE and SIGN guidelines and the first five chapters of the BNF.
  • InnovAit magazine is worth reading and is available at the surgery.
  • Know your vaccinations- make sure that you have a tutorial with Jackie Edwards, sit in on appropriate clinics and read the Green Book.
  • Then start doing lots of MCQs.

On-line help

A low cost bank of over 1000 questions with expalinations of answers and links to relevant guidelines.

A bank of questions from the BMJ group.

Low cost and there's an app. for your phone.

RCGP examiners feedback from the examination going back over several years.

Bandolier contains articles on critical appraisal and health economics.

A critical appraisal skills programme with useful checklists to help make sense of systematic reviews, CTs, cohort studies etc.

Modules cover critical ppraisal and research using interactive tests and links to resources. Need to register with RCGP

Books (all available at the Surgery)


InnovAit magazine

The Oxford Handbook of General Practice- but it may not have the latest guidelines.

nMRCGP Practice Papers: Applied Knowledge Test, Rob Daniels

nMRCGP AKT Study Guide, Khan, Jabbour & Rehman

How to Read a Paper, Greenhalgh


We don't know any of them well enough to recommend but have read that the link here GP Update course is good and provides a useful accompanying book.

At the Surgery and outside

Concentrate on areas such as chronic disease management and immunisations that are managed by the Practice Nurses

Some ares come up regularly and can be prepared for, e.g death certificates, cremation forms, fitness to drive/fly/work, sick notes, certification/reports. Make sure you have covered these.

Form a revision group, either at the Surgery with the other Registrars- we give you protected time each week to work together- or with other local colleagues, or on-line, www.rxpgonline.com. Form a journal club at the surgery ot outside.

Make sure you cover statistics and critical appraisal on the VTS, or external course.

Ask us to share with you dermatology, ENT, and opthalmology cases and consider attending the Out Patient clinics.

Keep a list of areas that you are weak on and cover these again immediately before the exam.

Do some timed exams.



AKT Overview
Word file

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