What is the AKT?

The AKT is the Applied Knowledge Test, a computerised multiple-choice examination which is the first of the three components of the MRCGP - the others being the Simulated Consultation Assessment (SCA) and the trainee e-portfolio.

The AKT comprises of 200 questions which must be answered within 3 hours and 10 minutes. Questions can cover the entirety of the GP curriculum, but the vast majority will be based on clinical knowledge, with smaller allocations to evidence-based medicine and the organisation and management of primary care.

The general breakdown is that 80% of questions will be based on clinical knowledge, 10% on evidence-based practice (including evidence interpretation and the critical appraisal skills needed to interpret research data) and 10% on primary care organisation and management aspects.

There are a variety of different question formats you will encounter in the AKT exam. These include Single Best Answer (SBA), Extended Match Questions (EMQ), free text answer and picture/photo questions as well as calculation questions.

• Single Best Answer, like the name suggests, gives you a question vignette and a list of usually five answers. More than one may be correct, but you must choose the most correct answer.
  • Picture/photo questions are increasingly used and can include clinical photos for which you have to identify the condition, or sometimes graphs which need to be interpreted.
• Extended Match Questions give a variety of scenarios with a longer list of potential answers, and you must match the scenario/question with the correct answer.
• Free text answers involve you typing your, usually short, answer out in a text answer box.
  • Calculation questions may require you to use the AKT examination software built in calculator to derive the correct answer mathematically, for example when calculating the correct dosage of a drug.

The core GP curriculum provides an overview of the areas covered, and it is important to familiarise yourself with it. Each question will be linked to specific clinical domains, and to reflect this each question in the Pastest AKT package is also mapped in a similar way.

The AKT is not a basic medical sciences examination, instead candidates must be prepared for a degree of problem solving in order to derive the correct – or most the correct – answer.

When should I take the exam?

Although it is a personal decision as to when you sit the AKT, there are a few factors that should be kept in mind.

The AKT can be only undertaken from the ST2 year onwards and generally there are at least 3 dates each year when it can be done. You sign up for the AKT through the RCGP website, whilst the examination itself takes place at a number of Pearson sites around the country. When registering, it is important to keep in mind that every year candidates are turned away from the test centre because they forget their identification documents or the identification documents do not match the candidates registration details. Make sure you fill this in accurately.

To increase your chances of passing, it is recommended to schedule the AKT exam when you will be working in a job that provides both the necessary time and a supportive network to help you make the most of your preparation. For this reason, many candidates choose to sit their AKT at a time when they will be working in General Practice. The advantages of this include:

• Protected teaching time
• More peer support
• Support from trainers and the experience which comes from day-to-day practice
• Being free from nighttime and weekend on-calls.

There is preliminary evidence that candidates who sit the AKT early in their ST2 year are more likely to pass than those who leave it until ST3.

When determining the ideal timing for your AKT examination, a crucial factor to consider is the duration required for preparation. Opting to take and successfully pass the AKT during the ST2 year allows the ST3 year to be dedicated entirely to focusing on the RCA and portfolio components of the MRCGP assessment.

How long should I spend preparing?

The preparation time needed for each candidate varies based on their individual needs. When deciding how long it will take to prepare, it's important to consider both work and personal life, including the jobs leading up to the exam and any on-call duties involved. Typically, candidates will require, at the very least, six months preparation to give themselves the best chance of passing the AKT.

What do I need to know?

Whilst the AKT is a multiple-choice examination, it is key to have good overall knowledge to draw from and to apply to the questions. To assist you in this, the Pastest AKT resource has detailed, dynamic explanations for each question to ensure your learning for each area covered in the exam is more rounded. For SBAs, each answer option has an explanation to help you understand why the answer you chose is either right or wrong.

In addition, the unique Pastest Microlearning resource will ensure you stay engaged and focused as you build your knowledge – with searchable topics, podcasts, videos, flashcards and more.

What should my strategy be?

A large part of your preparation should be concerned with replicating exam conditions through the use of questions written specifically to the style, standard and level of difficulty that you will face in the AKT examination. The Pastest AKT resource has over 3400 questions written by doctors who have undertaken the AKT themselves, as well as currently practising GPs.

The Mock Exams feature replicates the real exam experience with tests structured to reflect the timing, content and difficulty found in the AKT. Remember, in the real exam you will only have approximately 57 seconds to spend on each question before moving on, therefore, practice at your timing and efficiency is crucial. The examination is not negatively marked and so you lose nothing guessing an answer even if you're not sure – this is far better than leaving the question unanswered which will only ensure you are not awarded any marks.

Of all the new updates and improvements to the Pastest AKT resource, one recent addition which I am particularly excited about is the Microlearning feature. Microlearning is Pastest’s comprehensive, searchable library of Media, Expanded Explanations (written topic summaries) and Flashcards, designed to strengthen your knowledge on hot topics that commonly appear in the AKT exam.

We know that revising for the AKT is a marathon, not a sprint. As such, as I am aware from personal experience from when I was preparing for the AKT, there can come a point when you would benefit from tackling the material in a new way and from a fresh perspective. This is where microlearning comes in.

Taking a multi-step approach to ensure you get the most out of your revision time, the Microlearning feature first of all breaks up the knowledge needed to cover each part of the AKT syllabus into short, bitesize chunks, providing you with succinct high-yield clinical summaries which are easy to read and absorb. The next stage is to reinforce this learning with compelling and easy-to-understand podcasts and videos created specifically for the topic at hand by leaders in the field. Finally, Microlearning provides you with flashcards on each topic so you can test and reinforce what you have learnt, helping you to quickly identify areas of weakness and strength.

The Microlearning feature is a powerful addition to the Pastest AKT resource, and I have no doubt it will assist you greatly in your preparation for your AKT exam.

How can I monitor my performance?

A key aspect to the learning cycle when preparing for the AKT is to closely monitor your performance and have the ability to highlight areas of the curriculum where you perform more poorly – so that you can spend time efficiently strengthening your knowledge prior to the exam. The Pastest AKT question bank features real-time performance feedback so you can get an in-depth understanding of how you perform in each area of the GP curriculum.

Any tips for the day of the exam?

It is always advisable to arrive at your examination centre in good time and taking account of traffic. Every year candidates are turned away from the test centre because they forget their Identification documents or the identification documents do not match the candidate’s registration details.

With 57 seconds available for each question, it is crucial you approach the exam efficiently and confidently. Candidates who struggle with timing in the AKT have often spent too long pondering over a question early on in the exam and, therefore, feel rushed towards the end of the exam. Given that there is no negative marking, it can be advantageous to choose any option and move on, rather than spending time pondering over a question that you do not know the answer to.