Tackling the MRCGP AKT – How I Passed with a Score of 92.5%

Dr Jennifer Patel is a GP trainee from South Manchester, North West England. Her AKT was postponed in April 2020 during the Covid pandemic, but she took the exam a few months later in August, passing first time with a score of 92.5%. Here, she shares her experience and advice for those preparing for the AKT.

Usually taken as the 1st of 2 exams that are part of MRCGP, the AKT is a challenging postgraduate exam. However, with the right preparation it is by no means impossible. The main aim of the exam is to test your ability to take the knowledge you have and APPLY it practically to a situation outlined in the question. Basically like a real-life GP (just without Google to help).

Below are some of the questions I had when preparing for the exam. Of course everyone has their own revision method, but I hope this guide can provide some ideas to help get you started.

  • When should I sit the AKT?

This answer is a simple one – when it’s the right time for YOU.  Trying to sit your exam whilst on nights on a busy ED job compared to the bliss of a GP placement without nights and weekends because you’re in ST2 and you’ve been told it’s a ‘good time to sit it’, is probably not sensible. At least 4 weeks prior to sitting the exam, you will want the time to practise questions or learn the more difficult things to remember, so you should feel able to commit the time. If you have a major life event just before the exam date, then postpone the exam, even if that means taking it in ST3 like I did. The only right time is the one where you can commit the time needed beforehand.

  • How much time do I need to revise?

Of course it’s an individual decision, but a rough guide is 3-4 months. Think of yourself as the tortoise in this race, not the hare! Slow and steady, building up your knowledge from a good foundation of understanding will lead to you remembering more. However, if you start too early, you’ll be fed up before the end and could lose momentum which is why 3-4 months is a reasonable amount of time. Be sure to leave time 2-3 weeks before the end to hammer question practice and last minute guideline cramming.

  • There is SO much to know. HOW do I go about revising?!

I remember that first day I set about focused revision for the AKT. I felt hopelessly overwhelmed which made that day and the next few days after that really unproductive. What you need to remember is the AKT tests 80% clinical medicine, 10% evidence based medicine and 10% organisation/management/ethics. The pass mark is usually around 67%. Therefore that 20% non-clinical section is key to passing! It is much easier to increase your score in these areas than clinical medicine which is a vast topic.

For me, the organisation and statistics section was a good place to start. Then I’d suggest making a list of the KEY COMMON clinical topics within each system to focus on. For example in cardiology, you may spend an evening understanding a few NICE CKS guidelines: hypertension, angina and high cholesterol. A few days later mix it up by trying some questions on what you read. This highlights areas you know well and weaker areas that may need revising further. Mix up reading with questions to vary your learning and keep boredom at bay.

  • Would you recommend doing an AKT course?

Of course, this is entirely your decision. For me, I felt that doing some form of AKT course would increase my confidence and ultimately save time in the revision process. In the end, I chose to do the 3 x 3.5 hr online AKT Emedica webinars (1 for each of the 3 domains tested). They offer a variety of other courses on their website and I would recommend checking these options out if you do want that boost. For me, the webinars on stats and admin helped immensely and I scored 100% and 95% respectively so I felt it was money well spent.

  • What other resources would you recommend to help guarantee a pass?

Question banks:-

  • iMedics – a free online resource of 2500+ AKT questions. These ask questions primarily from guidelines, which I found extremely helpful to solidify my knowledge
  • GP self-test – this is a free resource if you are a RCGP member. There are 1000s of questions here which are about a similar level to the exam
  • Emedica AKT question bank – 2100+ questions that really get you ready for the more unexpected and challenging questions in the exam, as well as the basics

Other resources:-

  • BNF – pages 1-31 – summarise this onto a few A4 pages to read before the exam
  • Youtube videos – great resource for varying up revision e.g. the Emedica AKT 30 day challenge, developmental milestone videos (much easier to remember than reading in a textbook)
  • NICE CKS guidelines – there are over 300! Please don’t try to revise all of them. Make a list and choose MAXIMUM 100 to read over. Choose the common or most important topics.
  • GMC guidance – this was tested as part of the organisation and management domain; look at the key topics including consent, 0-18 years, confidentiality. Be able to apply this guidance to clinical scenarios.
  • DVLA guidelines – I made a summary table for Group 1 and 2 driver restrictions for very common conditions, then revised it the night before
  • AKT section on RCGP website – on here are tips on how to prepare and FAQs. The examiner reports are particularly helpful for highlighting common pitfalls from previous candidates – I just revised these topics a little more to avoid the same mistakes as peers.
  • Real life experience – nothing beats this. Truly, the more GP experience you have, the more comfortable you’ll feel managing the real life cases presented in the exam. In your clinic you may take a watch and wait approach, so don’t be afraid to put this as an answer in the exam too.
  • What advice would you give for the exam itself?

Get a good night’s rest before the day of the exam. There are 2 slots – morning or afternoon. Pick the one that suits your lifestyle. I picked the morning to get it out the way and avoid feeling too stressed waiting for the exam.  Once you’re at the test centre, the only other bit to think about is EXAM TECHNIQUE. This cannot be underestimated. You have 200 questions to do in 190 minutes: 160 on clinical medicine, 20 on organisation and 20 on stats. Timing can be tight. Some questions may be 1 line of text and quick to answer; others require you to interpret data, so take longer. If you know the answer, be confident, put it down and move on. Any you’re not sure about, spend up to 30-40 seconds on, then flag to come back to. Just be sure to finish!! Statistically you’re far more likely to pass if you complete the paper.

Also, don’t be too worried if the first few questions seem really challenging. This happened to me and it knocked my confidence at the start, but they soon got more straightforward.

I wish you the BEST of luck in revising and sitting the exam. I’m confident with the right attitude, preparation and exam technique, you can ALL pass this exam.

Dr Jennifer Patel passed her AKT first time with a score of 92.5% – this was one of the highest scores ever!

Details of the webinars that Dr Patel mentioned are here: