AKT exam technique: tips straight from the RCGP

1. Sometimes the best answer is to do nothing

The AKT rewards careful, cost-effective care. So the right answer can be to not investigate, prescribe or refer. The RCGP says candidates find this option hard to choose — but it is often correct.

• •Mildly abnormal blood results often need no further tests.
• •Doing less can be the safest, most appropriate answer.

2. Read the guidance the way they mean it

• •When a question says current national guidance, that means NICE or SIGN.
• •CKS is useful too — it covers more primary-care situations — but NICE or SIGN is the reference if they ever differ.

3. Pick one answer, not a safety net

• •When asked for an investigation, choose the single most useful one to confirm the likely diagnosis — not a whole screen of tests.
• •When asked for the next step, choose what matters now — not something that might be done later.

4. Prescribe like a GP

Nearly one in three questions has a prescribing element, so medicines are central.

• •Choose drugs that reflect normal, evidence-based primary-care practice — not specialist hospital choices.
• •Know the important side effects and severe interactions — the ones marked red in the BNF.
• •For dose and volume sums, the maths is simple — but check your decimal point. Reality-check the answer, especially a volume. The RCGP says it receives answers that are dangerously wrong.
• •Use the on-screen calculator if you want, but still sanity-check the result.

5. Make the numbers make sense

• •With any number, ask: does this fit the real world? Does it match what you would actually tell a patient?
• •Be ready to interpret risk, use patient decision aids, and explain risk clearly.

6. Know the picture questions

• •Some questions use photographs — including eye (retinal) findings and skin conditions.
• •Skin photos are shown across a range of skin tones, so practise spotting conditions on different skin.
• •Some photos show normal findings, not just abnormal ones.

7. Vaccines: principles, not timetables

• •You do not need to memorise the full childhood vaccine schedule.
• •Do know the key indications, contraindications and side effects of vaccines, for all ages.
• •Also know consent, patient group directions, and occupational vaccines for GP settings.

8. Referrals and rare conditions

• •You do not need deep knowledge of tests done in hospital after a referral — but know enough to answer a patient's questions when you discuss one.
• •Diagnostic questions can include rare but important conditions that present to a GP.

9. Get your statistics marks

Data and statistics is the lowest-scoring area — and it is very learnable.

• •Learn sensitivity, specificity and predictive values.
• •Understand risk, randomised controlled trials, and systematic reviews and meta-analyses.
• •The RCGP points candidates to a free set of tutorials by Professor Michael Harris for exactly this.

10. Do not leave anything blank

There is no negative marking. A wrong answer costs you nothing. A blank is a guaranteed zero. Almost every candidate answers every question — make sure you do too.

A note if you trained abroad

The RCGP knows some candidates have less experience in certain areas — for example women’s health, how UK general practice is run, or reading data the UK way. If that is you, find these gaps early and get focused practice. It is a known, fixable thing — not a disadvantage you are stuck with.

Next, see the high-yield topics candidates struggle with, and our guide on how to revise for the AKT. The advice here is drawn from the RCGP’s AKT feedback reports.