AKT Exam Feedback Report (April 2023)

The MRCGP AKT (Applied Knowledge Test) was held on the 26th of April 2023 and was sat by 2,504 candidates. This exam feedback report provides a summary of the April 2023 exam, including key statistics, areas of strength and difficulty for candidates, and tips for AKT exam preparation. If you would like to review feedback reports for other AKT examinations held in the past, please click on any of the below for more information:


The AKT scores ranged from 46 to 193 out of 200 questions and a mean overall score of 145.64 marks achieved (72.82%). The AKT exam typically consists of 200 questions, however, after conducting a final review of the question performance, one of the 200 MCQs was redacted from the final scoring total. In total, 68.05% of all 2,504 candidates passed the April 2023 AKT exam. The mean score for each of the three subject areas was as follows:

Areas of Strength

For the April 2023 AKT exam, candidates performed better than in previous sittings in questions relating to:

Areas of Difficulty

Improving Quality, Safety and Prescribing

Firstly, candidates demonstrated lower performance in questions regarding the proper prescription of antibiotics in primary care, such as prescribing for urinary tract infections in various clinical scenarios involving different age groups. We acknowledge that there are variations in local guidelines throughout the UK, and secondary care guidelines in specific regions may differ from primary care guidelines. Nevertheless, national guidelines clearly outline the appropriate prescribing practices, taking into account diverse presentations.

Secondly, candidates encountered difficulties in appropriately monitoring medications prescribed for common mental health conditions. This is a significant aspect of general practice that pertains to ensuring safety and enhancing the quality of care. Candidates are reminded of the value of consulting the British National Formulary (BNF) as a reliable resource while preparing for the AKT exam, particularly focusing on the "monitoring requirements" section.

Antibiotic prescribing/stewardship and drug monitoring are areas where we consistently provide feedback, highlighting areas that offer potential for improvement.

Leadership and Management

Firstly, candidates encountered some difficulty with questions regarding the administration of death and situations that require a referral to a coroner or procurator fiscal. It is important to note that there are regulations on notifying deaths in place throughout the UK, and candidates are advised to utilize this guidance as a study resource.

In addition, candidates faced challenges related to data protection and confidentiality, particularly concerning the use of social media. While an in-depth understanding of the specific legislation is not required, a working knowledge of the general principles of social media and confidentiality, as well as their application to real-life scenarios, is expected in the AKT. The General Medical Council (GMC) has issued guidance in this area.


Candidates encountered difficulties with questions pertaining to the management of acne in AKT exam. It is important to note that candidates should prioritise national guidelines over local guidelines when preparing for the AKT. Additionally, staying updated on new national guidance regarding clinical topics is essential.


Candidates should be aware that they may encounter questions related to medically unexplained symptoms in the AKT, whether or not there is a definite underlying pathology. These scenarios require the application of knowledge to determine the presence or absence of an underlying diagnosis, such as a neurological condition. When preparing for the AKT, it is crucial to have exposure to a variety of patient presentations in primary care, as general practice is becoming increasingly complex. It is important to note that certain symptoms may not have a clear-cut diagnosis.

Urgent and unscheduled care

During the AKT, candidates will encounter scenarios where they need to determine the most suitable referral pathway for a given clinical situation. It is important for candidates to consider the diagnosis in order to make an informed decision regarding the appropriate management plan. This includes urgent care scenarios, such as breathlessness. Candidates should remain mindful of symptoms and signs that may indicate a diagnosis requiring emergency admission.

Exam Preparation

Candidates aspiring for success in their exams must heed to the importance of these vital areas in their preparation. The GP curriculum offers an all-encompassing roadmap for exam readiness, with the knowledge and skills sections within each topic guide being a valuable resource for those seeking to thoroughly cover all crucial topics. To further boost their chances, it is suggested that candidates do the MRCGP AKT question bank and mock exam, periodically review feedback from previous AKT exams, and pinpoint areas that require extra attention in their preparation.