Information on the AKT    Added 31st August 2007

Question styles

The test is based on the RCGP curriculum. It has been designed to avoid `low level' factual questions, instead focusing on the application of knowledge to real-life general practice situations.

The old true or false multiple choice questions are long gone. The three-hour paper consists of single best answer (SBA), extended matching questions (EMQ), tables and algorithms for completion and questions relating to clinical photographs.  Typically, in an SBA question, a brief clinical scenario or factual statement is given with a list of five potential answers for you to select the one you think is most correct. Several options might sound plausible and there are usually no erroneous distracters.

An EMQ is usually a list of about 10 possible answers followed by several clinical scenarios. For each scenario you need to choose the most appropriate answer from the list. Each item may be used once, more than once or not at all.

In `tables or algorithms for completion' questions, you will be presented with, for example, a flow chart containing blank spaces and be asked to fill the gaps with the correct answers from a list of options.

Clinical photograph based questions could ask you to identify the most likely diagnosis from a list of options for a patient in the photograph.

How to answer

Most candidates will need the three hours to complete the AKT.

Cover up the list of answers for each question and try to answer from the question stem alone. If your unprompted answer matches one of the listed options then it is highly likely that one is correct. Working in this manner helps stop you being misled by the other distracting options.

If you do not instantly recognise an answer, narrow it down to the two or three most plausible. Bear in mind that 200 questions in 180 minutes gives you less than a minute per question and that clinical-scenario-based questions can take longer. If you are still unsure when you return to the unanswered questions then guess, going for any `gut instinct' answer. Remember there is no negative marking.

How to prepare

This is a high stakes licensing exam so you clearly need to take your preparation seriously. Ensure you have protected learning time, and define your weaker subject areas early, for example by using confidence-rating scales. It is important not to rely on out-of-date exam preparation books because the AKT will change rapidly in response to emerging evidence. A huge amount of work goes into preparing fresh questions. Definitive resources for preparation include the British National Formulary and Clinical Evidence, in addition to the Cochrane Library and national guidelines.

Make use of your rich and daily work exposure to general practice. Look up answers to things you are unsure about. If you have quickly seen a patient with a simple problem, like a sore throat, then use the spare consultation time to think on a wider perspective. What evidence base is there for treatment versus non-treatment? What guidelines exist, such as PRODIGY?