MRCGP AKT Format: 160 Questions, 160 Minutes and the 80/10/10 Split
Published Oct 18, 2026
The MRCGP Applied Knowledge Test (AKT) changed shape in October 2025, so older guides describe a longer exam. Here's what the Royal College of General Practitioners' own AKT pages (https://www.rcgp.org.uk/mrcgp-exams/applied-knowledge-test/akt-introduction) say about the current format.
From October 2025 the AKT has 160 questions answered in 2 hours 40 minutes. It used to be 200 questions in 3 hours 10 minutes, and the RCGP's timetable-change page sets out the move "from 200 to 160 items" and "from 190 to 160 minutes".
The content is split three ways: 80% clinical knowledge, 10% evidence-based practice (including evidence interpretation and critical appraisal), and 10% primary care organisation and management (including administrative, ethical, regulatory and statutory frameworks). The RCGP says questions test "higher order problem-solving rather than the recall of basic facts", and the GP Curriculum is its guide to the topics.
Most questions are single best answer (SBA), but the exam also uses multiple best answer, free text and extended matching questions. Questions on abnormal examination findings will generally be photographs, for example retinal findings, and the evidence-based practice questions use the kinds of graphs and tables practices regularly receive from local health organisations.
The AKT is a computer-based, computer-marked exam taken at Pearson test centres, and it runs four times a year, in January, April, July and October. Each question is worth one mark and there is no negative marking, so a wrong answer costs nothing more than a blank one.
Study takeaway: clinical knowledge is 80% of the marks, but the two 10% sections are where many candidates lose easy points. Practise data interpretation and practice-administration questions alongside clinical topics, and never leave a question blank, since there is no negative marking.