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AKT - it’s as easy as A, B, C (D or E)!

26 May 2017 - A/Prof Stephen Barnett

The Applied Knowledge Test (AKT) is the most straightforward of the FRACGP exams, and yet many still struggle with it. In the 2016.1 exam cycle, the pass rate was around 64%, meaning that one-third of the candidates still have some trouble passing the AKT. The full RACGP report can be found here.

As with the other exams, is seems that the more times you attempt the AKT, the lower your chance of passing. For those sitting four or more times the pass rate is a low 17%. So it pays to study hard and to get it right first go!

What is the AKT?

The AKT aims to test the “Knows” part of a candidate’s competency.  This rests at the base of Miller’s pyramid of “Knows”, “Knows how”, “Shows”, “Does”

The 4-hour exam is comprised of 150 questions: 

  • 70 “Single Best Answer” questions
  • 80 “Extended Matching” questions

Importantly, this means 1 minute 36 seconds per question with NO NEGATIVE MARKINGso answer every question!

TIP: PACE YOURSELF. There is no point getting 90% in 75% of the paper, and 0% for the last 25% of the paper.

Question types

There are two types of question - Single Best Answer and Extended Matching Questions.
A Single Best Answer:
  • This is comprised of a clinical stem - a clinical scenario followed by a question
  • Five options for the answer. You choose the SINGLE BEST answer

Remember to develop a good MCQ technique as well as a good knowledge base: 

  • Read the question VERY CAREFULLY
  • Keep in mind that answers such as ALWAYS and NEVER are less likely to be correct
  • Notice words like: LEAST, MOST, NOT, IMPORTANT, LIKELY, EXCEPT. Many marks can be lost when candidates give the right answer to the WRONG question!

There will not be 4 INCORRECT and 1 CORRECT answers; rather there is one “BEST FIT” answer. Use a process of elimination to find the most likely answer.

An Extended Matching Question (EMQ):
  • EMQ is comprised of a clinical stem, followed by a question and then up to 26 options
  • There will often be a “cluster” of questions with variations on a presenting problem, or theme with the same list of choices, for example THREE questions in a row on headaches, but different scenarios in the stem.

TIP for answering EMQ: Try to make a mental diagnosis before looking at the options list.

Why do candidates fail?

Here is a list the Medcast Medical Educators have put together of common reasons AKT candidates fail:

  1. Didn’t study widely enough
  2. Didn’t have a systematic approach to studying
  3. Didn’t use correct resources
  4. Didn’t work on weaknesses
  5. Didn’t cover Australian specific themes – i.e. Aboriginal health and Rural Australia issues
  6. Didn’t know how to write a care plan
  7. Didn’t look up / think about the “other” stuff - i.e. statistics, legal issues, Medicare MBS
  8. Didn’t have a study plan – too disorganised – missed topics
  9. Didn’t keep to time on the day
  10. Wasn’t familiar with exam format
  11. Did not read the questions properly
  12. Panicked on the day
  13. Too blasé about the whole process
  14. Didn’t do practice exam questions
  15. Didn’t think about issues pertaining to General Practice

How to prepare

Put together a study timetable. Use something like the Wentwest study grid to guide your preparation. This lists the BEACH weighted topics that will be covered in the exam.

Give yourself time to prepare. You can’t get ready in the last month before the exam.

At a minimum, focus on:

  • Murtagh
  • All CHECKs in last 3 years
  • AFP last 2 years
  • Australian especially RACGP guidelines
  • Therapeutic guidelines for management


The AKT is a straightforward exam of knowledge, with no tricks. It focuses on COMMON and SERIOUS / IMPORTANT diagnoses. Give yourself time to prepare, read widely and avoid common mistakes such as running out of time or not reading the question properly.

Exam Preparation Courses

Medcast has an online AKT & KFP course to help prepare for the FRACGP exams.  This course includes a study planner and practice questions and is facilitated by our expert Medical Education team.  Click here for more information.

A/Prof Stephen Barnett
A/Prof Stephen Barnett

Stephen is a GP Supervisor, Medical Educator, GP academic and Medical Director of Medcast. He has completed a PhD on Virtual Communities of Practice in GP Training.

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