AKT Feedback Reports
Summaries of official RCGP feedback from the last 4 AKT sittings. Learn where candidates excelled, struggled, and focus your revision on recurring weak areas.
View original reports on RCGP websiteRecurring Weak Areas
Topics flagged across multiple sittings — prioritise these in your revision
Neurology
Recognising classic symptom combinations: MND (mixed UMN/LMN signs), MS (dissemination in time/space), myasthenia (fatiguable weakness), peripheral neuropathy patterns, headache red flags
Prescribing & Drug Monitoring
Side effects of long-term meds (ACE inhibitors, statins, metformin, SSRIs), monitoring requirements (lithium levels, DMARD bloods, amiodarone TFTs), drug interactions (red flags in BNF)
Children and Young People
Paediatric cancer recognition (lymphadenopathy, bone pain, pallor), acute illness assessment (NICE traffic light), safeguarding patterns, urological issues (undescended testis, phimosis, UTI investigation)
Leadership & Administration
GMC confidentiality guidance (when to share without consent), medical records access (GDPR timelines, subject access requests), capacity assessment
Evidence-based Practice
Data interpretation (forest plots, NNT/NNH, sensitivity/specificity), study design terminology (RCT vs cohort vs case-control), understanding bias types
Master These Weak Areas
Our question bank includes targeted practice on every topic flagged in these reports. Get AI-powered feedback on every wrong answer to build real understanding.
- NeurologyPrescribingPaediatricsData Interpretation
Individual Sitting Reports
AKT 57
28th October 2025
Performance by Subject Area
Areas of Improvement
- Urgent and unscheduled care — Assessment of acute ill health in adults — recognising red flags and appropriate escalation
- Gastroenterology — GI presentations — e.g. dyspepsia, IBS, inflammatory bowel disease, colorectal symptoms
- Eyes and vision — Common eye presentations — conjunctivitis, red eye, visual symptoms
- Haematology — Interpreting FBC abnormalities — anaemia workup, thrombocytopenia, leucocytosis
- Leadership and administration — Chaperone guidance and policies — when required, documentation
Areas Causing Difficulty
- Prescribing — Side-effects of medications for long-term conditions — e.g. ACE inhibitors (cough, hyperkalaemia), metformin (B12 deficiency), statins (myopathy), SSRIs (bleeding risk)
- Confidentiality — GMC confidentiality guidance — when to share without consent (child protection, DVLA, infectious diseases), capacity issues
- Paediatric cancer — Recognising cancer in children — persistent unexplained symptoms, lymphadenopathy, bone pain, pallor, bruising, abdominal masses
- Paediatric acute illness — Assessing the acutely unwell child — NICE traffic light, sepsis recognition, dehydration
- Safeguarding — Recognising patterns of abuse — NAI presentations, neglect indicators, fabricated illness
- Neurology — Significant neurological conditions — combinations of symptoms/signs e.g. motor neurone disease (mixed UMN/LMN), MS (dissemination in time/space), myasthenia (fatiguable weakness)
Key Insight
First sitting with new 160-question format. Neurology remains a persistent challenge — focus on recognising classic symptom combinations that point to specific diagnoses.
AKT 56
9th July 2025
Performance by Subject Area
Areas of Improvement
- Children and young people — Common childhood conditions — viral exanthems, normal developmental variants, minor illness management
- Cardiovascular health — Long-term CV management — heart failure (NICE NG106), AF anticoagulation (CHA2DS2-VASc), hypertension targets
- Dermatology — Rash recognition — eczema vs psoriasis, drug eruptions, urticaria, acne management
Areas Causing Difficulty
- Research terminology — Study design terms — RCT, cohort, case-control, cross-sectional; understanding bias types (selection, recall, attrition); confounding; blinding terminology
- Infectious disease diagnostics — Which tests for which infections — e.g. throat swab vs serology, stool PCR, HIV testing window, TB investigations (IGRA vs Mantoux)
- Neurology — Neurological symptoms and signs — distinguishing upper vs lower motor neurone, cerebellar vs sensory ataxia, peripheral neuropathy patterns
Key Insight
Research methodology questions caught many candidates out. Know your study designs and bias types. For infectious diseases, focus on first-line diagnostic tests in primary care.
AKT 55
30th April 2025
Performance by Subject Area
Areas of Improvement
- Duties of a doctor — GMC duties — probity, raising concerns, delegation, continuity of care
- Cancer recognition — 2-week wait criteria — red flag symptoms for each cancer type, NICE NG12 referral guidance
- Renal function — Abnormal renal function management — AKI vs CKD, when to refer, medication adjustments
- Emergency presentations — Continued improvement in acute care — sepsis, anaphylaxis, MI recognition
Areas Causing Difficulty
- Paediatric urology — Common urological issues — undescended testis (when to refer), phimosis (normal variants vs pathological), UTI investigation (NICE NG224), bedwetting age thresholds
- Long-term conditions — Keeping up with guideline changes — recent updates to diabetes (NICE NG28), hypertension (NICE NG136), asthma (NICE NG80), COPD (NICE NG115)
- Neurology — Neurological symptom recognition — headache red flags, TIA vs stroke, peripheral neuropathy causes, dementia subtypes
Key Insight
Highest pass rate of 2025. Key lesson: sometimes the correct answer is NOT to investigate, prescribe, or refer. Cost-effective, evidence-based watchful waiting is often the right choice.
AKT 54
29th January 2025
Performance by Subject Area
Areas of Improvement
- Prescribing knowledge — Therapeutics improvement — appropriate drug choices, dose calculations, common interactions
- Substance misuse — Alcohol and drug management — AUDIT-C scoring, brief interventions, referral thresholds, opioid substitution basics
- Emergency care — Emergency presentations — anaphylaxis management, sepsis 6, acute coronary syndrome
Areas Causing Difficulty
- Data interpretation — Charts and statistics — interpreting forest plots, funnel plots, survival curves, NNT/NNH calculations, sensitivity vs specificity, PPV/NPV
- Drug monitoring — Monitoring requirements — e.g. lithium (levels, renal, thyroid), DMARDs (FBC, LFTs), amiodarone (TFTs, LFTs, CXR), carbimazole (urgent FBC if sore throat)
- Medical records access — Subject access requests — GDPR timelines, exemptions, third party data, deceased patient records, police requests
- Early pregnancy — Pregnancy complications — ectopic symptoms (pain before bleeding), miscarriage types, hyperemesis, early pregnancy unit referral criteria
- Dermatology treatment — Skin condition management — topical steroid potencies, emollient prescribing, acne ladder, psoriasis treatment pathway
- Ophthalmology signs — Eye examination findings — normal vs abnormal fundoscopy (disc pallor, cupping, macular changes), pupil abnormalities (RAPD, Horner), red eye causes
- Genetic conditions — Recognising genetic syndromes — Down syndrome health surveillance, fragile X features, Williams syndrome, Prader-Willi, neurofibromatosis skin signs
Key Insight
Evidence-based practice score (65.19%) was notably lower than other domains. Watch Professor Michael Harris video tutorials on RCGP website for data interpretation.
Key Advice from Examiners
Exam Strategy
- The correct answer is sometimes not to investigate, prescribe, or refer
- "Current national guidance" refers to NICE/SIGN (CKS is broader but NICE takes precedence)
- For drug calculations, reality-check your answers — dangerous errors are common
- No negative marking — always answer every question
Revision Focus
- Learn drug monitoring requirements — use BNF as a revision source
- Familiarise with common and important drug side effects (especially "red" interactions)
- Practice data interpretation — RCGP provides video tutorials by Prof Michael Harris
- Engage regularly with safeguarding learning activities
Practice These Weak Areas Now
Use our AI-powered question bank to focus on the topics candidates struggle with most.