AKT Feedback Reports
Summaries of official RCGP feedback from the last 6 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, common gait disturbances
Evidence-based Practice
Data interpretation (forest plots, NNT/NNH, sensitivity/specificity, practice-level data charts), study design terminology (RCT vs cohort vs case-control), understanding bias types
Prescribing & Drug Monitoring
Side effects of long-term meds (ACE inhibitors, statins, metformin, SSRIs), monitoring requirements (lithium levels, DMARD bloods, amiodarone TFTs), identifying prescribing errors, 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 and confidentiality, urological issues (undescended testis, phimosis, UTI investigation)
Leadership & Administration
GMC confidentiality guidance (when to share without consent), data protection around recorded consultations, medical records access (GDPR timelines, subject access requests), capacity assessment
Eyes and Vision
Diagnosis of common eye conditions and recognising eye signs — red eye causes, fundoscopy findings (disc pallor, cupping, macular changes), pupil abnormalities, visual symptoms
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 59
27th April 2026
Performance by Subject Area
Areas of Improvement
- Children and young people — Recognition of childhood cancers — persistent unexplained symptoms, lymphadenopathy, bone pain, pallor and bruising
- Leadership and administration — Chaperone policies — when a chaperone is required and how it is documented
- Respiratory health — Asthma management — diagnosis and stepwise treatment in line with current national guidance
Areas Causing Difficulty
- Drug monitoring — Monitoring of common medications — discuss monitoring schedules and practice audits with your community pharmacist or practice manager
- Prescribing errors — Identifying prescribing errors — the BNF is the recommended resource for revision
- Data protection — Data protection around recorded consultations — refer to GMC guidance and GDPR
- Safeguarding — Confidentiality in child safeguarding situations — consider covering the ethics in a safeguarding update or teaching session
- Minor illnesses — Recognising and managing minor illnesses in primary care — a good basis for a tutorial with your supervisor or peer group
Key Insight
Highest pass rate of the last six sittings at 80.22%, and the strongest evidence-based practice score in the set (79.99%). Prescribing featured twice — monitoring of common medications and spotting prescribing errors — with the BNF the recommended resource. Neurology was not flagged this time, but it has still been highlighted after three of the last four AKTs.
AKT 58
26th January 2026
Performance by Subject Area
Areas of Improvement
- Metabolic and endocrine — Rare but important endocrine presentations — better recognition than in previous sittings
- Prescribing — Therapeutic indications, side effects and drug monitoring — a previously flagged weak area showing improvement
- Renal and urology — Urological complaints presenting in primary care
- Evidence-based practice — Data interpretation of some chart types improved
Areas Causing Difficulty
- Palliative care — Management of common symptoms at the end of life — revise with the BNF and seek exposure via home visits and care home ward rounds
- Eyes and vision — Diagnosis of common ophthalmological conditions — core knowledge even where eye care is often delivered by other professionals
- Data interpretation — Charts pertaining to data within practices — consider attending practice cluster meetings or a session with your practice manager
- Neurology — Recognising common gait disturbances presenting in general practice — neurology has been flagged in each of the last four AKTs
- Metabolic and endocrine — Identifying common biochemical disturbances — practise actioning blood test results with your supervisor
Key Insight
Pass rate recovered to 76.52%, up sharply from AKT 57. Neurology was flagged for the fourth consecutive sitting (gait disturbances this time), and palliative care symptom management caused difficulty: the BNF is the recommended revision resource.
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.