Learning from the July 2026 AKT Feedback Report

The RCGP has published its feedback report for the July 2026 AKT (AKT 60), and it repays a careful read. If you're sitting in January, this is the most recent picture of where trainees are dropping marks, straight from the examiners.

As with every sitting, our summaries of the AKT feedback reports are free to read whether or not you subscribe.

The headline numbers

Candidates: 1,308

Score range: 56 – 153 / 160

Mean score: 120.15 (75.1%)

Pass mark: 112 (70%)

Overall pass rate: 73.2%

Pass rate for UK graduates, first-time takers: 86.2%

The reliability coefficient was 0.89, slightly higher than April's 0.88, so this paper was a very consistent measure of candidates' knowledge.

Higher mean score, lower pass rate. What happened?

Compared with April, the mean score went up (74.3% to 75.1%), yet the pass rate fell from 80.2% to 73.2%. The reason is the pass mark, which jumped from 107 to 112.

The RCGP sets the pass mark separately for each paper, so a higher number doesn't mean the bar for a "safe GP" has moved. It reflects that particular paper. The practical lesson is that you can't aim for a fixed score. Aim to be comfortably above the line, because a few marks either way decided a lot of results in July. You can see how the pass mark has moved over every recent sitting on our AKT pass mark page.

As always, UK graduates sitting for the first time did better than the overall cohort. Give your first attempt your full attention, and if you can, avoid sitting during your busiest rotation.

How did each section go?

Clinical knowledge: 128 questions, mean score 76.2%

Evidence-based practice: 16 questions, mean score 73.5%

Organisation & management: 16 questions, mean score 68.2%

Two things stand out.

First, evidence-based practice dropped sharply, from 80.0% in April to 73.5%. In April this was the section where candidates scored highest; in July, clinical knowledge overtook it. Statistics and data interpretation are usually where well-prepared trainees bank marks, so this is a warning not to leave them to the final week. Our AKT research and statistics module covers everything from 2×2 tables to NNT and confidence intervals.

Second, organisation & management is still the lowest-scoring section (68.2%, down from 71.1%). It has been at the bottom for several sittings now. Book a tutorial with your trainer, your practice manager or a GP who does appraisals, and ask them to walk you through the admin side of the job.

What improved this sitting?

Candidates did better than before on:

• Recognising common neonatal presentations (Children & Young People)
• Recognising normality and knowing when no treatment is needed (Being a General Practitioner)

The second one is worth dwelling on. Every report repeats the point that "sometimes the correct answer is not to investigate, prescribe or refer". That includes mildly abnormal blood results. It's good to see candidates getting more comfortable with that.

What caused difficulty?

Four areas were flagged in July: neurology, joint disorders in children, skin rashes and respiratory conditions.

Neurology: conditions affecting the cranial nerves

Candidates struggled to interpret presentations involving the cranial nerves.

How to improve? Revise common and important neurological conditions, and make sure you can link a pattern of cranial nerve signs to the likely cause. Practise with AKT revision questions until the patterns feel automatic.

Children & young people: diagnosing joint disorders

Trainees found it hard to tell paediatric joint conditions apart.

How to improve? Build common and important paediatric joint conditions into your revision plan. The RCGP even suggests a taster day in a paediatric orthopaedic clinic if you can arrange one.

Dermatology: diagnosing skin rashes

Rash recognition was a tricky area. The report also reminds candidates that skin photographs come from patients of a range of ethnic backgrounds, so revise how rashes look on different skin tones, not just on white skin.

How to improve? Tutorials with your supervisor, sitting in on a local skin clinic, or a reliable course or e-learning resource.

Respiratory health: common respiratory conditions

The diagnosis and management of common respiratory conditions caused problems. The RCGP says it will keep testing symptoms, investigations, diagnosis and management in this area.

How to improve? Make sure your knowledge matches current national guidance. Where NICE or SIGN differs from CKS, the exam follows NICE or SIGN.

The pattern across the last year

Looking across the last four sittings (AKT 57–60), the RCGP highlights two areas that have come up three times:

• Neurology: recognising symptoms, diagnosis, and now cranial nerves
• Children & young people: acute illness, safeguarding, and now joint problems

Two more came up twice: prescribing (side effects of long-term medication and prescribing errors) and data protection and confidentiality.

Neurology deserves a special mention. Across our summaries of the last ten feedback reports, it was flagged in eight. If you do one thing differently after reading this, give neurology its own block in your revision timetable.

What's new in this report

• Immunisations: the exam no longer expects detailed knowledge of the infant immunisation schedule. It still tests indications, contraindications and side effects of vaccines at all ages, occupational vaccines, consent and PGDs, and recent changes to immunisation programmes.
• Probity: the RCGP is clear that candidates must not seek, share or use recalled exam content. Questions are actively reviewed, edited and replaced, so recalled questions are both against the rules and unreliable.
• Test centre conduct: test centres use CCTV, and the RCGP will act on rude behaviour towards Pearson VUE staff.

Recurring advice worth repeating

• Nearly a third of questions can have a significant prescribing or treatment component. Know the BNF's important interactions.
• On dose and volume calculations, check the decimal point and ask whether your answer is realistic.
• Questions often ask for the single most appropriate option or the next step, so read the question carefully.
• There's no negative marking. Answer every question.

How we're using this report

We've added the areas from the July report to our question bank. Practice questions now tell you when they cover an area the RCGP has flagged as difficult, and which sittings flagged it. You can see every flagged area in one place on our AKT weaknesses page.

If you'd like to go deeper on any of the four July topics, ask our AKT Tutor to quiz you, explain a concept or build you a set of flashcards. Then test yourself under exam conditions with a full AKT mock exam.

Good luck with your revision.