How to Pass the RACGP AKT: A First-Attempt Guide

The Applied Knowledge Test (AKT) is the RACGP's 150-question, single-best-answer exam that tests the breadth of clinical and non-clinical knowledge required for independent general practice in Australia. It is one of two exams (alongside the KFP) that every GP registrar must pass to achieve Fellowship.

Most registrars who fail the AKT do not fail because they lack clinical knowledge. They fail because their preparation was unstructured, their exam technique was untested, or they neglected entire curriculum domains. This guide covers the specific strategies, timelines, and techniques that give you the highest chance of passing on your first attempt.

Understanding the AKT Format

Before building a study plan, understand exactly what the exam tests and how it is marked.

The AKT consists of 150 single-best-answer (SBA) questions. You have 3.5 hours of active exam time, plus a 30-minute reading and administrative allowance. There is no negative marking: if you select the wrong answer, you score zero for that question, but no marks are deducted from your total.

With 150 questions in 210 minutes of active time, you have approximately 1 minute and 24 seconds per question. That sounds short, but most well-prepared candidates find it sufficient. The key is not spending 4 minutes on a question you are uncertain about. Flag it, make your best selection, and move on.

The AKT is a knowledge-breadth exam: it asks whether you know the right answer, not how you arrived at it. Procedural skills, communication technique, and clinical reasoning depth are assessed by the KFP and workplace-based assessments.

The Five RACGP Curriculum Domains

Every AKT question maps to one of the five RACGP curriculum domains. Understanding this mapping is essential for structured preparation.

Building Your Study Plan: A 16-Week Framework

A structured 16-week (4-month) study plan balances knowledge building, active recall, and exam technique. Adjust the timeline if you have more or less time, but preserve the phase ratios.

Weeks 1 to 4: Foundation and gap identification

The goal of this phase is not to learn everything. It is to find out what you do not know.

• Download and read the current RACGP Curriculum and Syllabus from racgp.org.au. Map the 35 contextual units against your clinical experience.
• Complete the RACGP Self-Assessment Progress Tests (SAPTs) if available. These are the closest approximation to the real exam's question style.
• Start a question bank and complete 10 to 15 questions per day in untimed mode. Read the full explanations.
• Begin a mistake log: record every question you get wrong, why you chose the wrong answer, and the correct reasoning.

Weeks 5 to 10: Consolidation and active recall

This is the highest-yield phase. You shift from passive reading to active retrieval.

• Increase question bank volume to 20 to 30 questions per day, now in timed mode (90 seconds per question).
• Use spaced repetition for your mistake log. Review errors systematically.
• Study from Australian clinical guidelines, not textbooks alone. Key sources are the Therapeutic Guidelines (eTG), RACGP Red Book, and Australian Medicines Handbook (AMH).
• Dedicate at least one session per week to a non-clinical domain.

Weeks 11 to 14: Exam technique and mock exams

This phase is about simulating the real exam under realistic conditions.

• Complete at least 3 full-length mock exams (150 questions, 3.5 hours, no breaks, no answer checking).
• After each mock, spend at least 2 hours reviewing every incorrect answer.
• Identify your 3 weakest topics from each mock and schedule targeted revision sessions for those topics in the following week.
• Practise the flag-and-move strategy: if you cannot answer a question within 90 seconds, select your best guess, flag it, and return after completing the full paper.

Weeks 15 to 16: Final consolidation

• Review your mistake log one final time. Focus on patterns.
• Complete one final mock exam in the first half of week 15. Do not start a new mock after mid-week 15.
• Revise your high-yield flashcards daily in short sessions (20 to 30 minutes).
• In the final 3 days, reduce study intensity. Prioritise sleep, exercise, and exam logistics.

Exam Technique: The Strategies That Matter

The flag-and-move approach

Do not get stuck. The AKT rewards breadth: answering 140 questions correctly and leaving 10 unanswered is better than spending 8 minutes on one difficult question and running out of time for 15 easy ones.

Practical rule: if you have not selected an answer within 90 seconds, select your best guess (there is no negative marking), flag the question, and move on. Return to flagged questions after completing the full paper.

Reading the stem carefully

Many AKT errors come from misreading the question, not from lack of knowledge. Common traps include:

• "Most appropriate next step" vs "most likely diagnosis": these are different questions. The first asks what you would do; the second asks what the patient has.
• Patient age and context: a 25-year-old presenting with chest pain requires different reasoning than a 65-year-old with the same symptom.
• "In the primary care setting": this qualifier rules out answers that would be appropriate in an emergency department but not in a suburban GP clinic.

Thinking like a GP, not a specialist

The AKT is a general practice exam. The correct answer is usually the one a competent GP would choose in their rooms, not what a cardiologist or dermatologist would do in a tertiary centre. If an option involves a specialist investigation or treatment that a GP would not initiate independently, it is likely a distractor.

Eliminating distractors

For questions where you are unsure of the correct answer, systematically eliminate options that are clearly wrong. If you can eliminate 2 of 5 options, your probability of guessing correctly rises from 20% to 33%.

Common Mistakes That Cause Registrars to Fail

1. 1
   Studying only clinical topics

   Ignoring domains 3, 4, and 5 is the single most common strategic error. Questions on MBS billing, PBS restrictions, mandatory reporting, and screening intervals are straightforward when studied, and nearly impossible to guess correctly when they are not.

2. 2
   Passive reading without active recall

   Reading a textbook chapter and highlighting key points feels productive but is not. Research consistently shows that active recall (testing yourself on the material) produces significantly better retention than passive re-reading. Use question banks, flashcards, and practice sessions as your primary study tools.

3. 3
   Never taking a full-length mock exam

   Some registrars complete hundreds of practice questions but never sit a full 150-question mock under timed conditions. The full exam demands sustained concentration for 3.5 hours. You need to know whether you can maintain accuracy in question 140 the same way you do in question 10.

4. 4
   Studying from non-Australian sources

   UK and US clinical guidelines differ from Australian practice. Drug names, screening recommendations, referral pathways, and medico-legal frameworks are all jurisdiction-specific. An AKT question expects an answer based on current Australian Therapeutic Guidelines, not NICE or ACC/AHA recommendations.

5. 5
   Starting too late

   A 2-week "crash course" before the exam is insufficient for a 150-question exam that covers the entire GP curriculum. Most successful candidates report 4 to 6 months of consistent preparation. Starting early also allows you to identify and address weak areas without time pressure.

Choosing Your Resources

Recommended additional resources

• Australian Medicines Handbook (AMH): comprehensive drug reference with PBS information.
• Murtagh and Murtagh's General Practice: a standard Australian GP textbook for clinical reasoning.
• A high-quality question bank: choose one that provides detailed explanations, covers all five curriculum domains, and is written for the Australian clinical context.

Using Analytics to Guide Your Revision

Unstructured revision wastes time. If you are already scoring 85% in cardiovascular questions but only 40% in population health, spending another evening on cardiology is not the highest-yield use of your time.

A performance analytics dashboard that maps your results to the five RACGP curriculum domains shows you exactly where your gaps are. Look for domains you have never attempted, topics where your score is below 60%, and score trends over time.

Exam Day: Logistics and Mindset

Before the exam

• Confirm the exam venue, start time, and ID requirements at least one week in advance.
• Arrive 30 minutes early. Late arrival is not accommodated.
• Bring only permitted items: photo ID, your admission printout, and any approved aids specified in the candidate guide.
• Eat a proper meal beforehand. A 3.5-hour exam on an empty stomach degrades concentration.

During the exam

• Maintain a steady pace. Check your progress at question 50 (you should be approximately 70 minutes in) and question 100 (approximately 140 minutes in).
• If you feel your concentration dropping, close your eyes for 10 seconds, take three slow breaths, and continue.
• Answer every question. There is no negative marking. An educated guess has a 20% chance of being correct; a blank answer has a 0% chance.

Frequently Asked Questions