The AKT 49 exam was held on 25th October 2023 and was taken by 2070 candidates. This exam feedback report provides a summary of the October 2023 exam, including important statistics, areas of strength and difficulty for candidates, and advice for candidates looking to prepare for future AKT exams. If you would like to review other feedback reports for previous AKT examinations, please click on any of the below for more information:
The scores for this AKT exam ranged from 65 to 194 out of 200 questions, with a mean overall score of 147.56 marks (73.78%). The pass mark was set at 140, with 68.16% of all candidates passing this exam. The mean score for each of the three subject areas was as follows:
For the October 2023 AKT exam, candidates performed better than previous exams in questions that related to:
Summary of areas causing difficulty in AKT49:
This curriculum area includes several important themes on which we regularly feed back. Some areas related to safe prescribing, such as drug monitoring, often cause difficulties for candidates. In the case of AKT 49, candidates lacked awareness of safe prescribing requirements for DMARDs.
Aiming to improve the quality of care provided is a core part of the GP professional role. Candidates should have awareness and understanding of commonly used quality improvement tools and methodologies. This area caused some difficulty in AKT 49.
Whilst not requiring details of immunisation schedules, we do expect that candidates will be familiar with absolute contraindications to common, routine vaccinations. This has been our position for some time. Candidates found this area difficult in AKT 49. As noted at the start of this report, we have updated our guidance on the knowledge that we expect candidates to have about vaccinations/immunisations to make this even clearer.
Eating disorders can present with a range of symptoms, signs and laboratory findings. In AKT 49, candidates were uncertain about differential diagnoses in young people and overlooked the likelihood of an eating disorder.
After AKT 48, we fed back on difficulties with evidence-based prescribing for UTI. In AKT 49, candidates had difficulty more generally with this area, including overlooking the possibility of UTI in atypical presentations and uncertainty about appropriate antibiotic use for the treatment of UTI in children. Candidates should be familiar with the comprehensive national guidance on this common condition, which covers both acute and recurrent infections, at different life stages, as well as lower and upper UTIs.
In AKT 49, candidates had difficulty identifying acute exacerbation of asthma and making appropriate changes to therapy. There were problems with correctly interpreting peak flow monitoring records in this regard. Similar candidate difficulties were noted after AKT 47 and we provided feedback on that occasion also.
Asthma is a good example of a long-term condition where for most patients, most of the time, care will be provided from within the primary care team. However, despite the team approach, GPs must be up-to-date and confident with asthma diagnosis and management, given its high prevalence, range of presentations from mild to severe, and role of the GP as possible mentor/prescriber for other team members.
After each of the last three sittings of the AKT exam, we have highlighted a need for improvement regarding:
The feedback concerned drug monitoring, side effects, safe prescribing of drugs used in long-term conditions, antimicrobial prescribing/stewardship, and quality improvement methodologies.
After two of the last three sittings of the AKT exam, we have highlighted a need for improvement regarding:
Prescribing for children with long-term conditions, child development, eating disorders
This is related to asthma diagnosis and management, including acute exacerbations
Candidates must stay vigilant and scrutinise relevant guidance in their AKT exam preparation, which will help to improve their chances of success. The GP curriculum serves as a robust blueprint for exam readiness, and the knowledge and skills sections of each topic guide offer a valuable resource for those striving to make certain they've encompassed all critical topics. Additionally, regularly reviewing the scenarios in the AKT exam with caution and completing an online MRCGP AKT question bank and mock exam is highly recommended.