Chapter 1 – The Applied Knowledge Test (MCQ/SBA)

Overview of the AKT/MCQ

The Applied Knowedge Test will be centrally set for all UK medical schools with a common format, test standard, delivery process and policy framework. It seems highly likely that these will be in a format similar to that already set for the GMC Professional and Linguistics Board (PLAB) exam.

Question structure

The Medical Schools Council Assessment Allaince has produced comprehesnive guidance for the writing of MCQs and those in the PLAB are written in this format. Each question comprises a clinical scenario (‘the stem’), a single line stating the question itself (‘the lead-in’) and a list of five options (one correct answer and four distractors).

The stem will be written in the present tense and only contain information that pertains to the question. They should be more more than 100 words (ideally 50) and be worded in the simplest form possible.

The lead in to each question will be writtens such that a student should be able to arrive at the correct answer without being able to see the options. This means there should not be questions that are worded ‘which of the following statements are correct’. They also want to focus on the positive and avoid the negative: they should not have phrases such as ‘which is the least likely diagnosis’.

The five options should all be plausible and realistic: there should not be any that you can immediately dismiss as incorrect, and be relevant to the stem and related to the lead in.

Tips and tricks


  • Use the MLA content map and the St Emlyn’s Undergraduate Curriculum as a starting point
  • Focus on high yield areas by using the blue blueprint.
  • Share the revision load and buddy up.
  • Go on a course, use a question bank or book.
  • Time goes quicker than you think – timed practice is crucial!

On the day

  • GENERIC: eat; drink and toilet break before.
  • HOME: quiet environment; good lighting; reliable internet connection; look at RCEM device specification requirements; log in ahead of time. 
  • TEST CENTRE: plan how you are getting there; ensure plenty of time and  correct identification.  
  • Pace yourself.
  • Read the question carefully AND answer what it asks, not what you want it to ask.
  • No negative marks – give every question a go!
  • A ‘flag’ function exists for those questions you think you may want to revisit/haven’t answered.

Courses, Question banks and books

We have no conflict of interest to declare. There are multiple MCQ books available and students will be used to this form of assessment.

The table below shows some of the common resources, with links, those preparing for the exam typically use.  Most of the question banks are not specific to the FRCEM Final SAQ. As such sometimes the answers go into a depth not required for the FRCEM, however, they remain a good resource. Resources for the SBA are starting to appear. for example the Bromley SBA Course.

Collated Resources

In this section you will find  a collation of links useful not only for the AKT but also for the OSCE.  It is divided into adult and paediatric sections, with each area broadly divided by specialties. NICE guidelines are found in the first half of each speciality with other guidelines, in the second half. The links are regularly checked to ensure they still work and are current.

The Royal College of Paediatrics and Child Health (RCPCH) recently released a pdf document that contains links to the latest NICE; SIGN and RCPCH guidelines, it can be found here

A number of the topics are relevant to both adult and paediatric medicine. These will be found in the adult section.

  • Hampshire, Isle of Wight, Portsmouth and Southampton (HIPS) safeguarding children procedures manual (Includes the bruising protocol; fabricated and induced illness by carers guidance
  • GMC: Protecting children and young people                                     

Other resources: Adult and Paediatric

Cite this article as: Iain Beardsell, "Chapter 1 – The Applied Knowledge Test (MCQ/SBA)," in St.Emlyn's, April 12, 2021,