The Applied Knowledge Test

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The UK medical-school AKT

The applied knowledge test assesses how you use medical knowledge to make decisions in clinical situations. Facts matter, but the task is to recognise the problem, judge the importance of the information and choose the most appropriate answer for that patient.

The Medical Licensing Assessment (MLA) is part of the medical degree for UK students. Since the 2024–25 academic year, UK medical graduates must pass it before joining the medical register. It has two components: the applied knowledge test (AKT) and the clinical and professional skills assessment (CPSA). The GMC’s MLA framework sets out this requirement.

The UK medical-school AKT is constructed centrally and delivered locally. Your school sets and runs its CPSA and tells you the arrangements for both assessments. Passing the MLA is one requirement for graduation; you must also meet your university’s other academic requirements. Read the GMC explanation of the two assessments alongside your school’s assessment and progression policies.

This guide is a practical companion to clinical learning. Use it with your placements and medical-school curriculum; it does not cover the whole MLA or replace your course.

The 2026 AKT Student Handbook describes two papers of 100 single-best-answer questions, taken on consecutive days. Each question has five options; the standard time is two hours per paper, with individual adjustments where agreed. There is no negative marking. Delivery is on screen under invigilation. Your school provides your dates, venue, device arrangements and local instructions.

Use the content map to find gaps

Use the GMC content map for assessments from September 2026 onwards. Its six domains connect clinical practice, professional knowledge, capabilities, practical skills, patient presentations and conditions. The GMC’s explanation of the map shows how these domains fit together; the conditions list is not exhaustive.

Choose a presentation from a recent placement or a practice question. Check the relevant presentations, conditions and capabilities in the map, then ask what you can explain, what you can demonstrate and where you need help. Use those gaps to plan the next week’s learning. Check the breadth of your plan against your school’s curriculum, including areas you see less often on placement.

1. Read the whole stem and identify the patient, setting, time course and degree of illness.
2. Form a brief problem representation: the key features that distinguish this case from similar presentations.
3. Consider an answer before studying the options, then compare every option with the actual question.
4. Use the clinical evidence to reject alternatives. An unfamiliar option is not necessarily wrong, and a familiar treatment may be inappropriate at this stage.
5. Check that your choice addresses the requested priority and patient group.

For example, a question about a breathless patient may test recognition of deterioration rather than the definitive diagnostic test. Another may ask what investigation distinguishes two stable-patient differentials. Explain to yourself why the timing and setting change the decision; that reasoning transfers better than memorising a keyword. This is an educational example of question approach, not an official sample question.

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Build a revision method you can sustain

Use the official AKT practice papers and answer justifications before judging the relevance of a commercial question bank. The MSC provides two 100-question practice papers and records a September 2026 review. Attempt questions before opening the explanations, then compare the reasoning for the correct and alternative options.

Timed practice helps you learn when to move on. Discuss difficult questions with colleagues or teachers, but check disputed clinical recommendations against the appropriate current guidance. Optional apps, podcasts and courses can be useful; they do not replace the curriculum or establish what will appear in your examination. The MSC preparation page provides free official resources and explains the role of medical-school teaching.

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Before and during the examination

Follow your school’s joining instructions for identification, arrival, permitted items and reasonable adjustments. Practise with the assessment software where your school provides access, and understand how to record, review and submit answers. Arrange travel, food and rest so that avoidable practical problems do not compete with the examination.

Before submission, check for unanswered questions and obvious entry errors. Follow the invigilator’s instructions if you experience a technical problem. Do not assume that the BNF, personal notes, a phone or other resources are permitted; the AKT is a closed, invigilated assessment and the handbook and local instructions govern what you can use.

Your school manages results, progression, mitigating circumstances and resit arrangements. Consult its policy for the rules that apply to your sitting.

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A clinical resource library

Use the library below to answer a clinical question arising from revision, then return to the case and apply what you have learned. It is not a ranking of likely examination topics or a substitute for learning across your medical-school curriculum.

Resources are grouped into adult and paediatric topics. Maternity, mental health, older-person care, safeguarding and community presentations remain part of the guide. Some subjects span both age groups; check the population, setting, publication date and update history before applying any recommendation. Specialist emergency procedures are included for context, not as a claim that students should perform them independently.

NICE and UK professional-body guidance should be interpreted in its stated context. Educational websites and international resources can explain a topic well, but may use different practice standards. Some resources require institutional access or a UK connection. The RCPCH clinical guideline directory is a useful route to national paediatric guidance.

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Optional learning resources

Use these to supplement the core curriculum. Choose material that explains its evidence and patient group, and check clinical recommendations against current UK guidance. A podcast or video’s educational value does not make every older management detail current.

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