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Dr Shaun Tan, FRACGP, MD, BMSC
Medical Examiner | Associate Lecturer
Scored 90% on the AKT & Top 15th percentile in the KFP
Master AKT Questions and End Exam Anxiety
You’ve probably spent months balancing patient loads, on‑call shifts, and endless reading lists, all while carrying the quiet fear that your AKT exam might be the one hurdle standing between you and Fellowship. You’re not alone in that feeling. Most candidates reach this point exhausted yet determined, knowing that passing the AKT isn’t just about recalling facts, it’s about proving the kind of clinical judgement that defines a safe, competent GP.
And here’s the truth: the RACGP AKT is absolutely conquerable when you understand how its questions work. In fact, 82.15% of 829 candidates passed the 2025.2 AKT [1], proving that mastery of AKT questions comes down to strategy, pattern recognition, and composure under time pressure.
This article is written to help you approach the AKT not as a mystery to fear, but as a skill you can train. Think of this as sitting down with an examiner who wants you to see how the system works and use that knowledge to your advantage.
AKT Question Formats Explained
The RACGP AKT consists of 150 single best answer MCQs, completed within 4 hours [1]. These questions test your ability to reason clinically in scenarios closely resembling real-life Australian general practice. To perform well, understanding each question type is essential.
There are three main types of AKT questions:
Single Best Answer (SBA): Most common, these ask you to select the most accurate diagnosis or management step according to RACGP guidelines.
Negative Stem Questions: Include words like "NOT" or "except", designed to test careful reading. Missing one small word here can cost crucial marks.
Extended Matching Questions (EMQs): Present 8 to 10 answer options, assessing your ability to differentiate among similar diagnoses or treatments.
The AKT strictly reflects Australian general practice, guided by RACGP and Therapeutic Guidelines [3]. Remember: there is no negative marking, so leaving a question blank only hurts your score. Even a 50% guess is worth more than hesitation.
Think of these question types as mirrors of real consultations. You’re not just memorising data—you’re interpreting patterns, filtering noise, and prioritising actions under time constraints.
Example Questions and How to Think Through Them
Detailed examples illustrate effective approaches to AKT questions:
Example 1: Resistant Hypertension
A 52-year-old male patient remains hypertensive despite ramipril, amlodipine, and atenolol. His potassium level is 3.2 mmol/L (normal range 3.5 to 5.2 mmol/L) [2]. The question: "Which investigation result MOST supports the provisional diagnosis?"
Step 1: Recognise resistant hypertension with hypokalaemia suggests primary hyperaldosteronism (Conn’s syndrome).
Step 2: Confirm the best supporting test: elevated plasma aldosterone-to-renin ratio.
Step 3: Eliminate distractors: elevated cortisol or metanephrines belong to unrelated endocrine disorders.
Example 2: Post Viral Weakness
A healthy 35-year-old male experiences progressive bilateral leg weakness and diminished reflexes 2 days post-viral illness [2]. Question: "Most appropriate provisional diagnosis?"
Step 1: Notice rapid onset, bilateral, recent infection history, diminished reflexes indicating Guillain Barré Syndrome.
Step 2: Eliminate mismatched diagnoses such as multiple sclerosis (typically asymmetric), spinal conditions (usually sensory/bladder involvement), or polymyositis (usually proximal muscle weakness).
These examples demonstrate the importance of systematic reasoning, matching clinical details clearly to guidelines and differentiating carefully among plausible alternatives.
FAQs: Tackling AKT Questions
1. What is the structure of the RACGP AKT MCQ exam?
The AKT contains 150 single‑best‑answer MCQs over four hours, spanning all domains of Australian general practice [1]. Each item provides a detailed clinical stem with multiple plausible answers but only one correct choice. There is no negative marking, meaning you should answer every question.
2. Are all AKT questions single best answer?
Yes. Every AKT item uses the single‑best‑answer format, occasionally extended to 8–10 options for broader themes [2]. The focus is always applied reasoning within real GP contexts.
3. What strategies best help tackle AKT MCQs?
Read each stem fully before glancing at options.
Note directive words like “best,” “initial,” or “definitive.”
Predict your likely answer to avoid distraction by distractors.
Eliminate implausible options methodically.
Confirm your choice aligns exactly with the question.
4. How can practising AKT sample questions improve performance?
Practising AKT sample questions under timed conditions builds both recall speed and exam endurance. Deep review of answers reveals gaps in knowledge and logic. Use sources that match RACGP exam preparation standards to ensure exposure to current Australian guidelines [2].
5. What is the pass mark for the AKT, and how challenging is it to achieve?
Pass marks vary slightly between sittings but generally fall around the mid‑60s% range, based on standard setting. The 2025.2 AKT pass rate was 82.15%, with a mean candidate score of 75.67% [1]. With consistent practice and focused strategy, most candidates can surpass this threshold on their first attempt.
How to Practise Effectively Using Question Banks
Practice with realistic AKT sample questions transforms your theoretical knowledge into practical exam success. Recommended strategies include:
Use Australian‑aligned AKT sample questions from reputable banks. Avoid generic international sources.
Simulate time pressure: The AKT allows about 1.5 minutes per question, totalling four hours for 150 questions [1]. Use a timer to build pacing stamina.
Deep review after each set: Every mistake teaches more than a correct guess. Analyse rationales to understand both correct and incorrect logic.
Track weaknesses: Use a spreadsheet or app to identify recurring patterns (e.g. “missed negative stems” or “confused first‑line vs. second‑line”).
Integrate spaced repetition: Revisiting difficult questions reinforces recall [3].
Mix study with clinical work: Apply what you learn in your consultations. A hypertensive patient can remind you of cardiovascular management questions.
GP trainees often struggle to find balance between practice and patient care. You might have back‑to‑back clinic days, night shifts, or teaching responsibilities. Try scheduling smaller, focused study blocks of 30 minutes daily. Even ten well‑reviewed questions per day compound over months into deep familiarity with AKT logic.
The RACGP notes that strong candidates practise extensively and understand why each distractor is wrong—not just why the correct answer is right [2]. That depth of reasoning is what converts knowledge into passing scores.
For additional practical study techniques, see our comprehensive [AKT timing guide].
How to Read AKT Questions Strategically
Strong candidates approach the AKT like clinical problem‑solvers, not trivia players. The key lies in how you read each MCQ.
Start with the stem: read twice. Note the patient’s age, symptoms, and any qualifiers such as “acute,” “chronic,” or “recurrent.”
Identify the directive: Does the question ask for “initial management,” “most likely diagnosis,” or “definitive treatment”? Missing that single word can cost marks.
Predict before you peek: Before reading the options, form your likely answer. This limits distraction from plausible but incorrect choices.
Eliminate efficiently: Cross out options inconsistent with facts in the stem. Each removal increases your odds when you must guess.
Re‑read the lead‑in: Confirm your final choice answers the actual question being asked.
For example, imagine a 45‑year‑old presenting with chest pain. The question asks for the “most appropriate initial management.” The correct answer may be “Administer aspirin 300 mg orally,” not “Arrange urgent cardiology referral.” Both are valid actions in care, but only one is initial.
In the 2025.2 report, examiners noted that misreading or missing qualifiers was one of the leading causes of incorrect answers [2]. Underline those words. Slow down. This is a reading test as much as a reasoning one.
If you’re feeling overwhelmed by RACGP exam preparation, remember that every successful Fellow once stood where you are now. Fellow Academy provides an integrated preparation system:
AKT and KFP question banks aligned with Australian guidelines.
Comprehensive exam notes and flashcards built for rapid revision.
Interactive webinars that teach examiner‑level reasoning and timing strategies.
Free KFP case packs to sharpen applied problem solving.
Our mission is simple: to help you study smarter, not longer. With structured guidance, evidence‑based learning, and examiner insights, you’ll approach your next AKT paper with confidence and clarity.
Disclaimer: This content is not affiliated with, endorsed by, or representative of the Royal Australian College of General Practitioners (RACGP). The strategies and approaches shared are based on personal experience and the experiences of other GP candidates who successfully passed their exams. They are intended as general study guidance only and should not be taken as official RACGP advice.
Disclaimer: This content is not affiliated with, endorsed by, or representative of the Royal Australian College of General Practitioners (RACGP). The strategies and approaches shared are based on personal experience and the experiences of other GP candidates who successfully passed their exams. They are intended as general study guidance only and should not be taken as official RACGP advice.
References
[1] Royal Australian College of General Practitioners. (2025). AKT 2025.2 Public Exam Report. East Melbourne, VIC: RACGP. https://www.racgp.org.au/getmedia/11d7eccd-21b3-45d4-b295-773a664cca1a/KFP-2025-2-Public-Exam-Report.pdf.aspx
[2] Royal Australian College of General Practitioners. (2024). AKT 2024.2 Public Exam Report. East Melbourne, VIC: RACGP. https://www.racgp.org.au/FSDEDEV/media/documents/Education/Registrars/Fellowship%20Pathways/Exams/AKT-2024-2-Public-Exam-Report.pdf
[3] Royal Australian College of General Practitioners. (2025). RACGP Examinations Guide. East Melbourne, VIC: RACGP. https://www.racgp.org.au/education/fracgp-exams/racgp-exams/exam-support-program-resources/examination-guide
AKT Exam Preparation: Study Strategies That Work
AKT vs KFP: Which RACGP Exam Is Harder (and How to Prepare for Both)
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Dr Shaun Tan, FRACGP, MD, BMSC
Medical Examiner | Associate Lecturer
Scored 90% on the AKT & Top 15th percentile in the KFP
Summary
Master AKT Questions and End Exam Anxiety
You’ve probably spent months balancing patient loads, on‑call shifts, and endless reading lists, all while carrying the quiet fear that your AKT exam might be the one hurdle standing between you and Fellowship. You’re not alone in that feeling. Most candidates reach this point exhausted yet determined, knowing that passing the AKT isn’t just about recalling facts, it’s about proving the kind of clinical judgement that defines a safe, competent GP.
And here’s the truth: the RACGP AKT is absolutely conquerable when you understand how its questions work. In fact, 82.15% of 829 candidates passed the 2025.2 AKT [1], proving that mastery of AKT questions comes down to strategy, pattern recognition, and composure under time pressure.
This article is written to help you approach the AKT not as a mystery to fear, but as a skill you can train. Think of this as sitting down with an examiner who wants you to see how the system works and use that knowledge to your advantage.
AKT Question Formats Explained
The RACGP AKT consists of 150 single best answer MCQs, completed within 4 hours [1]. These questions test your ability to reason clinically in scenarios closely resembling real-life Australian general practice. To perform well, understanding each question type is essential.
There are three main types of AKT questions:
Single Best Answer (SBA): Most common, these ask you to select the most accurate diagnosis or management step according to RACGP guidelines.
Negative Stem Questions: Include words like "NOT" or "except", designed to test careful reading. Missing one small word here can cost crucial marks.
Extended Matching Questions (EMQs): Present 8 to 10 answer options, assessing your ability to differentiate among similar diagnoses or treatments.
The AKT strictly reflects Australian general practice, guided by RACGP and Therapeutic Guidelines [3]. Remember: there is no negative marking, so leaving a question blank only hurts your score. Even a 50% guess is worth more than hesitation.
Think of these question types as mirrors of real consultations. You’re not just memorising data—you’re interpreting patterns, filtering noise, and prioritising actions under time constraints.
Example Questions and How to Think Through Them
Detailed examples illustrate effective approaches to AKT questions:
Example 1: Resistant Hypertension
A 52-year-old male patient remains hypertensive despite ramipril, amlodipine, and atenolol. His potassium level is 3.2 mmol/L (normal range 3.5 to 5.2 mmol/L) [2]. The question: "Which investigation result MOST supports the provisional diagnosis?"
Step 1: Recognise resistant hypertension with hypokalaemia suggests primary hyperaldosteronism (Conn’s syndrome).
Step 2: Confirm the best supporting test: elevated plasma aldosterone-to-renin ratio.
Step 3: Eliminate distractors: elevated cortisol or metanephrines belong to unrelated endocrine disorders.
Example 2: Post Viral Weakness
A healthy 35-year-old male experiences progressive bilateral leg weakness and diminished reflexes 2 days post-viral illness [2]. Question: "Most appropriate provisional diagnosis?"
Step 1: Notice rapid onset, bilateral, recent infection history, diminished reflexes indicating Guillain Barré Syndrome.
Step 2: Eliminate mismatched diagnoses such as multiple sclerosis (typically asymmetric), spinal conditions (usually sensory/bladder involvement), or polymyositis (usually proximal muscle weakness).
These examples demonstrate the importance of systematic reasoning, matching clinical details clearly to guidelines and differentiating carefully among plausible alternatives.
Tools That Make Active Recall Easy
Digital tools simplify the process of integrating active recall and spaced repetition into your RACGP exam preparation.
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Brainscape: Uses adaptive algorithms to determine when you should review each flashcard based on your confidence level.
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Anki: Allows custom deck creation for topics like PBS rules or emergency management.
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Quizlet: Offers collaborative decks for study groups.
Using these tools allows you to:
-
Review flashcards during commutes or between patients.
-
Automatically revisit topics you’re struggling with.
-
Track progress and identify weak areas.
These platforms bring structure to your study plan, ensuring regular reinforcement and better recall.
(For time management strategies, see our AKT Study Planner.)
How to Combine These Methods for Peak Performance
When you combine active recall with spaced repetition, the results are exponential. This combination, known as “spaced retrieval practice”, creates a continuous cycle of learning, forgetting, and relearning that strengthens memory.
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Start early (at least 6–12 months before your exam).
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Create flashcards for each guideline or high-yield topic.
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Use Brainscape or Anki daily to review material in spaced cycles.
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Schedule mock exams every 3–4 weeks to test your applied knowledge.
Research indicates spaced repetition can significantly increase long-term retention, with spaced learners achieving approximately 58% accuracy compared to 43% among traditional learners (p<0.001) [4].
By six months into this method, most candidates report not only improved recall but also better confidence under pressure. You’re no longer scrambling to remember—you’re retrieving information automatically.
FAQs: Tackling AKT Questions
1. What is the structure of the RACGP AKT MCQ exam?
The AKT contains 150 single‑best‑answer MCQs over four hours, spanning all domains of Australian general practice [1]. Each item provides a detailed clinical stem with multiple plausible answers but only one correct choice. There is no negative marking, meaning you should answer every question.
2. Are all AKT questions single best answer?
Yes. Every AKT item uses the single‑best‑answer format, occasionally extended to 8–10 options for broader themes [2]. The focus is always applied reasoning within real GP contexts.
3. What strategies best help tackle AKT MCQs?
Read each stem fully before glancing at options.
Note directive words like “best,” “initial,” or “definitive.”
Predict your likely answer to avoid distraction by distractors.
Eliminate implausible options methodically.
Confirm your choice aligns exactly with the question.
4. How can practising AKT sample questions improve performance?
Practising AKT sample questions under timed conditions builds both recall speed and exam endurance. Deep review of answers reveals gaps in knowledge and logic. Use sources that match RACGP exam preparation standards to ensure exposure to current Australian guidelines [2].
5. What is the pass mark for the AKT, and how challenging is it to achieve?
Pass marks vary slightly between sittings but generally fall around the mid‑60s% range, based on standard setting. The 2025.2 AKT pass rate was 82.15%, with a mean candidate score of 75.67% [1]. With consistent practice and focused strategy, most candidates can surpass this threshold on their first attempt.
If you’re feeling overwhelmed by RACGP exam preparation, Fellow Academy offers high quality AKT and KFP questions, exam notes in concise and comprehensive format, and high yield, evidence based flashcards designed to help you study smarter and perform with confidence. You’ll also find free KFP case packs, webinars, and practical study resources to guide you every step of the way.
Disclaimer: This content is not affiliated with, endorsed by, or representative of the Royal Australian College of General Practitioners (RACGP). The strategies and approaches shared are based on personal experience and the experiences of other GP candidates who successfully passed their exams. They are intended as general study guidance only and should not be taken as official RACGP advice.
References
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GP Supervisors Australia. (2025). Study Skills Guide for GP Registrars: Studying Smarter, Not Harder. GPSA.
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Carpenter, S. K., Pan, S. C., & Butler, A. C. (2022). The science of effective learning with spacing and retrieval practice. Nature Reviews Psychology, 1(10), 496–511.
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Durrani, S. F., Yousuf, N., Ali, R., et al. (2024). Effectiveness of spaced repetition for clinical problem solving amongst undergraduate medical students studying paediatrics in Pakistan. BMC Medical Education, 24(1), 676.
-
Price, D. W., Wang, T., O’Neill, T. R., et al. (2025). The effect of spaced repetition on learning and knowledge transfer in a large cohort of practising physicians. Academic Medicine, 100(1), 94–102.
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AKT vs KFP: Which RACGP Exam Is Harder (and How to Prepare for Both)