During exam season, GP trainees experience a certain kind of quiet dread. Spreadsheets open. The timetables for revisions are displayed above desks. Additionally, a registrar is most likely staring at a screen in a busy NHS staffroom, attempting to figure out exactly how to schedule the Applied Knowledge Test. At least the last part will soon become simpler. It’s much harder to say whether everything else becomes easier.
In the UK, the MRCGP Applied Knowledge Test, also referred to as the AKT exam, is a computer-based test that is at the heart of the path to becoming a general practitioner. Although it isn’t the last obstacle, it frequently feels like the first. Three minutes and thirty minutes. Two hundred inquiries. Throughout, a visible timer is ticking down. Through the prism of general practice, the exam covers clinical knowledge, evidence-based practice, problem-solving, and health informatics. If you’re doing the math, each question takes about 57 seconds. Most trainees are.
The exam itself isn’t changing right now, at least not right now. It’s the surrounding machinery. In December 2025, the RCGP switched to a single system for scheduling exams via the MyRCGP portal. No more reservations are needed. No more traveling to the FourteenFish platform in order to reserve a spot. The ability for candidates to log in, select the My Exams tab, and make direct reservations is a change that may sound administrative, but it has been genuinely appreciated by many in training. There was friction in the previous system. Anyone who tried to coordinate between two platforms for twenty minutes during an already demanding practice week will know why.
The new payment structure, however, might be the more significant change. Staged payments will be required starting in April 2026. Six months prior to the exam date, or at the time of booking if that falls within the six-month window, a 25% deposit is required. Twelve weeks out is another twenty-five percent. The remaining amount is non-refundable and must be paid by the final booking deadline.
However, candidates can cancel up to eight weeks prior to the exam without incurring any fees, and both earlier payments are refundable until the final deadline. There’s a feeling that this arrangement is intended to relieve trainees of some of the financial strain while also strengthening commitment to reserved times, ensuring that spots are available rather than being held in reserve.
Three times a year, the AKT is held. Test dates in 2026 are April, July, and October. Results are usually released five to six weeks following the test. During ST2 or ST3 training, candidates can take the AKT at any point. One of the decisions that trainees seem to struggle with for longer than anticipated is when to take the test. With no additional burden of the Simulated Consultation Assessment running alongside it, ST2 provides breathing room. More clinical depth and travel distance are brought about by ST3, but there are also more conflicting demands. Clearly, neither response is correct. Whether earlier sitters consistently outperform later ones is still up for debate, and many seasoned trainers seem to disagree.
The exam costs £470, and applicants can select from more than 150 Pearson VUE testing facilities are dispersed throughout the United Kingdom. Early reservations are important both practically and administratively because popular locations fill up quickly, and traveling to a strange testing location in a strange city creates unnecessary friction. Since availability at remote centers depends on third-party Pearson arrangements and is not guaranteed, candidates from the UK’s mainland are advised to get in touch with the examinations department before the booking window opens.
Observing how this system has changed over the last few years, it’s difficult to ignore how demanding the UK GP certification process is for individuals who are already overburdened. The AKT exam is extremely difficult. Historically, the administrative layer surrounding it has been manageable at best. For trainees balancing night shifts, supervision, revision, and life, the move to simplify booking and implement staged payments seems like a genuine attempt to lessen some of that burden.
