- Applied Knowledge Test (AKT)
- Recorded Consultation Assessment (RCA)
- Work place-based Assessments (WPBA)
Applied Knowledge Test (AKT)
About the AKT
- A computer-based assessment
- Delivered four times a year in January, April, July and October: see full info on exam dates and booking windows
- Exclusive Pearson test centre usage on exam days across the UK
- Before October 2025 200 single best answer style questions, answered in 3 hours 10 minutes
- From October 2025 160 single best answer style questions, answered in 2 hours 40 minutes
- The questions are divided into three main sections:
- 80% on clinical knowledge
- 10% on evidence-based practice (including evidence interpretation and the critical appraisal skills needed to interpret research data)
- 10% on primary care organisation and management issues (including administrative, ethical, regulatory and statutory frameworks)
All questions address issues relating to UK general practice. They focus on higher order problem-solving rather than the recall of basic facts. The GP Curriculum gives an overview of the topics you should be aware of for the AKT.
Who can take the AKT?
You can take the AKT during or after the ST2 stage of GP training. A maximum of four attempts is allowed if you were already in training on 1 August 2023. A maximum of six attempts is allowed if you entered GP Speciality Training for the first time on or after 2 August 2023.
Recorded Consultation Assessment (RCA)
Simulated Consultation Assessment (SCA)
Format of the SCA
There will be twelve consultations with simulated patients, each lasting twelve minutes.
The cases are performed by professional role-players who are trained, calibrated and standardised so that although the case appears the same for every candidate, it responds to the approach of each individual doctor, as in real life. The case material has been reviewed by linguist and EDI experts to identify and remove potential bias for those candidates who do not have English as their first language.
The cases may be patients (most commonly), or their carer/parent or other health or social care workers. In the majority of these you will be able to see the simulated patient. Others will be audio only. There is 3-minutes reading time at the start of each case.
It is recognised that GP consultations in the UK do not follow a single model: they are complex, with many factors interacting in unpredictable ways. The new examination recognises this variability. There is not a preferred model, nor a script to follow.
The cases are testing the transferable capabilities from your workplace consulting which can be assessed objectively in a simulated environment. To ensure the assessment criteria are transparent, the capabilities, marking domains and feedback statements can all be found in the marking and results section.
Physical examinations will not be assessed within the SCA, and instead will be covered within WPBA.
Work place-based Assessments (WPBA)
RCGP WPBA Requirements and Other Evidence Summary and Tracker
WPBA evaluates the trainee’s progress in areas of professional practice best tested in the workplace.
- 3 Clinical Case Reviews per month
- 1 Other Learning Log entry per month
Complete assessments regularly throughout the placement, including:
- Mini-cex
- CBD/CAT
- MSF
- CEPS (Complete throughout the 3 year training program)
- QIP in ST1 and QIA annually
- Prescribing assessment (ST3 only)
- Leadership Activity and Leadership MSF (ST3 only)
- PSQ (ST3 only)
Clinical Examination and Procedural Skills (CEPS)
Demonstrate a range of clinical skills, including 5 mandatory examinations: Breast exam, prostate exam, rectal exam, speculum and bimanual exam, male genital exam.
Case Based Discussions (CBD)
The CBD is a structured oral interview designed to access your professional judgement in a clinical case. The assessment assesses your performance against the capabilities and looks at how you made holistic and justifiable decisions in relation to the patient care.
CBDs can be carried out in hospitals by doctors ST4 and above, you choose who completes the assessments and it is advisable to have them completed by a range of doctors. Your named clinical supervisor should complete at least one CBD. In the primary care setting CBDs will be completed by GP Educational/ Clinical Supervisor. You should select the case you want to share with your supervisor and link with 3 or 4 capabilities.
A minimum of 4 CBDs are required in ST1 and 2.
Care Assessment Tool (CAT)
CBDs in general practice placements are being replaced by the CAT, which allows a greater range of information and performance to be recorded and assessed against the capabilities. A minimum of 5 CATs (which can include CBDs) are needed by the end of ST3.
CATs can include:
Mini-CEX
A Mini-CEX is an observed, real-life interaction between you and a patient. The Mini-CEX assesses your clinical skills, attitudes and behaviours. Mini-CEX assessments are completed in hospital placements.
Clinical Observation Tool (COT)
The COT is an expanded version of the Mini-CEX and considers your consultations with real patients in real time during the primary care placements. It assesses the clinical skills and professionalism necessary for good clinical care within your consultations and this includes your performance of the more holistic judgements needed to consult in General Practice.
COT assessments can be directly observed by your GP Trainer, or can be carried out using a recorded consultation.
Audio-COT
General Practice has evolved and more consultations are being carried out by phone. Audio-COT provides an additional tool to enable the assessment of your telephone consultation skills. The Audio-COT uses the same methodology and process of completing the assessment as the COT, but is used in a different setting.
Multi-Source Feedback (MSF)
The MSF tool is used to collect your colleagues’ opinions on your clinical performance and professional behaviour. You need to do an MSF in every year of training and you need a minimum of 10 respondents (5 clinical and 5 non-clinical) each time. In ST3 you need to complete 2 MSFs, with one being a leadership MSF.
Patient Satisfaction Questionnaire (PSQ)
The PSQ provides patient feedback on your empathy and relationship-building skills during consultations. It is completed once in ST3 and it is recommended that you do this in the second half of the year.
Leadership Activity and MSF
The leadership WPBA should be completed in ST3 year and gives residents an opportunity to gain practical experience in developing leadership skills in primary care. You can choose your own activity or select from the examples on the RCGP website. The proposed activity should be discussed and agreed with your Educational or clinical Supervisor to ensure its suitability. It should be recorded in your portfolio by writing a reflective entry using the specific leadership log entry template.
The 2Nd MSF in ST3 is a leadership MSF with questions specifically focused on obtaining feedback around your leadership skills. Ten respondents are required.
Quality Improvement Project (QIP)
The GMC recommends that all doctors demonstrate an involvement in Quality Improvement at least once a year. During your GP training you are expected to complete a QIP when you are in primary care placement, either ST1 or ST2 year and a quality improvement activity (QIA) in other training years.
By the end of ST3 you will need a minimum of 1 QIP and 2 QIAs
Prescribing Assessments
The Prescribing assessment is a formative exercise to reflect on prescribing practice, which should highlight trends and learning needs within your prescribing. By reflecting on errors identified t will enable learning plans to be put in place in order to improve your prescribing in the future.
- The resident searches on their last 50 retrospective prescriptions
- Using the prescribing manual, the resident reviews these prescriptions and maps them against potential prescribing errors
- The GP trainer / Supervisor reviews 20 of these prescriptions, maps these against potential errors and adds these to the spreadsheet
- The resident completes the resident reflection form in the ePortfolio and in particular reflects on their prescribing using the GP prescribing proficiencies
- The resident and GP trainer / Supervisor complete the assessment using the GP trainer/ Supervisor assessment form found in the ePortfolio
- Both the resident and GP trainer / Supervisor complete and submit the questionnaires
- The resident uploads the anonymised spreadsheet to their learning log=