Exam Preparation and Support

Applied Knowledge Test (AKT)

The AKT is sat by trainees during or after their ST2 year. Trainees are allowed up to a maximum of four attempts. 

The RCGP AKT guide contains further information on the exam, resources to assist with preparation, and practice questions. 

Usefully, this includes a downloadable guide on preparing for statistics and data interpretation questions in the AKT.

Trainees are entitled to a fully-funded RCGP AKT preparation course which they will be invited to sign up for via email.

If trainees are unsuccessful in an AKT attempt then funding for a further one-day AKT preparation course will be considered on a case-by-case basis.

Simulated Consultation Assessment (SCA)

The SCA has replaced the Recorded Consultation Assessment (RCA) as the final professional exam required to achieve MRCGP. It can only be sat during the ST3 year and is conducted remotely at the trainees’ host GP practice.

The assessment simulates twelve consultations, each 12 minutes long. In order to achieve appropriate curriculum coverage, each trainee will be assessed according to a blueprint of the twelve clinical experience groups. More information on the blueprints can be found here.

Information for trainers and trainees on the SCA can be found here, including relevant dates, bookings information, and links to Q&A webinars delivered by RCGP.

RCGP have published an SCA guide, and links to SCA Q&A webinars for trainers.


The RCGP endorses this SCA toolkit to assist trainers in the analysis of trainee performance and plan educational strategies or activities to focus development of weaker competencies before sitting the exams.

Trainees are funded to attend a Severn Faculty SCA course. Details and dates of these courses are disseminated via email.

If trainees are unsuccessful in their first SCA attempt then funding for a further one-day SCA preparation course will be considered on a case-by-case basis.

Videos with tips on how to make the most of the toolkit can be found here

Case examples can be found in the RCGP SCA guide. 

Support for Performance and Exams (SPEX) Programme

The SPEX programme is a highly successful, evidence-based intervention to help Doctors in Training (DiTs) improve communication skills, learn to “Consult like a GP”, and provide revision support for AKT and RCA/SCA exams based on the award-winning HEE North West Support on Extension Programme.

The South West SPEX programme is a course delivered online during the general practice stages of training to improve exam success rates. The SCA and AKT exams comprise the MRCGP which all GP DiTs will need to pass prior to CCT.

It is comprised of SPEX 1, SPEX AKT and SPEX 2/SCA:

  • SPEX1 is offered by invitation and is designed to be an early introduction to “consulting like a GP”, and done in General Practice in ST1/2. It is an additional communication course which complements the VTS for registrars that are identified as requiring additional support. Please see the SPEX FAQs page for more information on the programme including it’s recruitment methods.
  • SPEX AKT is a one day course run online. The morning is run by the RCGP and the afternoon by the SPEX team. Throughout the course there will be discussion about revision techniques, exam techniques, question formats, learning needs and support. This is a course offered to:
    • all DiT who are enrolled on the SPEX courses.
    • any DiT that has had a previous unsuccessful attempt at AKT
    • For repeated attempts at the AKT, the SPEX AKT course can be repeated up to 3 times if it is felt this will be helpful.
  • All DiT who are on their 4th or 5th attempt at the AKT will be offered an AKT 1:1 with one of the SPEX team in addition to their meetings with their patch TPD/AD. The focus will be on their individual situation and adapting advice accordingly as well as looking at previous attempts and where to focus.
  • SPEX2 is a one-off tutorial to provide additional support to DiTs during ST3 to improve consultation skills and pass the SCA. It is offered by invitation and is conducted by an experienced educator, often an AD, TPD or RCGP examiner. Please see the SPEX FAQs page for more information on SPEX 2.

More information on exams support can be found on the Severn Deanery School of Primary Care SPEX pages

Page last reviewed: 4 April, 2024