Why So Many GP Trainees Struggle With AKT Statistics (And What Fixes It)
If you dread the statistics questions in the MRCGP AKT more than any other part of the exam, you are not imagining it. Evidence based practice, the section covering statistics, data interpretation and research methods, is consistently the lowest scoring domain in the exam. RCGP’s own feedback reports confirm it sitting after sitting. Candidates typically score in the low seventies here, several points behind clinical knowledge, and it is flagged for improvement more often than almost any other area of the curriculum.
That is useful information, not a reason to panic. It tells us this is a predictable, solvable weak point. Having taught AKT preparation (akt home) for over fifteen years, I have seen the same small set of reasons come up again and again when trainees lose marks here. None of them are about intelligence or capability. They are about how stats gets approached in the run up to the exam, and every one of them is fixable once you see the pattern.
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What does the AKT statistics section actually involve?
Evidence based practice makes up sixteen of the exam’s one hundred and sixty questions, ten percent of the paper. It sits within the “Evidence in Practice, Research, Teaching and Lifelong Learning” area of the RCGP curriculum, alongside organisation and management as the second non-clinical domain.
In practice this covers diagnostic test statistics such as sensitivity, specificity and predictive values, interpreting and explaining risk to patients, understanding how randomised controlled trials are designed and reported, systematic reviews and meta-analyses, basic qualitative research concepts, and reading graphs, charts and tables of the kind a practice might receive from a local health board.
Ten percent sounds small. In an exam where every domain feeds into one overall pass mark, it is not.
Why this is the exam's genuine weak point
This is not a subjective impression. Across recent AKT sittings, RCGP’s published feedback reports have shown evidence based practice scoring around seventy percent, noticeably below clinical knowledge, which typically sits in the mid seventies. Chart interpretation and study design terminology have both been flagged as recurring difficulties across multiple diets.
Reason one: learning answers instead of learning the principles
This is the pattern behind most of the others. Many trainees revise stats by working through question bank items, memorising which formula or graph shape matched which answer, then moving on. It feels productive. Question counts go up. Confidence goes up.
The problem shows up on exam day. The AKT does not repeat questions in a fixed format. It tests understanding through different scenarios and different combinations of numbers. A trainee who has learned that a particular shape of graph means a particular answer, rather than understanding what sensitivity or an odds ratio actually represents, will freeze the moment a question looks even slightly unfamiliar. This is what we mean by the basic building blocks of stats, the principles behind the equations and graphs, rather than the surface pattern of one specific question. Trainees who understand the principle can reason their way through something unfamiliar. Trainees who only recognise the pattern cannot.
Reason two: leaving stats until the final stretch
Stats gets left later than any other AKT topic, usually because it feels less urgent than clinical revision, not because of poor planning. Clinical topics feel familiar, since they connect to daily ward or surgery work. Stats can feel abstract and disconnected from that, so it slips down the list.
The trouble is that statistical understanding does not compress well. Clinical facts can be revised at pace close to the exam because they build on knowledge already partly held. Real statistical reasoning takes longer to settle, because it usually means unlearning a half remembered version of a concept from medical school and rebuilding it properly. Two or three weeks of last minute effort is rarely enough time for that rebuild to actually happen, however many hours go in.
Reason three: avoidance driven by fear rather than logic
Closely related, but worth naming on its own, is straightforward avoidance. A number of trainees tell us they simply do not enjoy stats, find it intimidating, or associate it with feeling lost back in medical school. So they put off engaging with it, sometimes without fully realising they are doing it. Difficult tasks tend to get pushed behind easier ones that still feel like progress.
This is a very human response, not a failing. But avoided material does not become easier for having been avoided. It becomes more frightening, because the gap between what is known and what is needed keeps growing the longer it is left untouched.
Reason four: assuming clinical strength will cover the gap
This is the most dangerous assumption on this list, because it sounds reasonable on the surface. Many trainees tell themselves that if they are strong clinically, the stats questions will not matter much in the overall mark. Sixteen questions out of one hundred and sixty feels small enough to absorb.
It rarely works out that way. RCGP’s own figures show this domain scoring lower than clinical knowledge sitting after sitting, which strongly suggests trainees across the board are underestimating it in exactly this way. Marks written off in preparation tend to become marks lost on the day, and every domain feeds into the same overall pass mark. There is no separate bar to clear for stats, but there is no exemption from it either.
What you can do in practice
– Learn the concept behind each stats topic before touching a single practice question. Understand what sensitivity, specificity and predictive value actually mean before working through calculations built on them.
– Start stats at the same time as clinical revision, not after it. Give it the same ten to twelve week runway as any other weak area.
– Practise stats questions in varied formats and different clinical scenarios, not repeated attempts at the same question style.
– Check RCGP’s published feedback reports for which specific stats areas caused difficulty in recent sittings, and revise those deliberately.
– Reality check every numerical answer against what would make sense in a real consultation, rather than trusting a calculation blindly.
– Treat the ten percent evidence based practice mark as protected in your revision plan, not optional.
How Arora Medical Education Can Help
Statistics is one of the areas we focus on most deliberately in AKT preparation, precisely because RCGP’s own data shows it is where trainees lose the most ground. The AKT Ultimate Package includes a full one day live statistics course built around the concepts that actually come up in evidence based practice questions, alongside a dedicated statistics video course and statistics audio course that support building understanding gradually rather than cramming it in at the end. The AI powered question bank and mock papers include a substantial bank of statistics questions presented in varied formats, so the underlying principle is tested from different angles rather than the same question shape repeated. Statistics flashcards are also included, useful for keeping key definitions and formulae fresh without it becoming a last minute scramble.
The aim is the same as everything else we teach for the AKT. Build real understanding early, so that whatever form a question takes on the day, you can reason your way to the right answer rather than hoping you recognise it.
Also:
– Join National AKT WhatsApp Teaching Group here
– Get AKT Updates and Teaching Emails here.
– Register for next Free AKT Webinar here.
Author Bio — Dr Aman Arora
Hi! I’m Dr. Aman Arora, a Portfolio GP with over a decade of clinical and teaching experience, dedicated to helping doctors achieve their goals with confidence. Having had the privilege of supporting more than 50,000 doctors worldwide across exams such as MRCGP AKT, SCA, MSRA, PLAB 2 and PLAB 1, I understand the challenges you face and the strategies needed to overcome them. Through personalised face-to-face sessions, engaging online courses, mocks, audio and a vibrant social media community, we’re here to guide you every step of the way.
Whether you’re looking to pass crucial exams or take the next big step in your medical career, we’re here to help you succeed. Feel free to get in touch with any thoughts, questions, or ideas — I look forward to working with you and being part of your journey.
Author Bio — Dr Pooja Arora
Dr Pooja Arora is a GP with a background in Medical Politics, where she passionately focuses on improving the opportunities and working conditions for junior doctors. She is proud to hold FRCGP (Fellow of Royal College of General Practitioners).
You can find out more about Pooja’s previous roles and qualifications here.
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