What Is the MRCGP? AKT, SCA and WPBA Explained
If you have just found out you are starting GP training, or you are already a few weeks into ST1, there is a good chance you have heard the word MRCGP more times than you can count, usually said alongside WPBA, AKT and SCA, and rarely with anyone stopping to explain what any of it actually means. That gap is completely normal. GP training introduces a lot of unfamiliar structure very quickly, and the MRCGP sits right at the centre of it. This guide sets out, plainly and in one place, what the MRCGP actually is, what each of its three components measures, and how they fit together across your three years of training.
– For GP trainee update and teaching emails click here
– Join National AKT WhatsApp teaching group here
– Join National SCA WhatsApp teaching group here
What Is the MRCGP?
MRCGP stands for Membership of the Royal College of General Practitioners. It is the postgraduate qualification every GP trainee in the UK must complete during specialty training, and it sits alongside your Certificate of Completion of Training (CCT) as the point at which you become eligible to practise independently as a GP.
The MRCGP is not a single exam. It is made up of three separate components, each testing a different set of capabilities using a different method of assessment, and together they map across the full GP curriculum. Those three components are Workplace Based Assessment (WPBA), the Applied Knowledge Test (AKT) and the Simulated Consultation Assessment (SCA). All three have to be completed. Doing well in two out of three is not enough, and none of them is optional or interchangeable with another.
None of this needs to be tackled all at once. WPBA runs continuously from your first day of ST1, while the AKT and SCA are usually sat later, once you have built up enough clinical experience to prepare for them properly. The sections below explain each one in turn, in the order you are likely to meet them, with links through to a more detailed Arora guide on each if you want to go deeper into a specific component right now.
WPBA, the AKT and the SCA in Brief
Before going into detail, it helps to see how the three components differ in what they actually measure. WPBA is not an exam at all. It is a continuous, ongoing record of your everyday clinical practice, built up across all three years of training and reviewed regularly by your supervisors. The AKT is a written knowledge test that checks whether you can apply clinical knowledge under exam conditions. The SCA is a live, simulated consultation exam that checks whether you can bring that knowledge together with communication and consultation skills in real time. Each one exists because the other two cannot test everything on their own.
What Is WPBA?
Workplace Based Assessment is the component you meet first, because it starts on day one of ST1 and runs continuously through to the end of ST3. It is also the one new trainees tend to understand least clearly, mostly because it is not a single exam with a booked date. WPBA is an ongoing collection of evidence from your everyday clinical practice, recorded in your Trainee Portfolio on the FourteenFish ePortfolio system, and it exists to test the things a written exam and a simulated consultation genuinely cannot. Professional judgement, real-time consultation behaviour, and how you actually practise day to day are far better assessed by people who see you working over time than by any single exam.
Throughout training you build evidence against 13 areas of professional capability, using a range of assessment tools. These include Case-based Discussions and Care Assessment Tools (CbDs and CATs), the Mini Consultation Evaluation Exercise (MiniCEX), the Consultation Observation Tool and its telephone equivalent (COT and Audio-COT), Clinical Examination and Procedural Skills assessments (CEPS), Multi-Source Feedback (MSF), the Patient Satisfaction Questionnaire (PSQ), a Quality Improvement Project or Activity (QIP/QIA), and Learning Log entries, alongside mandatory evidence such as CPR/AED competence and safeguarding training. This evidence is reviewed at six-monthly Educational Supervisor Reviews and at least annually at your Annual Review of Competence Progression (ARCP), which is the panel that ultimately judges your readiness to progress.
The minimum numbers required change slightly by training year. As a general guide, ST1 requires 4 CbDs or CATs across the year, with at least 2 completed in each 6-monthly review period, and ST2 follows the same pattern. ST3 requires 5 CATs, which can include CbDs. The RCGP also updates the finer detail of WPBA from time to time, most recently with a set of changes to reporting and assessment flexibility that do not increase the overall number of assessments required, so it is always worth checking the current RCGP WPBA pages for the latest position rather than relying on what a colleague a year or two ahead of you remembers from their own training.
Because WPBA runs from day one and cannot be caught up in a final few weeks, it rewards early, steady habits far more than late effort. Arora’s full WPBA guide sets out exactly what is required in each training year and how each assessment type works, and is worth reading properly in your first few weeks rather than months into ST1.
What Is the AKT?
The Applied Knowledge Test is a computer-based exam sat at Pearson VUE test centres across the UK. It consists of 160 single best answer questions completed in 160 minutes. There is no negative marking, so it is worth attempting every question.
The content is split as 80 percent clinical medicine, 10 percent evidence-based practice and critical appraisal, and 10 percent primary care organisation and administration. The statistics and administrative sections are disproportionately under-revised by candidates, which is worth bearing in mind early rather than discovering it close to your own sitting.
You become eligible to sit the AKT from ST2 onwards, and it runs four times a year, in January, April, July and October. The pass mark is set individually for each sitting using standard-setting methodology, and typically falls somewhere between 60 and 70 percent. How many attempts you get depends on when you started GP Specialty Training. If you entered before 2 August 2023, you are allowed a maximum of 4 attempts. If you entered on or after that date, you are allowed up to 6 attempts.
Arora’s dedicated AKT guide covers the exam and how to prepare for it in far more depth, and the AKT resources page sets out the video courses, question bank and mock papers available if you want to start planning your own preparation early.
What Is the SCA?
The Simulated Consultation Assessment is the clinical skills component of the MRCGP, and the permanent replacement for the older CSA and RCA formats. It is usually the last of the three components trainees complete, taken entirely remotely from a local GP practice using an online exam platform.
The exam consists of 12 simulated consultations with trained role players, each lasting 12 minutes with 3 minutes of reading time beforehand. Most cases are on video, with a smaller number audio only, and role players may appear as patients, relatives, carers or other healthcare professionals depending on the scenario. Each consultation is marked across three domains: Data Gathering, Clinical Management, and Relating to Others. The exam is testing how well you integrate clinical knowledge, decision-making and communication together, rather than any one of those skills in isolation.
You become eligible to sit the SCA from ST3 onwards, and you will need active RCGP membership and up-to-date training records to book. There are 9 diets a year, held roughly monthly. There is no formal rule requiring you to pass the AKT before attempting the SCA, but most trainees sit the AKT first, since the clinical knowledge revision naturally supports SCA preparation too. Attempts follow the same pattern as the AKT: a maximum of 4 if you started training before 2 August 2023, and up to 6 if you started on or after that date.
Arora’s full SCA guide walks through the format and preparation in detail, and the SCA resources page has the case bank, video course and live roleplay sessions if you want to see what structured SCA preparation actually looks like.
How the Three Fit Together
It helps to picture the three components running on different timelines rather than as one continuous checklist. WPBA starts on your very first day of ST1 and continues without a break through to the end of ST3, since it is built from evidence you generate simply by doing your job well and reflecting on it properly. The AKT is usually sat during ST2 or early ST3, once you have enough GP placement experience to apply the clinical reasoning the exam expects, though you become formally eligible from ST2 onwards. The SCA generally follows in ST3, once you are consulting independently and have consolidated the consultation skills it assesses, and most trainees find it easier once the AKT is behind them.
All three are ultimately reviewed together. Your ARCP panel looks at your accumulated WPBA evidence, your AKT result and your SCA result as a whole picture, not as three separate tick boxes, because no single component was ever designed to demonstrate readiness for independent practice on its own. CCT, and the right to work as a fully qualified GP, depends on all three being completed to standard.
If You Do Not Meet the Standard First Time
WPBA does not work in the same way as the AKT or SCA, since there is no single sitting to pass or fail. If gaps or concerns come up in your evidence, they are addressed through your six-monthly review and your ARCP outcome, which may mean more time, more targeted support, or specific evidence to complete, rather than anything described as a resit.
The AKT and SCA are different, in that not passing a particular sitting is far more common than it feels in the days afterwards, and the attempt limits set out above exist precisely because resits are built into the system rather than treated as exceptional. If you are in that position now, or want to understand the process before you need it, Arora has separate, more detailed guides on what to do after a failed AKT sitting and how to prepare for an SCA re-sit, both written specifically for that situation rather than as a general overview.
A Practical Starting Point for ST1
A few habits are worth building in from your very first weeks, before any of this starts to feel urgent.
– Start Learning Log entries and link them to the relevant Capabilities from week one, rather than waiting for your first formal assessment
– Arrange a placement planning meeting with your Clinical Supervisor early in each post to agree what evidence that particular placement can realistically provide
– Ask your Educational Supervisor to go through the Trainee Portfolio’s requirements with you at your first proper meeting, rather than piecing it together on your own
– Keep the AKT and SCA in view even in ST1, since the clinical reasoning and consultation habits you are building now will carry directly into both
Final Thoughts
The MRCGP is not something you need to fully understand or master in your first week of ST1. It is simply the structure that supports and measures the development that is already happening as you train, spread sensibly across three years rather than crammed into one. WPBA, the AKT and the SCA will each get their own moment, and each is far more manageable when approached with proper preparation rather than left until it feels unavoidable.
When you do reach the point of preparing for the AKT or SCA specifically, Arora’s AKT and SCA resources are built around how GP trainees actually learn, combining structured teaching with real technique. You can also join the free national AKT and SCA WhatsApp teaching groups for daily teaching from Dr Arora, or download the free Arora revision planner whenever you are ready to start structuring your own preparation.
Other Blogs That May Help
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.
Other blogs that may interest you
