Professional knowledge

Why this matters on day one

The AKT samples this domain most heavily, and it is broader than disease. The parts candidates neglect are the non-clinical sciences — statistics, genetics, immunology, health psychology and how the NHS actually works — which are cheap marks precisely because they are neglected.

What the domain requires

1. 1Biomedical sciences. Anatomy, physiology, pharmacology, pathology, microbiology and genetics applied to clinical problems rather than recalled in isolation.
2. 2Psychological and social science. Health behaviour, adherence, cognitive bias in diagnosis, the social determinants of health, and how illness affects people and families.
3. 3Population health and prevention. Screening principles, immunisation, health promotion, epidemiology, and the meaning of the numbers in a screening or trial result.
4. 4The health service. How UK care is organised and funded, referral pathways, the role of primary care, and the regulatory and legal framework you practise inside.
5. 5Research and scholarship. Study design, critical appraisal, evidence hierarchies, and how guidelines are made — enough to read a paper and know whether it should change what you do.

What evidencing it looks like

• AKT performance broken down by system and by reasoning skill, not just an overall percentage.
• A critical appraisal of a paper relevant to a patient you saw.
• A presentation or teaching session you delivered.

What falls short

• Revising conditions and ignoring statistics, genetics and immunology — a substantial and predictable share of the paper.
• Learning sensitivity and specificity as definitions without ever applying them to a positive result.
• Not knowing how the service works, then being unable to make a safe discharge or referral.

Demonstrated by