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Aligning expectations and experiences: Medical student perspectives on progress testing for National Licensing
Sarah E Doherty1, Kathy M Cullen1, Aidan J Cole1
1Centre for Medical Education, Queen's University Belfast, UK.
Medical Teacher
|December 19, 2025
Summary
UK medical students preparing for the Applied Knowledge Test (AKT) with Progress Tests (PTs) found initial misalignment between expectations and experiences. However, passing the AKT led to agreement, though concerns about clinical readiness remain.
Area of Science:
- Medical Education
- Assessment and Evaluation
- Healthcare Professional Training
Background:
- The UK General Medical Council introduced the Applied Knowledge Test (AKT) in 2024 for medical licensing.
- Some UK medical schools implemented Progress Tests (PTs) as a preparatory tool for the AKT.
- Understanding student perspectives on PTs as preparation for the AKT is crucial for curriculum development.
Purpose of the Study:
- To explore the expectations and experiences of the first cohort of UK medical students who took the AKT after preparation using PTs.
- To analyze the alignment between medical school promises regarding PTs and students' actual learning experiences.
- To identify any lingering concerns students had post-AKT regarding their preparedness for clinical practice.
Main Methods:
- A qualitative study was conducted at a UK medical school that administered the AKT in 2024.
- Eight final-year medical students were interviewed after completing their AKT, using Psychological Contract theory as a framework.
- Interview data was transcribed, coded, and analyzed by the research team.
Main Results:
- Students' initial expectations of PTs for AKT preparation did not match their experiences, leading them to self-teach.
- Successful completion of the AKT resulted in a perceived reciprocity and agreement with the medical school's initial expectations.
- Despite passing the AKT, students reported unresolved concerns about whether their learning adequately prepared them for future medical practice.
Conclusions:
- While students were satisfied with passing the AKT, they highlighted a gap between AKT preparation and readiness for clinical work.
- Early completion of the AKT provided students with more time to focus on preparing for practical clinical responsibilities.
- The findings suggest a need to re-evaluate the integration of PTs and AKT preparation to ensure comprehensive readiness for medical practice.
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