Top tips for your RACGP Fellowship exams

The RACGP exams are an important aspect in achieving your Fellowship in General Practice. To help you navigate the process, our team at Ensure Health have collated a comprehensive selection of tips to help you with this important part of your GP journey.​

The exam basics 

The RACGP Fellowship exams are made up of three components:

1. Applied Knowledge Test (AKT) 

A 3-hour, computer-based exam in a multiple choice format which tests your knowledge.

2. Key Feature Problems (KFP) exam 

A 3.5-hour computer-based exam featuring GP cases with questions in multiple choice and short answer format which tests your decision-making skills.

3. Objective Structured Clinical Exam (OSCE)

The OSCE is a 4 hour (approximately) exam which assesses competency based on objective testing through direct observation and role play. It is comprised of a number of stations in which examinees are expected to perform a variety of clinical tasks within a specified time period. The OSCE tests your clinical reasoning, communication skills and professional attitude.

Each of these exams are held twice per year. The AKT and KFP are held in February and July and the OSCE is held in May and November.

To ensure you’re well-equipped for what is required to both sit the exam, and in the exam situation itself, please review the resources below:

1. RACGP Examinations Guide
2. Eligibility, enrolment, dates and fees
3. Additional information

Some general advice

Here are some tips of a general nature, some of which you’ve likely put to good use during your university and training years, but others that may be new to you.

1. Read widely  All three exams test your knowledge in one form or another. A diverse reading list will yield great rewards here. Journals, textbooks, GP publications and RACGP specific documents will help, as will ensuring you’re up to speed with current guidelines.
   
   
2. Start your exam prep early This is one of the most important tips we can offer. Many registrars we’ve spoken to say starting at least six months before exams was the best move they made. It allowed them to incorporate study into their work and lifestyle to avoid feeling like they were suddenly overburdened.
   
   
3. Do the RACGP practice exams The RACGP offer online practice exams and they are a great way to identify knowledge gaps and put a plan in place to improve them, both through reading and during your consults. We highly recommend you do the practice exams. Of the RACGP 2019 exam cohort, almost 70% of those who did the practice exams, passed the real one. Only 35% of those who opted not to practice, passed their real exam.
   
   
4. Attend a pre-exam course, listen to exam podcasts or watch videosThese are all really important resources to help you grasp exam content and the way each one is structured.
   
   
5. Consider joining a study group Being able to connect with others going through the same exam experience is vital, both for study purposes and emotional support. Your RTO will likely have such a group, or be able to put you in touch with one. Alternatively, there are a number of online groups such as this Facebook one for GP registrars.
   
   
6. Time with patients The more patients you see, the more knowledge you’ll gain for use in your exams. Taking your time with each patient allows you to develop not just the knowledge base, but the nuances involved in clinical reasoning and communication. ​
   
   
7. Reflect on your patient consultations Either during or after consults, reflect on and get advice and feedback on your investigation and management options. This ensures your continued learning. When it’s time to reproduce this in an exam situation, you’re already in the habit of doing it correctly.
   
   
8. Read each exam question carefully  ​​Subtle changes in question wording between the practice exams and the real ones have caught many registrars out. That’s why it’s important to read the question properly, and answer based on only the information given, not from the answer you remember from the practice exam. 

Specific AKT tips

1. Spend time on common GP presentations Knowing about the diagnosis and management of the most common GP presentations is a great way to study for the questions you’ll come across in the AKT. Accessing BEACH data might be helpful here. 
2. Go beyond the first step in an investigation In the most recent RACGP exam cohort, examiners felt registrars struggled with being able to provide more than just the first step in an investigation or management. Understanding what might be the second-line or third-line choice demonstrates your depth of knowledge.
3. Expand your knowledge base This exam requires you to have a wide variety of knowledge across multiple areas. The RACGP suggests you:
   - Are aware of new guidelines and patient screening practices
   - Know patient ‘red flags’ and what steps to take when a situation looks like turning into an emergency 
   - Aim to appreciate the total patient when diagnosing disease (biological, psychological and social factors)

Specific KFP tips

1. Adequate patient load As mentioned in the general advice section, seeing patients regularly will be very helpful, particularly for the KFP.
2. Complete the RACGP practice modules The KFP questions are worded in a unique way, so taking the time to do the practice test will help you to structure your answers.
3. Be careful with how you respond The RACGP offer quite a bit of advice around framing your responses to questions.  ​Previous candidates fell into the trap of:
   - providing non-specific responses
   - providing irrelevant history details, or diagnoses/drug recommendation
   - missing vital information contained in the question
   - failing to grasp the urgency of the issue
   - offering another diagnosis, rather than a cause 

Specific OSCE tips

1. Pay attention to the details  Each case has its nuances so read the instructions carefully.
   
   
2. Tailor your consult to the assessor’s preferences Try to follow best practice when it comes to the consult. For example, taking the right amount of time to find out the patient’s history.
   
   
3. Let the patient talk Allow the patient to speak fully at the start of the consult as it’s likely they will give you most of what you need to successfully complete the case. 
   
   
4. Focus on your communication  Aim to be empathic and involve the patient by asking them what they think, and if they feel they can adhere to the management plan.
   ​
5. Take care with the physical exam RACGP advise taking a systematic approach during this section of the consult so you don’t miss anything. But it’s also good to remember to also focus on management and investigations. 

A final word

Preparing for your exams can be a stressful time, so it’s important to make sure you look after yourself. Surround yourself with a strong support network of family, friends and colleagues. Your network can act as a sounding board, provide advice and remind you to get out of the house! It’s important to schedule regular breaks - whether it’s a walk outdoors, dinner with friends or treating yourself to a massage.

And finally, once you’ve sat your exams, avoid the exam ‘post-mortem’. Instead, take a moment to celebrate your achievements! 

We wish you all the best in your preparations. When you succeed in gaining your Fellowship, we’d love to help you secure your first position as a vocationally registered GP. Better yet, sign up to our Job Alerts so you never miss out on seeing a great GP vacancy near you!