Exam Preparation

The Royal Australian College of General Practitioners (RACGP) Fellowship exams consists of three segments:

    1. Applied knowledge test (AKT)
      1. Single best answer (SBA) questions
      2. Extended matching (EM) questions
    2. Key feature problems (KFP)
    3. Objective structured clinical exam (OSCE)

Please read the following resources for information about the exam.

    1. The RACGP Fellowship Exam Candidate Handbook October 2016 
    2. The FRACGP Exams section of the RACGP website provides information about exam dates, location and enrollment. Please make sure you are very clear about this information including the format of the online written examinations.
    3. Assessing general practice knowledge base. The applied knowledge test. Australian Family Physician 2008; 27(8): 659-661.
    4. Wearne, S. The RACGP Fellowship examination. 10 tips for answering key feature problems. Australian Family Physician 2008; 37(7): 559-561.

 

The following articles give some insights and resources:

  1. Stewart SM et al. Getting a life: Surviving the FRACGP and staying sane. Australian Family Physician 2004; 33(9): 683-685.

  2. Bhuiyan, A. K. Overseas trained doctors. How to prepare for a fellowship exam. Australian Family Physician 2004; 33(9): 746-7. 

What to cover?

The exam topics has a spread similar to a matrix with the domains of general practice on one axis and the pattern and frequency of GP presentation according to the Bettering and Evaluation and Care of Health (BEACH) study on the other axis.

The RACGP domains are:

  1. Communication Skills and the Doctor – Patient relationship
  2. Applied Professional Knowledge and Skills 
  3. Population Health and the Context of General Practice
  4. Professional and Ethical Role
  5. Organisational and Legal Dimensions

Pattern and frequency of GP presentation according to the Bettering and Evaluation and Care of Health (BEACH) can be found at:

  1. Britt H et al.General practice activity in Australia 2015–16. Sydney: Sydney University Press, 2016. 

  2. RACGP curriculum

 

General hints:

  1. The objectives for the different components of the exam are:
    1. AKT: breadth and depth of knowledge
    2. KFP: clinical decision skills
    3. OSCE: applied knowledge, clinical reasoning, clinical skills, communication skills, professional attitudes
  2. Read the questions carefully. 
  3. Know the common things really well e.g. diabetes, asthma.
  4. Clinical work is the best practise for the exam, particularly the OSCE. Therefore, don’t take too much time off to prepare for the exam.
  5. Be systematic in your approach to avoid missing items.
  6. Be specific about your answers. E.g. drugs with route and dosage, specific diagnosis
  7. Some uncommon but frequently asked clinical topics include: coeliac disease, haemochromatosis, erythema nodosum, erythema multiforme, sarcoidosis, Addison’s disease.
  8. Know about topical items.
  9. Remember notification of infectious disease, notification of licensing authority etc. Remember surgery tests e.g. BSL, pregnancy test, ECG, U/A etc.

EM hints:

  1. Try to answer the question before reading the possible answer list. This avoids you getting distracted by supplied answers.

KFP hints:

  1. Don’t give more answers than requested.
  2. Be succinct and specific in your responses.
  3. Answer according to the context of the question.

OSCE hints:

  1. Read the instructions carefully.
  2. Do what is asked by the questions especially in short cases where time is limited, so if something is not required, don’t do it.
  3. Use your reading time to plan what you need to cover in the station. Try to forget about what has happened with the previous stations and concentrate on what you are about to face in this station.
  4. Remember examiners want to pass the candidates and there’s no negative marking, so don’t get hung up over errors, just try to move on.
  5. Use open questions especially early in the consultation and listen to what your patient or examiner say to you.
  6. If the examiner (patient) is trying to steer you away from an area of questioning, go with it. The examiners are generally trying to help you.
  7. If you are asked to discuss something with the patient, try to avoid using jargon. One way to learn how to explain clinical problems to patients without jargon is to read the many patient pamphlets available.
  8. If a ‘patient’ is asking you to do something you don’t wish to do, e.g. prescribe benzodiazepines, stand your ground. This is probably what the station is testing.
  9. Use study group/role play to refine exam techniques and timing.
  10. Stations can be similar to a consultation, a physical examination station or require discussion about ethical, medicolegal, research or practice issues. For physical examination stations, practice examination of systems and joints.
  11. Have a list of quick, practiced systems review questions ready and don’t forget:
    1. Weight
    2. Appetite
    3. Sleep
    4. Temperature
    5. Energy

 

Highly recommend RACGP membership so that you can access their resources:

  1. Clinical Challenges 
With each month’s Australian Family Physician. Can be accessed on 
http://gplearning.racgp.org.au/
  2. gplearning 
http://gplearning.racgp.org.au
  3. CHECK 
http://www.racgp.org.au/education/courses/check/ 
Review issues from the last 2-3 years.
  4. Australian Family Physician 
http://www.racgp.org.au/afp/ 
Review issues from the last 2-3 years.
  5. Exam support online
 http://www.racgp.org.au/education/fellowship/exams/exam-support-online/ 
Available from 5 weeks prior to enrolled exam

Other resources:

  1. BMJ On Examination. 
Expensive and contains some UK information 
http://www.onexamination.com/general-practice/mrcgp
  2. O’Connor, K et al. The General Practice Exam Book.
  3. Wearne, S. Clinical Cases for General Practice Exams. 3rd Edition
  4. National Prescribing Service 
http://www.nps.org.au
  5. Australian Prescriber 
http://www.australianprescriber.com
  6. Dermnet NZ 
http://www.dermnet.org.nz
  7. Australian Medicines Handbook
  8. Therapeutic Guidelines
  9. The Australian Immunisation Handbook. http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook10-home
  10. Diagnosing Imaging Pathways 
http://www.imagingpathways.health.wa.gov.au
  11. Royal Children’s Hospital 
http://www.rch.org.au/home/
  12. Australians Society of Clinical Immunology and Allergy. 
http://www.allergy.org.au
  13. Heart Foundation 
http://heartfoundation.org.au
  14. Australian Asthma Handbook 
http://www.asthmahandbook.org.au
  15. Stroke Foundation 
https://strokefoundation.com.au
  16. Red book, green book, prescribing drugs of dependence in general practice
 http://www.racgp.org.au/your-practice/guidelines/
  17. GPRA website 
http://www.gpra.org.au/exam

Remember, the best preparation for the exams is your working experience with real patients.

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