RACGP Fellowship exams explained

The three exams at a glance

To gain Fellowship of the RACGP (FRACGP) you need to pass three exams as well as meet your training requirements: the Applied Knowledge Test (AKT), the Key Feature Problem (KFP) exam and the Clinical Competency Exam (CCE). The AKT and KFP are written exams. The CCE is a clinical exam run online.

Formats summarised from RACGP exam information current at the date above. The RACGP updates its exams, dates and fees, so always confirm details on the RACGP exams page before you enrol.

The Applied Knowledge Test (AKT)

The AKT is 150 single-best-answer questions in one four-hour session. It is delivered on paper at exam venues: you shade a bubble answer sheet that is scanned and marked electronically. Each question is worth the same, and there is no penalty for a wrong answer, so never leave a question blank.

What candidates find hard

• Breadth. Questions range across the whole RACGP curriculum, including paediatrics, women's health, mental health, dermatology, ophthalmology, ENT, population health and practice management.
• Australian detail. Screening intervals, immunisation schedules, notifiable diseases and PBS prescribing rules are tested in their Australian form.
• Pace. Four hours for 150 questions is about 96 seconds each. Long stems and image questions eat time if you have not practised under the clock.

How to prepare

1. Start with a timed diagnostic block of 50 questions to find your weakest curriculum areas.
2. Work through topic blocks in tutor mode, reading the explanation for every option, not only the right one.
3. From six weeks out, do mixed timed blocks and at least two full 150-question papers in four hours.
4. Keep a list of the Australian specifics you miss, such as screening ages and vaccine timing, and revise it weekly.

The Key Feature Problem exam (KFP)

The KFP tests clinical reasoning at the moments in a case where decisions matter most: the key features. Since the second 2025 sitting it has been fully multiple choice, with 70 clinical scenarios in a single four-hour session, delivered on paper like the AKT.

Unlike the AKT, many KFP questions ask you to choose more than one answer, and the question tells you how many. Shading more options than requested costs marks, so read the instruction on every question.

What candidates find hard

• Choosing the most important next steps rather than everything that would be reasonable.
• Prioritising safety: red flags, urgent referral and what must not be missed.
• Applying Australian guidelines to a specific patient, for example a pregnant woman, a child or an Aboriginal and Torres Strait Islander patient.

How to prepare

1. Practise scenarios where you must pick a set number of options, and mark yourself strictly.
2. After each case, write down the one decision you would make differently next time.
3. Study high-risk presentations by their red flags: chest pain, headache, febrile infant, abdominal pain, mental state and suicide risk.

The Clinical Competency Exam (CCE)

The CCE is the final Fellowship exam. It has nine cases: four case discussions, where you discuss a case with the examiner, and five clinical encounters, where you consult with a role-player while the examiner observes. Each case has five minutes of reading time and fifteen minutes to complete. The exam is run online by video.

The RACGP has announced that from the 2027.1 sitting all nine cases will be completed on a single day, rather than across two weekends. The competencies assessed and the standard stay the same.

What candidates find hard

• Structuring a consultation within fifteen minutes while still covering safety netting and follow-up.
• Explaining management in plain language that a patient can follow.
• Case discussions that move into ethics, practice systems or uncertainty rather than pure clinical knowledge.

How to prepare

1. Practise in a group of three: candidate, role-player and examiner, swapping roles each case.
2. Use the reading time to plan: the likely diagnosis, what must be excluded and the three things the patient most needs to leave with.
3. Record practice cases on video and watch them back for timing and jargon.

Planning the order of your exams

Most registrars sit the AKT and KFP first and the CCE later in training. Because the written exams are held only a few times a year, plan backwards from the enrolment deadline rather than the exam date. Check your own eligibility and the current enrolment periods on the RACGP website, as rules differ between training programs.

A common approach is to sit the AKT and KFP in the same sitting, preparing for both together: AKT questions build the knowledge base, while KFP practice turns it into decisions.

What about ACRRM?

If you are training for Fellowship of ACRRM (FACRRM), your assessments are different, and include a multiple-choice exam, case-based discussions and the StAMPS structured assessment. Much of the clinical knowledge overlaps with the RACGP exams, but always prepare to the ACRRM assessment format.

Common questions