Major college exam to be fully multi-choice

The RACGP is dropping the short answer section of the Key Feature Problem fellowship exam.

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Two of the three high-stakes RACGP fellowship exams will be fully multiple choice from July 2025, which the college says will make for “a better experience” for registrars.

The Key Feature Problem, which is offered twice per year, has traditionally been a mixture of multiple-choice and short answer questions covering about 25 cases, sat in one four-hour block.

Crunching the numbers, the KFP – at least in recent years – has been the toughest for registrars to pass.

The average pass rate for the KFP over the previous six exam cycles – i.e. since the beginning of 2021 – is 71%, compared to 81% for the Applied Knowledge Test and 87% for the Clinical Competence Exam (noting that the second CCE of 2024 has not been run yet).

It will run in its existing format one final time in January 2025.

The second round of 2025 KFP exams, which are scheduled for 5 July 2025, will be entirely made up of multiple-choice questions.

Candidates will still sit it in one four-hour block, but it will now cover 70 individual scenarios rather than 25.

It will still test for the same skills, namely clinical decision making and reasoning.

RACGP censor-in-chief Dr Tess van Duuren said the new format would be faster to mark, meaning that results will be available before the cut-off date to register for the Clinical Competence Exam, which is the last of the fellowship exams.

“We listened to our members and exam candidates, and have improved our KFP exam,” Dr van Duuren said.

“The new format makes for a better experience for candidates, while ensuring the same rigorous standards – there is no change in what is being assessed.

“This is a tried and tested format that we use for our AKT, so we know it works.

“It’s also more accessible for candidates with special requirements.”

The RACGP’s public report on the most recent KFP exam identified seven common themes across incorrect errors.

These included candidates not answering the question in the context of the clinical scenario or failing to include relevant features like the age, gender and comorbidities in their answers.

Candidates also lost marks for providing too much information, which the college said “increases the risk of overcoding”, and for not being specific enough in answers.

There are no changes to the format of the AKT or CCE.