Sitting the RACGP fellowship exams is one of the most consequential milestones in your career. Whether you are preparing for the Applied Knowledge Test (AKT), the Key Feature Problem (KFP), or both, the difference between passing and failing often comes down to how you study - not just how much.
This guide distils what we know from RACGP public exam reports, the cognitive science of learning, and the practical experience of registrars who have recently sat the exams. Every claim below is referenced. Nothing is fabricated.
What the data actually says about pass rates
Before building a study plan, it helps to understand the landscape you are entering. The RACGP publishes psychometric data after every exam cycle. Here are the verified figures from the RACGP Public Exam Report:
The first-attempt advantage
Source: RACGP, RACGP Exam Report, published March 2026.
The gap between 90% and 45% is not subtle. It tells you that preparation and readiness to sit are paramount for candidate success, to quote the RACGP's own language.
Of the 1,036 candidates who sat both the AKT and KFP in 2026.1, 78.67% passed both exams. Most candidates who are well-prepared pass both together. Those who are not prepared enough to pass one are often not prepared enough to pass the other.
The science of revision: what actually works
In 2013, Dunlosky and colleagues published a landmark review in Psychological Science in the Public Interest evaluating ten common study techniques. Their findings are directly relevant:
High utility
Practice testing (active recall)
Testing yourself on material, rather than passively reviewing it, forces your brain to retrieve information and strengthens memory traces. This is the single most effective revision strategy identified in the literature.
Distributed practice (spaced repetition)
Spreading study sessions across days and weeks combats the forgetting curve first described by Ebbinghaus. Reviewing material at increasing intervals produces significantly better long-term retention than massed study sessions.
Low utility
Highlighting & underlining
Creates a false sense of familiarity without deep encoding.
Rereading
The most common study strategy, and one of the least effective. Recognising text is not the same as recalling it under exam conditions.
Summarisation
Useful for comprehension, but weak for long-term retention compared with active recall.
Dunlosky J, et al. Psychological Science in the Public Interest. 2013;14(1):4-58.
The implication is straightforward: if most of your revision time is spent reading guidelines and highlighting notes, you are using the least effective strategies available. Shift the balance toward doing questions and testing yourself.
Nine strategies that matter for the AKT and KFP
1 Understand the exams before you sit them
The AKT and KFP assess different competencies and use different formats. Treating them as the same exam is a common mistake.
AKT
- 150 single best answer (SBA) questions
- 4 hours total
- ~1.6 minutes per question
- 5-10 options per question
- No negative marking
KFP
- ~70 standalone MSQ scenarios (paper-based)
- 2-6 correct answers per question
- Partial credit awarded
- Over-selection penalised (0.35% per extra bubble)
- Tests clinical reasoning
2 Read the question before you read the stem
This is one of the most widely taught exam techniques among experienced GP educators. The RACGP's own exam guidance recommends:
Read the question first and identify any qualifiers. Read the stem. Find the important patient features and key features. Read the question again so you know you are answering the right question.
When you read a clinical scenario first, your brain begins generating differential diagnoses before you know what is being asked. Reading the question first tells you whether you are looking for a diagnosis, an investigation, a management step, or a medication.
3 Pay attention to qualifiers - they change the answer
The words "most appropriate", "initial", "next step", and "most likely" are not interchangeable. The RACGP exam report consistently notes that candidates lose marks by answering the question they expected rather than the question that was asked.
4 Use every piece of information in the stem
The RACGP states explicitly in the RACGP exam report:
In the KFP exam, all information in the stem is given for a reason. Candidates should read the stems carefully, taking note of all key features, to ensure they receive maximal marks.
5 Answer before you look at the options
Experienced GP educators widely recommend a specific technique:
See if you can answer the question without looking at the options → see if your choice is there → read through other answers to see if there's a better answer.
If you arrive at the options with your own answer already formed, you are less likely to be pulled toward a plausible-sounding distractor.
6 In the KFP, count your answers - then stop
Provide only the number of answers requested; providing additional answers will result in a penalty being applied to the overall score.
If the question asks for four answers, select four. Not five. The instinct to "add one more just in case" is understandable - but it is actively penalised. Build the habit of counting your selections before you move on.
7 Anchor your revision to Australian guidelines
Because the cases are all developed in line with current guidelines, it is important that candidates are aware of current clinical guidelines relevant to the provision of primary care at Fellowship level.
US and UK question banks do not map to the RACGP curriculum, Australian PBS prescribing, or the medico-legal context of Australian general practice. If you are using international resources, supplement them with Australian guidelines - do not substitute them.
8 Learn the common errors - so you do not repeat them
The RACGP publishes specific examples of common candidate errors in its public exam reports. These patterns recur across exam cycles:
Misreading the question
Selecting an answer that fits a different question than the one asked, or confusing the direction the question requires - for example, features that support a diagnosis versus features that exclude it.
Ignoring comorbidities and medications
Missing a medication or comorbidity listed in the stem that changes the appropriate clinical response.
Unnecessary referrals
Escalating or delegating management that is appropriately handled within primary care at Fellowship level.
Not applying Australian-specific guidelines
Candidates were expected to recognise PBS prescribing criteria for common medications and prescribe within those boundaries.
9 Form a study group - but structure it
Small group learning is a cornerstone of GP training. Discussing clinical scenarios with peers forces you to articulate your reasoning and exposes gaps in your knowledge.
- Meet weekly, with a fixed agenda and time limit.
- Do questions independently first, then discuss your reasoning - not just your answers.
- Use random case analysis - the RACGP specifically recommends this technique for KFP preparation.
- Rotate the role of "question presenter" - the person who has to explain the answer learns more than anyone else in the room.
A 12-week study plan structure
The following framework assumes you are sitting both the AKT and KFP together, which is the approach most candidates take.
Foundation and audit
- Complete a baseline RACGP Self-Assessment Progress Test (SAPT) under timed conditions.
- Review the RACGP curriculum contextual units and identify your weakest domains.
- Set up your primary resources: eTG access, RACGP guidelines, a question bank, and a tracking system.
Systematic coverage
- Work through curriculum domains systematically, starting with your weakest areas.
- Do 20–30 AKT-style questions per day, reviewing explanations for every question.
- Complete 2–3 KFP cases per sitting, paying close attention to required answer counts.
- Review the relevant Australian guideline for every topic you encounter.
Targeted revision
- Re-test weak domains using spaced repetition - return at increasing intervals.
- Complete a second SAPT to measure progress.
- Begin full-length timed practice papers (at least one per week).
Exam simulation
- Complete at least two full-length AKT mock papers (150 questions, 4 hours) under strict exam conditions.
- Complete at least two full-length KFP mock papers under timed conditions.
- Categorise errors as knowledge gaps, misread questions, over-selection, or time pressure.
Consolidation
- Review high-yield topics only - the areas where you have been consistently losing marks.
- Light question practice (10–15 per day) to maintain retrieval strength.
- Review exam logistics: venue, timing, what to bring, how the interface works.
- Rest properly. Sleep deprivation impairs clinical reasoning - precisely the skill the exam tests.
The topics the exams cover
The RACGP curriculum is broad by design. From the RACGP exam report, the topics examined included:
Cardiovascular
AAA, acute coronary syndrome, atrial fibrillation, familial hypercholesterolaemia, heart block, hypertension, hypertensive urgency
Respiratory
Acute asthma, atypical pneumonia, COPD, interstitial lung disease, lung cancer, pleural effusion
Endocrine & metabolic
Addison's disease, hyponatraemia, osteoporosis, precocious puberty, subclinical hypothyroidism, thyroid nodule, type 2 diabetes
Mental health
Anorexia nervosa, PTSD, separation anxiety, suicidal ideation
Dermatology
BCC, chilblains, Grover's disease, hidradenitis suppurativa, perioral dermatitis
Musculoskeletal
De Quervain's, gout, olecranon bursitis, OA, paediatric limp, reactive arthritis, shoulder dislocation
Women's & reproductive
Breastfeeding problems, dyspareunia, menopause, perinatal depression
Gastrointestinal
BBV serology, CRC screening, eosinophilic oesophagitis, IBD, vitamin B12 deficiency
Additionally, six questions focused on Aboriginal and Torres Strait Islander health and seven were set in a rural location.
Essential resources checklist
| Resource | What it covers | Access |
|---|---|---|
| Therapeutic Guidelines (eTG) | Treatment algorithms across all clinical domains | Subscription (often via training org) |
| RACGP Curriculum | Complete framework of examinable content | racgp.org.au (free) |
| Red Book | Screening, preventive care, risk assessment | racgp.org.au (free) |
| Silver Book | Dementia, delirium, falls, polypharmacy | racgp.org.au (free) |
| SAPTs | Practice questions in exam format | gplearning (free for registrars) |
| Public Exam Reports | Common errors and topic lists | racgp.org.au (free) |
| Kidney Health Australia CKD Handbook | CKD detection, staging, management | kidney.org.au (free) |
| National Asthma Handbook | Stepwise asthma management | asthmahandbook.org.au (free) |
| Australian Prescriber | Prescribing decisions, drug interactions | australianprescriber.tg.org.au (free) |
What candidates who pass at first attempt do differently
A note on exam day
- Answer every AKT question. There is no negative marking. A guess is better than a blank.
- In the KFP, select only the number of answers requested. Over-selection is penalised. Count before you move on.
- Do not spend more than 90 seconds on a single AKT question. Mark it for review and come back if you have time.
- If you cannot answer, use elimination. Identify the key features in the stem and check which options are supported - and which are contradicted.
Start with the approach that works
The evidence is clear: practice testing and spaced repetition produce better outcomes than passive reading. The RACGP data is clear: first-attempt candidates pass at significantly higher rates. And the exam reports are clear: candidates lose marks not because the content is impossibly hard, but because they misread questions, ignore stem details, over-select in the KFP, or study from the wrong guidelines.
If you are looking for a question bank that mirrors the AKT and KFP formats - including the KFP's partial credit and over-selection penalty - with analytics that show you exactly which curriculum domains need your attention, FellowPath was built for exactly this purpose.
References
- RACGP. RACGP Exam Report. East Melbourne, Vic: RACGP, 2026.
- Dunlosky J, Rawson KA, Marsh EJ, Nathan MJ, Willingham DT. Improving students' learning with effective learning techniques. Psychological Science in the Public Interest. 2013;14(1):4-58.
- RACGP. Examination Guide. racgp.org.au
- RACGP. Exam Preparation Toolkit. gplearning
- Kidney Health Australia. CKD Management Handbook, 5th Edition. 2024.
- RACGP. Guidelines for Preventive Activities in General Practice (Red Book), 9th Edition.
- RACGP. Osteoporosis: Guidelines for diagnosis and management in general practice. 2024.