Every question on the RACGP AKT and KFP exams is mapped to one of five curriculum domains. These domains define what the RACGP considers essential for competent, independent general practice in Australia, blueprinting what the exams test.
Most registrars know Domain 2 (clinical medicine) thoroughly. They have spent years studying cardiology, respiratory medicine, dermatology, and mental health. What many registrars do not realise is that three of the five domains are non-clinical. Questions on Medicare billing, medico-legal obligations, ethics, preventive health, and practice management appear on every sitting of both exams.
Why the Domains Matter for Exam Preparation
The RACGP does not randomly select exam questions. Both the AKT and KFP are blueprinted against the curriculum. This means the exam committee designs each sitting to ensure all five domains are represented, and the proportion of questions in each domain is intentional.
If your study plan covers only clinical medicine, you are preparing for one domain out of five. You might still pass if your clinical knowledge is excellent, but you are leaving marks uncollected in domains that reward a few hours of targeted study.
Understanding the blueprint also helps you interpret your exam results. The RACGP post-exam report breaks down your performance by domain and contextual unit. If your report shows underperformance in a specific domain, you know exactly where to focus for your next sitting.
Domain 1: Communication and the Patient-Doctor Relationship
Domain 1 addresses how GPs communicate with patients, families, carers, and other health professionals. It encompasses:
- Patient-centred care: understanding the patient's perspective, expectations, and concerns.
- Shared decision-making: involving patients in management decisions, presenting options and trade-offs.
- Breaking bad news: delivering difficult diagnoses or prognoses with sensitivity and clarity.
- Motivational interviewing: helping patients change behaviour (smoking cessation, weight management).
- Cross-cultural communication: adapting communication style for patients from diverse cultural backgrounds.
- Handover and referral: writing clear referral letters and providing structured handovers.
How it appears on the AKT: Questions typically present a clinical scenario and ask you to identify the most appropriate communication approach. The correct answer is usually the option that reflects patient autonomy, informed consent, and respect for the patient's values.
How it appears on the KFP: Questions often ask you to identify the key features of a consultation where communication is the critical skill (e.g. key elements of breaking bad news).
Domain 2: Applied Professional Knowledge and Skills
Domain 2 is the largest domain, representing the core clinical knowledge and skills required to manage general practice presentations. The RACGP organises this domain across 35 clinical contextual units.
How it appears on the AKT: This accounts for the majority of questions. These test clinical knowledge: diagnosing conditions, selecting first-line treatments, interpreting investigations, and identifying red flags based on Australian guidelines.
How it appears on the KFP: Questions test clinical reasoning and prioritisation rather than simple knowledge recall. You are asked to select key features of clinical investigation or management.
Domain 3: Population Health and the Context of General Practice
Domain 3 addresses the GP's role beyond individual patient consultations. It encompasses:
- Preventive health and screening: applying the RACGP Red Book screening recommendations.
- Chronic disease management: GP Management Plans, Team Care Arrangements, and multidisciplinary care.
- Aboriginal and Torres Strait Islander health: health assessment items (item 715), cultural safety, and specific screening recommendations.
- Rural and remote health: managing resource limitations, delayed transfers, and telehealth.
- Epidemiology: understanding disease prevalence and public health schedules.
The Importance of Domain 3
Domain 4: Professional and Ethical Role
Domain 4 addresses the GP's professional identity, ethical obligations, and personal wellbeing:
- Medical ethics: autonomy, beneficence, non-maleficence, justice.
- Informed consent: valid consent, capacity assessment, and mature minor principles (Gillick competence).
- Confidentiality and privacy: boundaries, mandatory reporting exceptions, and AHPRA notifications.
- The impaired colleague: legal requirements under national law to report impaired practitioners.
- Voluntary Assisted Dying (VAD): legal requirements and conscientious objection rights by state.
How it appears on the exams: Questions present ethical dilemmas (e.g. patient refusing life-saving treatment, or adolescent requesting confidential contraception) and test your knowledge of legal obligations.
Domain 5: Organisational and Legal Dimensions
Domain 5 covers the administrative, business, and legal side of general practice. It is highly factual and tests regulations that cannot be reasoned through clinically.
- Medicare Benefits Schedule (MBS): billing codes for standard consultations, health assessments, chronic disease management, and mental health plans.
- Pharmaceutical Benefits Scheme (PBS): authority prescriptions, restricted listings, and brand substitution.
- Medico-legal obligations: mandatory reporting (child abuse, unfit drivers, notifiable diseases), clinical record-keeping legislation, and subpoenas.
- Controlled substances: prescribing regulations and state-specific scheduling permits.
Domain 5 Study Strategy
How the Exam Is Blueprinted
The RACGP exam committee blueprints both sittings to ensure all five domains are represented in intentional proportions. You cannot predict which specific clinical cases will appear, but you can predict that all five domains will be tested.
Map your study plan to the blueprint. Allocate study time to match:
- Domain 2 (Clinical): Largest time allocation, reinforcing existing medical knowledge.
- Domain 5 (Organisational): Concentrated study block to close the administrative knowledge gap.
- Domain 3 (Population Health): High-yield focus on the Red Book and chronic disease billing.
- Domain 4 (Ethics): Key legal frameworks, advance care planning, and consent laws.
- Domain 1 (Communication): Calgary-Cambridge consultation steps and motivational interviewing.
The 35 Contextual Units
The RACGP curriculum organises clinical content into 35 contextual units. Every exam question combines a curriculum domain with one of these units. For example, managing a diabetic patient's chronic disease management plan combines Domain 3 (Population Health) with the endocrine health contextual unit.
High-yield contextual units include cardiovascular health, mental health, women's health, children's health, and endocrine health (diabetes).
Aboriginal and Torres Strait Islander Health
Indigenous health is a critical cross-cutting priority in the curriculum, intersecting with all five domains. Expect around 6 to 7 questions on every sitting. Key revision topics include:
- Early cardiovascular risk screening thresholds (lower age limits).
- MBS item 715 components and eligibility.
- Rheumatic Heart Disease screening and secondary benzathine penicillin prophylaxis guidelines.
- Endemic conditions (trachoma, chronic suppurative otitis media).
- Cultural safety principles and holistic emotional wellbeing frameworks.
Frequently Asked Questions
How many domains are in the RACGP curriculum?
The RACGP curriculum is structured around 5 core domains of general practice, which blueprint the assessment of candidates.
Which domain has the most questions?
Domain 2 (Applied Professional Knowledge and Skills) accounts for the largest proportion of questions, representing clinical medicine. However, non-clinical domains constitute a significant portion of both exams.
Where can I find study material for Domain 5?
The Medicare Benefits Schedule (MBS Online) for GP item descriptors, the PBS prescribing handbook, state-specific health department guides on mandatory reporting, and medical indemnity factsheets on legal records are your best sources of truth.