7 mistakes made in the KFP Fellowship examinations according to the RACGP
Following each of its fellowship exams after results are released, the Royal Australian College of General Practitioners (RACGP) releases a report outlining the exam psychometrics (e.g., mean and standard deviation of the candidate cohort) as well as providing feedback to candidates regarding common errors made. But what has this got to do with your exam preparation, I hear you ask?
Understanding exam requirements and common mistakes made gives you the opportunity to learn from others’ mistakes and avoiding making the same ones. According to the RACGP (as made in the 2023.1 Fellowship exam), seven common KFP mistakes are:
1. Candidates didn’t answer the question.
Its important to answer the question in the context of the clinical scenario presented, using all the information provided. Sometimes, candidates erroneously assume that there is ‘filler’ information or ‘traps’ to lead them astray or confuse and trick them. But there isn’t! The information are instead clues. You need to put your clinical reasoning hat on, imagine you are sitting in your GP practice with the patient in front of you, and follow the ‘clues’ to reach the correct answer.
RACGP 2023.1 KFP Report: Candidates must answer the question in the context of the clinical scenario, using all the information provided. The information will be relevant to consider in response to each question and will impact answers, as it might provide information that could significantly impact investigations or management.
2. The answers provided did not consider all the key features of the case presentation.
It’s important to ensure that the answers you provide are relevant to the key features provided. Candidates can make the error of ignoring some key features or emphasising others which may lead them down the wrong decision path. The key features are like pieces of a puzzle – they must all fit together! Remember – if its listed, its important to consider so don’t ignore any key features.
RACGP 2023.1 KFP Report: It is important to ensure that answers provided are relevant to the key features of the case presentation, including the age, gender, comorbidities and other information provided.
3. Candidates don’t provide what they’re asked to.
In the past when you’ve sat exams, likely because of nerves, you’ve frantically written down everything you knew about a topic, whether they asked for it or not – and it worked! Lecturers, especially in undergraduate years, had scope to give you marks for extra information you provided, and they definitely didn’t penalise you for it. Well, those days are gone! The KFP exam is precise and specific, and if it asks for 3 answers, provide only 3 answers – not two and definitely not four or more! Otherwise you risk overcoding and losing marks.
RACGP 2023.1 KFP Report: Provide only the number of answers requested; providing additional answers increases the risk of overcoding. Do not provide examples unless requested.
4. Answers are not specific enough.
Consider you have your patient in front of you – do you give general or specific instructions to them (e.g., on how to take their medication or regarding their treatment)? When ordering an x-ray or blood test, are you general or specific in regards to what you are ordering? The KFP is examining you on your clinical reasoning. Hence you need to demonstrate the same level of specificity as you would in your clinical practice. You will not score in the KFP exam for one word answers like “Referral”, “Education”, “Analgesia”, or “X-ray”. Don’t lose marks due to a lack of specificity in your answers.
RACGP 2023.1 KFP Report: Be specific in answers. Non-specific answers might not score or could attract fewer marks.
5. Candidates don’t address the acuity of the illness within the case presentation.
Acuity refers to the level of severity of an illness, according to Miller Keane Encyclopedia Dictionary of Medicine, Nursing and Allied Health. Acuteness or severity, such as patient classification systems, are designed to serve as guidelines for decision-making and treatment. Failure to consider the acuity of the presenting illness can lead to failure to treat or manage appropriately, leading to a loss of marks. You want to optimise your marks with every question; failure to consider the acuity of illness won’t get you there!
RACGP 2023.1 KFP Report: Ensure that answers provided are appropriate to, and address the severity and acuity of, illness within the case presentation, as well as the location of the patient encounter.
6. Answers are not in line with Australian clinical guidelines.
There are many great resources out there for your GP exam preparation but when it comes to guidelines, it’s important that you learn them (don’t forget them in your exam preparation!) and that the only ones you memorise are Australian ones! Failure to know them or refer to the wrong ones is sure to lose you precious marks. Maximise your scoring potential by ensuring you know and refer to Australian clinical guidelines only.
RACGP 2023.1 KFP Report: As the cases are all developed in line with current guidelines, it is therefore important that candidates are aware of current clinical guidelines relevant to the provision of primary care at Fellowship level.
7. Candidates who do not practice are less likely to pass.
As the saying goes, “Practice makes perfect”. The more you practice at completing KFP-style questions and learn from your mistakes, the less likely you’ll make them, thereby perfecting your exam preparation and KFP exam technique.
RACGP 2023.1 KFP Report: Candidates should access the practice exams provided and use the RACGP assessment resources, such as the exam support online modules accessed via gplearning.
Hence its important, if you want to avoid repeating the errors of those that have gone before you, recheck your technique, ensure you understand what the KFP exam requires, and ensure you give them what they want to pass your exams. The RACGP report that “it is evident that candidates who attempt online practice exams perform better in the real exam than those who do not” (RACGP, 2020, p3). Hence, the use of practice exams, such as GPEx’s Dr KFP therefore comes “highly recommended”. Or for more intensive training in the KFP technique, with one-on-one coaching, consider KFP Coach. So, to boost your marks or to get a higher pass rate that before, learn from other’s mistakes and follow these seven tips.
- Miller Keane. Encyclopedia of medicine, nursing and allied health. in: 5th ed. WB Saunders, Philadelphia, 1992: 23, accessed 16/6/2020 from https://www.jpeds.com/article/S0022-3476(95)70325-X/abstract#secd14279152e74
- The Royal Australian College of General Practitioners. Exam report 2020.1 KFP. East Melbourne, Vic: RACGP, 2020 from RCE-20201-Public-exam-report.pdf (racgp.org.au)