What is often not realised by many candidates sitting GP exams, is that there are common phrases and terms used in Fellowship exams that have specific meanings, often called command or clue words.  

Command or clue words (also known as instruction or directive words) tell you how to answer a specific exam question or complete an assessment task. Knowing the definitions of common command words will help you understand what the word (and therefore the exam question) is asking you to do.  

We have compiled a list of common command words and their definitions such as discuss, critically analyse, compare. The RACGP’s CCE exams contain command words, so it is vital to understand these words to fully address the topic under consideration. Note that there are usually two types of short-answer questions: factual (recalling relevant information) and interpretative (applying your understanding and clinical reasoning to key concepts). Via command words, a question can sometimes require you to first provide facts and then demonstrate your clinical reasoning. A useful strategy to better understand the command words you will likely see in the exam you are sitting, is to closely read exam question examples or past exam reports and highlight the command words that are commonly used by your College.  

Understanding Command Words in the Exam 

Command words are particularly important to consider when sitting the RACGP’s Clinical Competency Exam (CCE) for several reasons. Namely: 

  • Time is a limiting factor – you need to perform on the spot and do not want to waste your precious time. Interpreting the question accurately when it is asked is very important.  
  • You are observed in real time which can be very intimidating and off-putting.  
  • You are asked the questions verbally, adding some pressure to performance for those who prefer to read/see questions visually.  
  • There is often more than one task or question needed to be completed/answered (e.g., a multi-part question) in a short time, adding to cognitive-effort and load, under exam conditions – all adding to the stress experienced.  

All these factors mean having a thorough understanding of possible command words will enable you to manage some of these more effectively, thereby enhancing your overall performance on the day. Here are some common command words used in the CCE (see the table below). 

Common Verbs Found in the CCE 
Assess  To make an informed judgement. For example, provide a structured description of an investigation result or image (e.g. clinical photo, ECG, or medical imaging scan), highlighting the most significant findings. It can also mean how you would assess a patient, encompassing aspects of history, examination and/or investigations. For example, you might be asked: “What questions on history would you ask Tom in order to further assess his presentation?” 
Analyse  Examine in detail to show meaning and identify important elements and the relationship(s) between them.  For example, you might be asked: “Analyse the abstract provided. What are the strengths and limitations of the research?”  
Critically evaluate  As with ‘evaluate’, but showing how judgments vary from different perspectives and how some judgments are stronger than others. This often means creating an objective, reasoned argument for your overall case, based on the evaluation from different perspectives. This may also be used in questions that involve a research article or abstract provided as part of the question.  
Evaluate Similar to “assess”, this often has more emphasis on an overall judgement of something, explaining the extent to which it is, for example, effective, useful, or true. Evaluation is therefore sometimes more subjective and contestable than some kinds of pure assessment. 
Interpret  Provide conclusion(s) after analysing an investigation result or image. Analyse the actual meaning: break into separate parts and discuss, examine, or interpret each part (e.g. interpret investigations such as blood results or CT scans). For example: “Interpret the result of the investigations that were ordered for this patient.” 
Justify  Justify is an evaluative term (e.g. you need to provide a rationale for the conclusions you have drawn or the plan you have developed for your patient). Therefore, a process to adopt to ‘justify’ your conclusions includes: List the components (e.g. of the presentation); Describe the characteristics (e.g. patient demographics) and the key features; Explain the impact of the various components and/or features of the case and the purpose of each aspect of your plan (e.g. why you plan to order a particular investigation). Explain the positives and negatives of each aspect of your plan, and any conclusion you can reach. That could include explaining the reasons (i.e. “good” reasons) for something being done or believed, considering different possible perspectives, views and ideas; or to support a case with evidence. For example, you may be asked to justify why one differential diagnosis is more likely over another or why one treatment option is more suitable than another, by applying your clinical reasoning skills 
Outline  Simply, provide the main points or ideas, normally without going into detail. Also, provide a logical framework in which all key decisions/topics are covered. For example: “Outline any additional red flag features that you would ask the patient about.”  
Structured processes to use when certain words/phrases used (e.g. when asked by examiner in Case-based discussion) 
Approach This is often termed ‘general approach’ however you could also be asked about how you would approach a specific aspect of the case. A process – a way of addressing a clinical scenario (e.g. having a conscious, structured approach to gathering information and making clinical decisions). This also encompasses facets such as medicolegal aspects to consider, your manner in speaking with the patient, or what setting would be appropriate for your interaction with the patient. For example, you might be asked: “Please outline your approach to performing an examination of the patient in relation to their presenting complaint.” “Please outline your approach to handling Evan’s complaint about your GP colleague’s behaviour” 
Counsel Meaning: advice given formally; to recommend a course of action or behaviours; professional help and advice to a patient to resolve personal, physical or psychological problems. It can also encompass advice around prognosis or self-management.  For example, you might be asked: “How would you counsel this patient regarding the available emergency contraception options and which one would be most suitable for them, providing reasoning for your choice” 
Discuss  Provide a response that explores the issue or situation that is being targeted in the question, considering different viewpoints and contrasting ideas such as ‘advantages vs disadvantages’ or ‘strengths vs weaknesses. A process that could be used when asked to ‘discuss’ is: Define Pros (advantages) Cons (disadvantages) Controversies Practice Statement Note: adapt this process to suit the question you are asked (i.e. not all steps may be needed in each case).  For example, you might be asked to:  “Discuss the patient’s most likely diagnosis and the clinical features which support the diagnosis.” ” Discuss with the patient your plan to manage their condition.”  
Key Features  Meaning: identifying or listing the overarching or important points. This will then help narrow down your differentials or plan out the most appropriate management (e.g. age or gender of the patient, what medical conditions they have, what drug allergies are relevant). For example: a patient with upper gastrointestinal bleeding: the key features of history and examination may help you: determine risk – severity, complications and life threats; determine implications for acute management; determine implications for resource utilisation (e.g. a rural versus urban area will have different resources). 
Prepare  Meaning: Getting ready for a particular course of action may encompass the following considerations: Place (location) for example, where you would carry out the consultation, where you would perform the procedure Staff (who and how many would you need?) Any medications or equipment that would be needed. For example, “You are a rural GP who is on shift at your local hospital’s Emergency Department. The ambulance service has called ahead of time, advising that they are bringing in a patient following a suspected drug overdose. Outline the steps you would take in order to prepare for the ambulance’s incoming arrival”.  
Procedure  Candidates may be asked to describe how they would perform a particular procedure or clinical process/investigation. Examples of procedures may be the removal of a foreign body, excising a skin lesion, or performing a cervical screening test.   Candidates should provide this explanation in a step-wise manner, including gaining consent for the procedure after an explanation to the patient, what medical equipment might be needed, any Personal Protective Equipment (PPE) requirements, and also the following: Indications for the procedure Contraindications The potential for complications How you would perform the procedure in a stepwise manner Documentation of the procedure Safety netting after the procedure 
Rationale Meaning: to give the reasoning or justification for an action or a choice made, with the focus on ‘why’ (e.g., why you chose to do something). It is a set of statements of purpose and significance. You may be called upon to provide a rationale prior to an action or decision; why you plan to do something and how, or after you have acted or decided something; reflecting, looking back, why you did something and how it worked or not.   For example, you may be asked to provide your rationale (reasons) for carrying out a particular course of action or for considering particular diagnoses.   An example: “Outline the investigations that you would order to assess Kate’s fatigue, including your rationale for why you would order these investigations”. 

For other common CCE terminology, see our Glossary of CCE terms.  

Comprehensively understanding the common command words used in your Fellowship exam(s) will enable you to decode the language of GP exams and add precision to your performance. Now that you have understood what these terms mean, it is time to apply it to your exam preparation. Practicing exam questions and cases, particularly with individualised feedback about your performance will help to hone your exam technique.  

References: 

What to expect on exam day – Command Words. Accessed 8/1/24 from: https://www.cambridgeinternational.org/exam-administration/what-to-expect-on-exams-day/command-words/  

Clue words in exams. University of Melbourne. Accessed 8/1/24 from: https://services.unimelb.edu.au/__data/assets/pdf_file/0007/2712418/Clue-Words.pdf  

University of Melbourne. Academic Skills: Resources. Accessed 16/1/24 from: https://students.unimelb.edu.au/academic-skills/resources/