The Royal Australian College of General Practitioners (RACGP) provides candidates with a public exam report after results are released, giving feedback on what the common errors were for the cohort and what to consider or learn from these. This provides valuable insights which can be applied to future exams or possible improvement to make if you had sat the exam in the past. So, whether you are sitting the Applied Knowledge Test (AKT) for the first time or re-sitting it, it is recommended that you pay close attention to the advice given in this report.   

For example, the RACGP report informs us that the exam outcomes and psychometrics can vary each exam cycle (e.g., between each cohort). As RACGP emphasise in their report each exam, a candidate must achieve a score equal to or higher than the pass mark to pass the AKT. The ‘pass rate’ is the percentage of candidates who achieved the pass mark. The RACGP has no quotas on pass rates; there is not a set number of candidates who must pass the exam or a set number who must fail – a common myth among candidates. Pass rates may therefore vary each cohort, dependant on a number of variables.  

For example, in the 2024.2 AKT, 829 doctors sat the exam; 82.15% passing the AKT, with a passing mark, or cut off score, of 66.44 out of 100; with an average (mean) score of 75.67% being achieved. It further reports that regarding the number of AKT attempts candidates have made, there is a general diminished rate of passing with each subsequent attempt made, from 91.3% on the first attempt, to 72.6%, 53.8% and 23.9% on each consecutive attempt made respectively. Therefore, this suggests that preparation and readiness to sit the AKT are important for candidates’ success. 

One important exam preparation strategy we recommend you use is to fully understand the exam you are sitting. It is difficult to pass an exam if you don’t fully understand the expectations of you to pass it. Therefore, it is important to read and understand all the information RACGP make available to you. This includes their AKT Exam report. For example, it is important that you understand that all the questions in the AKT are based on clinical presentations typically seen in an Australian general practice setting (i.e., the Australian general practice context). There are two types of questions in the AKT: single best answer and modified extended match questions. Also, all questions follow the same format, which includes a stem (case vignette) followed by a question. Single best answer questions have five answer options for you to select from. Modified extended match questions have 8–10 answer options. Each question has only one correct answer. It is important that candidates carefully read the clinical scenario and question. RACGP stress that though more than one answer option may be plausible, only the most appropriate option for the clinical scenario provided should be selected. 

The RACGP AKT exam report provides a sample of clinical scenarios from the 2024.2 AKT exam. RACGP select the cases to use as examples because: 

  • the cohort performed poorly on that particular case, 
  • the case highlights a common error in approaching the AKT, or 
  • the case is an example of a serious condition that should not be missed.  

Here are our five key takeaways from the RACGP 2024.2 AKT exam report case examples. It’s important to be aware during clinical decision-making which factors are important to consider when answering a question such as ‘What is the MOST appropriate next step?’ or ‘What is the MOST appropriate management?’. This question entails: 

  1. As a first step, ensuring an appropriate diagnosis to be able to decide on the most appropriate next step or on management. Therefore, it’s important to evaluate the key features of the case. 
  2. Be aware of clinical areas and diagnoses where errors may be common or where it may be more difficult to distinguish between various causes because of similarity of symptoms (Example #1: Lichen sclerosis case and Example #5: Breast eczema case). 
  3. Be aware of the indications and contraindications of potential answer options (Example #3: rubella immunisation case). 
  4. Have a strong understanding of common conditions in Australia, their potential complications and appropriate management (Example #4: Diabetic retinopathy case) 
  5. Lastly, regarding questions that ask, ‘What is the MOST appropriate provisional diagnosis?’, “most appropriate” is the qualifier in the question that must be taken into account when providing your answer. It requires you to demonstrate that you understand diagnoses that are most likely based on the clinical stem presented, such as that in Example #2, the syndesmosis injury case. 

Tips for the AKT: 

  1. Manage your time – calculate how much time you have per question. 
  2. Read the stem carefully. 
  3. Check your understanding of the question (What precisely is it asking?). 
  4. Consider the answer choices carefully 
  5. Do a final check – leave time at the end of the exam to go back to check your answers. 
  6. Remember – if there is any word or part of the answer option that is incorrect, this means it is 100% incorrect and can be discarded. 

As you can see, the AKT assesses your knowledge and understanding of general practice in Australia. It requires a strong knowledge foundation to pass the AKT. Knowledge together with exam strategies, such as reading the case carefully, identifying its key features, understanding how qualifying words (e.g., most, initial) change the question, and considering the answer options carefully, are important to enable exam success. 

References: 

The Royal Australian College of General Practitioners. (2024) Exam report 2024.2 AKT. East Melbourne, Vic: RACGP.