You may or may not have heard, but the RACGP Key Feature Problem (KFP) exam is changing dramatically for the 2025.2 sitting. Amazing right?! RACGP have listened to your feedback about this exam and changed its format in response.

So, what are the changes and what does this mean for me, I hear you ask.

The KFP exam changes

Firstly, the RACGP stress that they haven’t changed what they are assessing, only how they will be assessing it from 2025.2. The exam content will continue to assess clinical decision-making and reasoning, based on the RACGP curriculum and syllabus. The exam will also have the same duration of four hours.

The new-format KFP 2025.2 exam will be as follows:

  • 70 multiple selection questions (MSQ).
  • Each question will start with a clinical vignette (i.e., total of 70 individual scenarios or ‘stems’) with details of the patient presentation, examination findings and/or investigation results.
  • Each MSQ will have 2 –  6  correct answers.
  • The question will tell you how many options to select.
  • Questions can specifically ask for history or examination features, potential differential diagnoses, appropriate investigation options, management options, or there may be a list of both investigation and management options to select from.
  • This format will utilise a paper answer sheet, similar to the Applied Knowledge Test (AKT), where a ‘bubble’ is selected by shading. No handwritten responses will be required.
  • As the answer sheets are computer-readable (special pens are provided by RACGP), it will allow faster marking, ensuring KFP exam results will be available before Clinical Competency Exam (CCE) enrolments. Thereby, allowing candidates more effective exam preparation for the CCE.
  • Each KFP question is worth 1.43% or 1/70 of your overall score.
  • There is no negative marking for incorrect answers.
  • However, it is in your best interest to select the correct number of responses for each question (e.g. important to be clear how many answers are requested). If you shade more options (bubbles) on the answer sheet than requested, though each response will be marked, a 0.35% penalty will be deducted from the overall mark of your paper, per additional bubble shaded.

RACGP has kindly provided two examples of the new KFP format. Here is one:

Paul Holt, aged 62 years, has noticed mild pain gradually increasing in his left scrotum over the last three weeks. He has increased pain when sitting. He has not had any penile discharge but has noticed mild stinging at the end of urination. He is a widower and has not been sexually active for six months. He has never had sex with men.   On examination, his temperature is 37.6oC, heart rate 83/min regular, respiratory rate 16/min, blood pressure 135/90 mmHg, oxygen saturation 99% on room air. Examination of the scrotum reveals normal position of the testes with tenderness at the superior pole of the left testis and a normal cremasteric reflex.    What are the MOST appropriate next steps? Select four (4) from the following list.   Doppler ultrasound of the scrotumDoxycycline 100 mg twice daily for 14 daysFirst void urine for chlamydia and gonorrhoea PCRIbuprofen 400 mg three times dailyIndometacin 100mg rectally as a single doseManually externally rotate the left testisParacetamol 1g four times dailyProstate specific antigenReassure that symptoms are likely to settle without treatmentRefer to urologist for scrotal explorationRefer urgently to the Emergency DepartmentTapentadol controlled-release 50mg twice dailyTrimethoprim 300 mg daily for 14 daysUrethral swab for herpes simplex virus PCRUrethral swab microscopy, culture and sensitivityUrine microscopy, culture and sensitivity   Answer: C. First void urine for chlamydia and gonorrhoea PCR (Score: 1)   D. Ibuprofen 400 mg three times daily (Score: 1)   G. Paracetamol 1g four times daily (Score: 1)   P. Urine microscopy, culture and sensitivity (Score: 1)   This is a four answer multiple selection question with a mixture of investigations and management options. The patient is presenting with sub-acute slowly worsening scrotal pain, mild dysuria without discharge, a low grade temperature, and unilateral localised testicular tenderness. The most likely diagnosis is epididymo-orchitis. The subacute presentation and patient age makes an acute testicular torsion unlikely. Whilst a sexually transmitted infection is a less likely cause, it cannot be excluded from the history. His pain is not severe.   Therefore, correct answers relate to rational initial investigation to determine the causative organism and provision of simple analgesia. Antibiotics can be initiated once the causative organism is known. There is no imminent emergency to warrant urgent referral.
Source: RACGP AKT and KFP information for candidates: FAQs https://www.racgp.org.au/kfp-and-akt-exam-day-information

For more information about the KFP 2025.2 format change, please see the RACGP AKT and KFP Guide.

So, how are you feeling about this change?

There are a range of feelings you may be experiencing – all of them normal. You could be feeling…

  • Surprise
  • Relief (that’s the exam I’m planning to sit)
  • Happiness (RACGP is listening to our feedback)
  • Joy (it’s changing – about time!)
  • Disappointment (e.g.didn’t happen sooner or for my exam. I like the current format, why did they have to change?)
  • Frustration (it took so long to change after years of  feedback!)
  • Unfairness (I sat under the old format – others should too), to name a few.

You may also have mixed emotions; joy, relief, as well as frustration.
Humans are creatures of habit. When things go as planned and expected, we feel in control. When life or exams change, even if welcomed, it can leave us feeling uncertain or confused.

What to do?

  • Firstly, take a deep breath – this has been a huge surprise! Give yourself time to absorb and understand. It is normal to need some time to process the change and to get used to what this change means for you.​
  • Be kind to yourself – regarding how you are feeling. Don’t beat yourself up. Plan some relaxation or mindfulness practices, depending on the intensity of your feelings​.
  • Notice your self-talk – how are you talking to yourself? Critically? Judgementally? If surprised by the change and your self-talk is negative (e.g., I shouldn’t feel this way or I’m stupid to feel this way), it will likely intensify your feelings about the new format. This is not going to be helpful in accepting and dealing with the change​. Notice your self-talk and work on using more helpful or calming self-talk, such as, “I can deal with this”, “It will be ok”, or “I’ll work through this one step at a time”.
  • Talk to others (including supervisors, mentors and colleagues, as well as family and friends) – this helps to normalise both your feelings and what’s happening – getting others’ perspectives can also help you feel connected (I’m not alone in this)​.
  • Reflect on what the change means to you – possible questions to ask yourself include: what does this change for me? Does it actually change anything? Is this a positive change for me? How can I make this a positive change for me? How can I take advantage of this change?​
  • Control what you can – Focus on the things that are within your control.  Some candidates may only have one exam attempt left and are wondering whether to sit in 2025.1 with the old format or wait until 2025.2 and the new format. It is important that you consider your own personal circumstances, as well as discuss with your RACGP coordinator or contact to seek their advice and discuss your options​.
  • Plan – put some strategies in place. For example, if you’re sitting the 2025.1 exam then its business as usual – focus on your 2025.1 strategy; try not to be distracted by the new format. Or, if you’re planning to sit the 2025.2 KFP with the new format, learn as much as possible about it and strategies that will suit it best (e.g. multiple-choice question techniques); connect with others planning to sit it in 2025.2 and develop a study group to plan your exam preparation strategically, seeking out practice questions.​

We at GPEx are committed to supporting you throughout this change. See our new KFP 2025.2 format resources to help get you started:

Summary of KFP 2025.2 changes: The new format commences as of the 2025.2 KFP exam.There will be 70 individual clinical scenarios (‘stems’), each with a single multiple selection question (MSQ). The MSQ will have two to six correct answers.The question will tell you how many options to select. It is important to be clear how many answers are requested for each question. If you shade more options than asked for, though each response will be marked, a 0.35% penalty will apply per additional bubble shaded (penalty will be deducted from the overall mark of your paper).

References

American Psychological Society  https://www.apa.org/helpcenter/stress-uncertainty

Australian Psychological Society (APS): https://www.psychology.org.au/for-the-public/Psychology-Topics

Happier: https://www.happier.com/blog/how-deal-uncertainty-without-losing-your-mind/

RACGP. (2024). Applied Knowledge Test (AKT) and Key Feature Problem (KFP) Frequently Asked Questions (FAQs): Update to Key Feature Problem exam format from 2025.2 https://www.racgp.org.au/kfp-and-akt-exam-day-information

RACGP. (2024). AKT) and KFP Guide. https://www.racgp.org.au/FSDEDEV/media/documents/Education/Registrars/Fellowship%20Pathways/Exams/Examinations-guide.pdf